BACKGROUND Chronic non-cancer pain (CNCP) among patients with substance use disorder (SUD) poses a risk for worse treatment outcomes. Understanding the association of CNCP with SUD is important for informing the need and potential benefits of pain assessment/management among those with SUDs. METHODS We analyzed electronic health record data from 2013 to 2018 among adults aged ≥18 years (N = 951,533; mean age: 48.4 years; 57.4 % female) in a large academic healthcare system. Adjusted logistic regression models were conducted to estimate the association of CNCP conditions with opioid overdose, emergency department utilization, and inpatient hospitalization stratified by different SUD diagnoses and by gender. RESULTS Among the total sample, the prevalence of CNCP was 46.6 % and any SUD was 11.2 %. The majority of patients with a SUD had CNCP (opioid: 74.7 %; sedative: 72.3 %; cannabis: 64.3 %; alcohol: 58.7 %; tobacco: 59.5 %). The prevalence of CNCP was greater in females vs. males for most SUD diagnoses. The presence of CNCP was associated with more mental health disorders and chronic medical conditions among each SUD group. CNCP was associated with significantly decreased odds of overdose among those with opioid use disorder but increased odds of overdose and healthcare utilization among other SUDs. CNCP was positively associated with overdose in females, but not males, with alcohol or non-opioid drug use disorders. CONCLUSIONS The direction and magnitude of the association between CNCP and negative health indicators differed as a function of SUD type and gender, respectively. Greater awareness of potential unmet pain treatment need may have implications for improving SUD outcomes.

中文翻译：

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患有物质使用障碍的成年人中的慢性非癌性疼痛：患病率，特征以及与阿片类药物过量和医疗保健利用的关联。

背景技术物质使用障碍（SUD）患者中的慢性非癌性疼痛（CNCP）带来治疗结果恶化的风险。了解CNCP与SUD的关联对于告知SUD者疼痛评估/管理的需求和潜在益处非常重要。方法我们分析了大型学术医疗保健系统中2013年至2018年年龄≥18岁（N = 951533;平均年龄：48.4岁;女性57.4％）的成年人的电子健康记录数据。进行了调整后的logistic回归模型，以估计CNCP状况与阿片类药物过量，急诊科使用率以及按不同SUD诊断和性别分层的住院治疗之间的关联。结果在所有样本中，CNCP的患病率为46.6％，SUD的患病率为11.2％。大部分SUD患者患有CNCP（阿片类药物：74.7％;镇静剂：72.3％;大麻：64.3％;酒精：58.7％;烟草：59.5％）。在大多数SUD诊断中，女性相对于男性的CNCP患病率更高。在每个SUD组中，CNCP的存在与更多的精神健康疾病和慢性病相关。在患有阿片类药物使用障碍的患者中，CNCP与过量用药的几率显着降低有关，但在其他SUD中，过量用药和医疗保健的使用几率增加。在女性中，CNPC与服药过量呈正相关，而与酒精或非阿片类药物使用障碍呈正相关。结论CNCP和负面健康指标之间的关联的方向和程度分别随SUD类型和性别而变化。