Managing acute pain in individuals with a history of substance use disorders (SUD) is complex. Distress tolerance (DT) (e.g., the ability to handle uncomfortable sensations) may serve as an ideal non-pharmacological intervention target in this population. Among 293 emergency department (ED) patients seeking treatment for pain (M_age = 41; 42% Female; 43% Black), we examined rates of SUD treatment and DT, whether an objective DT task is feasible to conduct in the ED, and relationships between DT and SUD. Patients completed a self-report DT survey, an objective DT task, and brief surveys of pain, drug use, current or past SUD treatment, and depression/anxiety. Average DT was 18.50 (SD = 9.4) out of 50; patients with past or current SUD treatment (n = 43; 14.7%) reported lower DT than patients with no SUD treatment history (n = 250; 85.3%). Controlling for demographics, depression/anxiety, and pain severity, lower subjective DT (adjusted odds ratio [aOR] = 1.05) and objective DT (aOR = 1.02) was associated a current or past history or SUD treatment. Assessing subjective and objective DT in ED patients with acute pain is feasible; interventions aimed at boosting DT may improve outcomes among patients with acute pain and SUD.

中文翻译：

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急诊科急性疼痛患者的痛苦耐受性：与物质使用治疗的关联

管理有物质使用障碍 (SUD) 病史的个体的急性疼痛是复杂的。痛苦耐受（DT）（例如，处理不舒服感觉的能力）可以作为该人群理想的非药物干预目标。在寻求疼痛治疗的 293 名急诊科 (ED) 患者中（M_年龄 = 41；42% 女性；43% 黑人），我们检查了 SUD 治疗率和 DT，客观的 DT 任务在 ED 中是否可行，以及DT 和 SUD 之间的关系。患者完成了自我报告的 DT 调查、客观的 DT 任务以及对疼痛、药物使用、当前或过去的 SUD 治疗以及抑郁/焦虑的简要调查。平均 DT 为 18.50 ( SD  = 9.4)，满分 50；过去或当前接受过 SUD 治疗的患者（n = 43; 14.7%) 报告的 DT 低于没有 SUD 治疗史的患者 ( n  = 250; 85.3%)。控制人口统计学、抑郁/焦虑和疼痛严重程度，降低主观 DT（调整优势比 [aOR] = 1.05）和客观 DT（aOR = 1.02）与当前或过去的病史或 SUD 治疗相关。评估急性疼痛 ED 患者的主观和客观 DT 是可行的；旨在提高 DT 的干预措施可能会改善急性疼痛和 SUD 患者的预后。