ORIGINAL ARTICLE

Prescription Opioid Craving: Relationship With Pain and Substance Use-Related Characteristics

Lisham Ashrafiouna , b

a Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA; b VISN ? Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, New York, USA

KEYWORDS Craving; prescription opioids; pain; desire; opiates

ABSTRACT Background: Craving is associated with prescription opioid use in opioid-addicted pain patients. Objec- tives: This study evaluated the relationship between craving for prescription opioids and selected pain and substance use characteristics. Method: In this cross-sectional study, patients (N = 106) being treated for opioid dependence were recruited from one of three sites from December 2012 to April 2013. Participants completed the multi-dimensional Desire for Drugs Questionnaire to assess crav- ing, and other questionnaires to assess pain, substance use, and demographic characteristics. Data were analyzed using Pearson product-by-moment correlations, ANOVAs, and multiple linear regres- sions. Results: At the bivariate level, desire-and-intention to use prescription opioids and craving for relief from negative states were positively associated with both pain severity and interference. Lin- ear regression analyses revealed significant positive associations between Desire-and-Intention sub- scale scores and obsessive thoughts and compulsive behaviors associated with prescription opioids and pain severity. Negative Reinforcement subscales scores were positively associated with obsessive thoughts and compulsive behaviors associated with prescription opioids and the outcome expectan- cies of pain reduction, but not pain severity. Conclusions/Importance: This study extended previous research assessing the link between pain and craving by demonstrating that desire-and-intention, but not craving for the negative reinforcing effects are associated with pain severity after considering var- ious substance use characteristics. Additional research is needed to clarify the relationship between pain and aspects of craving while also considering pain-specific covariates. This study highlights that the multi-dimensionality of craving is an important aspect to consider when clinicians and researchers evaluate the relationship between pain and craving.