Pain Intensity And Anxiety Sensitivity In Relation To Opioid Misuse And Dependence Among Individuals With Chronic Pain



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The United States (US) population consumes an estimated 68% of the world’s prescribed opioids each year, and over 2 million adults in the US suffer from an opioid use disorder. Although chronic pain populations are among the highest risk segments of the general population for opioid misuse and dependence, there is little understanding of individual risk characteristics that may be related to greater risk for these outcomes among this group. The present investigation explored the concurrent role of anxiety sensitivity and pain intensity and their interaction in relation to opioid misuse and dependence among 429 adults with chronic pain (73.9% female, Mage = 38.32 years, SD = 11.07). Results revealed that both anxiety sensitivity and pain intensity were associated with opioid misuse and dependence. Pain intensity and anxiety sensitivity interacted such that for individuals with higher anxiety sensitivity, but not lower anxiety sensitivity, higher pain interference was related to more severe opioid dependence. There was no evidence of an interaction for opioid misuse. Post-hoc analyses indicated that of the lower-order anxiety sensitivity facets, physical and mental incapacitation concerns significantly contributed to variance in opioid misuse and only mental incapacitation concerns significantly contributed to variance in opioid dependence. Overall, the current findings provide support for the importance of assessing anxiety sensitivity in screening for opioid-related problems among persons with chronic pain, as it may represent a distinct pathway to poorer opioid-related outcomes among this group.



chronic pain, anxiety sensitivity, opioid misuse, opioid dependence


Portions of this document appear in: Smit, Tanya, Andrew H. Rogers, Lorra Garey, Nicholas P. Allan, Andres G. Viana, and Michael J. Zvolensky. "Anxiety sensitivity and pain intensity independently predict opioid misuse and dependence in chronic pain patients." Psychiatry Research 294 (2020): 113523.