Evidence map›Paper›PMID 41219584›Full record

ArticleInternational journal of behavioral medicine2026

Associations Between Pain and Substance Use Among Individuals Diagnosed with Ehlers-Danlos Syndromes or Generalized Hypermobility Spectrum Disorder.

Callon M Williams, Molly McCarthy, Michelle Flynn, Rachel Siegal, Stephanie Buryk-Iggers, Keisha C Gobin, Dmitry Rozenberg, Max Rachinsky, Praveen Ganty, Laura McGillis and 5 more

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Article in International journal of behavioral medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Callon M WilliamsDepartment of Anesthesia and Pain Management, University Health Network, Toronto, Canada. callon.williams@uhn.ca.
Molly McCarthyDepartment of Anesthesia and Pain Management, University Health Network, Toronto, Canada.
Michelle FlynnDepartment of Anesthesia and Pain Management, University Health Network, Toronto, Canada.
Rachel SiegalDepartment of Anesthesia and Pain Management, University Health Network, Toronto, Canada.
Stephanie Buryk-IggersDepartment of Anesthesia and Pain Management, University Health Network, Toronto, Canada.
Keisha C GobinChronic Pain Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Canada.
Dmitry RozenbergGoodHope Ehlers-Danlos Syndrome Clinic, University Health Network, Toronto, Canada.
Max RachinskyGoodHope Ehlers-Danlos Syndrome Clinic, University Health Network, Toronto, Canada.
Praveen GantyDepartment of Anesthesia and Pain Management, University Health Network, Toronto, Canada.
Laura McGillisGoodHope Ehlers-Danlos Syndrome Clinic, University Health Network, Toronto, Canada.
Nimish MittalDepartment of Anesthesia and Pain Management, University Health Network, Toronto, Canada.
Tania Di RennaGoodHope Ehlers-Danlos Syndrome Clinic, University Health Network, Toronto, Canada.
Joel KatzDepartment of Anesthesia and Pain Management, University Health Network, Toronto, Canada.
Hance ClarkeDepartment of Anesthesia and Pain Management, University Health Network, Toronto, Canada.
P Maxwell SlepianDepartment of Anesthesia and Pain Management, University Health Network, Toronto, Canada. maxwell.slepian@uhn.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPain and substance use frequently co-occur. Research indicates pain motivates alcohol, cannabis, and tobacco use. Pain is also highly co-morbid with Ehlers-Danlos Syndromes (EDS) and Generalized Hypermobility Spectrum Disorder (G-HSD), however, research on pain and substance use in these populations remains limited.

methodsDescriptive, cross-sectional, retrospective chart review was conducted of 533 patients (89% female) seen at the GoodHope EDS Clinic at Toronto General Hospital and diagnosed with EDS or G-HSD. Patients provided self-report data on pain and substance use. Analyses included descriptive statistics and bivariate correlations.

resultsHalf of the sample reported clinically significant pain severity (55%) and interference (57%). Alcohol use was reported by half of the sample (59%) and 18% reported prescription opioid use. Cannabis use was reported by 48%, with 69% using ≥ 4 times per week. Patients who used cigarettes (14%) smoked a median of 8.0 cigarettes per day (IQR = 4.0-12.0). Pain severity and interference were positively associated with cannabis use frequency, quantity, opioid use, and cigarette use (ρ = .13 - .28, ps < .05), and negatively associated with alcohol use (ρ = -.20 and -.20, ps < .05).

conclusionsGreater pain severity and interference were associated with greater cannabis and cigarette use, but lower alcohol use. Longitudinal studies are needed to determine if pain is a motivator for cannabis/cigarette use and/or if persistent use exacerbates pain in this population. Research should also examine if negative associations between pain and alcohol use reflect alcohol analgesia (i.e., lower pain at greater drinking) or avoidance due to the exacerbation of co-occurring conditions with EDS/G-HSD.

Indexed as

Alcohol DrinkingEhlers-Danlos SyndromeJoint InstabilityPainSubstance-Related DisordersAdultComorbidityCross-Sectional StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesAlcoholCannabisEhlers-Danlos SyndromesPainTobacco

Identifiers

PMID41219584

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.