In light of the ongoing opioid overdose crisis, there is an urgent need for research on the impacts of mental health among people presenting with concurrent pain and substance use. This study examined the effect of depressive symptoms on pain severity and functional interference among people who use drugs (PWUD) during a community-wide overdose crisis. From December 1st 2016 to December 31st 2018, 288 participants in two cohort studies of PWUD in Vancouver, Canada completed interviewer-administered questionnaires that included the Brief Pain Inventory and PROMIS Emotional Distress–Depression instruments. Generalized linear regression modelling (GLM) was used to examine the cross-sectional effect of depressive symptoms and other confounding factors on pain severity and interference. Moderate to severe depressive symptoms were significantly associated with greater pain-related functional interference (adjusted β = 1.24, 95% confidence interval [CI] = 0.33–2.15), but not significantly associated with greater average pain severity (adjusted β = 0.22, 95% CI = − 0.3 – 0.82), when controlling for confounding variables. Reported daily heroin use (adjusted β = 1.26, 95% CI = 0.47–2.05) and non-fatal overdose (adjusted β = 1.02, 95% CI = 0.08–1.96) were also significantly associated with greater pain-related functional interference. In a substance-using population, greater pain-related functional interference was positively associated with depressive symptoms as well as overdose and daily heroin use. These findings emphasize the need to address the functional impact of pain, mental health comorbidity, and high-risk substance use that may contribute to overdose and other harms.

中文翻译：

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抑郁症状对持续性疼痛的物质使用人群疼痛的影响：一项横断面队列研究

鉴于持续的阿片类药物过量危机，迫切需要研究同时出现疼痛和物质使用的人的心理健康影响。本研究调查了在社区范围的药物过量危机期间，抑郁症状对吸毒者 (PWUD) 的疼痛严重程度和功能干扰的影响。从 2016 年 12 月 1 日到 2018 年 12 月 31 日，加拿大温哥华两项 PWUD 队列研究的 288 名参与者完成了访谈员管理的问卷，其中包括简要疼痛量表和 PROMIS 情绪困扰-抑郁工具。广义线性回归模型 (GLM) 用于检查抑郁症状和其他混杂因素对疼痛严重程度和干扰的横断面影响。中度至重度抑郁症状与更大的疼痛相关功能干扰显着相关（调整后 β = 1.24，95% 置信区间 [CI] = 0.33–2.15），但与更大的平均疼痛严重程度无显着相关（调整后 β = 0.22、95 % CI = − 0.3 – 0.82)，当控制混杂变量时。报告的每日海洛因使用（调整后 β = 1.26，95% CI = 0.47–2.05）和非致命性过量（调整后 β = 1.02，95% CI = 0.08–1.96）也与更大的疼痛相关功能干扰显着相关。在物质使用人群中，更大的疼痛相关功能干扰与抑郁症状以及过量和日常海洛因使用呈正相关。这些发现强调需要解决疼痛、心理健康合并症、