2209.0 - Religion and Spirituality Moderates Associations between Pain and Substance Misuse among U.S. Adults at Midlife

Program: Alcohol, Tobacco, and Other Drugs

Session: Polysubstance use patterns, trends, and disparities

Presenter: Yu-Tien Hsu

Authors: James Frater, Isaac Demuyakor, Yusuf Ransome

Abstract

Aims

To examine how social connectedness, spirituality, and religious attendance moderate relationships between pain and substance misuse.

Methods

We analyzed pooled national sample data from MIDUS 3 (n=2,671) and Refresher (n=2,410), a Black American sample from MIDUS Milwaukee (n=866). Pain was measured using a sum score assessing pain interference with daily activities, mood, relationships, sleep, and enjoyment. Spirituality was a sum of five items such as inner peace, beauty appreciation, life connection, deep appreciation, and caring for others. Religious attendance was categorized by frequency. Substance misuse was defined as non-prescribed use of medications or illicit substances in the past 12 months (e.g., heroin, cocaine, and methamphetamine).

Results

In the national sample, pain was associated with higher substance misuse (B=0.140, 95% CI [0.092, 0.188]). Two significant interactions emerged: higher religious attendance buffered the negative relationship between pain and substance misuse (B=-0.039, 95% CI [-0.066, -0.012]), while spirituality surprisingly intensified this relationship (B=0.034, 95% CI [0.001, 0.068]). In the Milwaukee sample, higher spirituality weakened the negative association between pain and substance misuse (B=-0.158, 95% CI [-0.249, -0.067]).

Conclusions

Poor treatment of chronic pain contributed to the opioid epidemic. We find some evidence that religious engagement and spirituality buffered the negative associations between pain and substance misuse. Addiction medicine clinicians may consider incorporating spirituality and religious elements in treating individuals with pain who are at risk for substance misuse.