Cannabis Use through Emotion Dysregulation Influencing Mental Health Outcomes in Opioid Misusing Chronic Pain Population

Cannabis is often used to manage pain, especially among persons who suffer from chronic pain. Yet, despite a large body of literature suggesting that cannabis use problems are associated with mental health problems, little work has examined mechanisms of this relationship within the context of a chronic pain population. Chronic pain is associated with emotion dysregulation. Consequently, individuals with chronic pain who experience more cannabis use problems may have less capacity to regulate negative emotions, which in turn, could be related to greater anxiety, depression, and negative emotional states (e.g., suicidal ideation). The current study explored whether emotion dysregulation explained, in part, the relation between cannabis use problems and anxiety, depression, and suicidal ideation among adults with chronic pain. Participants were 431 (74.60% female, Mage= 38.98 years, SD= 11.23) opioid-using adults with current moderate to severe chronic pain. The sample was predominately White (77.8%), with identifying as 13.1% Hispanic/Latino, 8.7% Black/African American, 3.3% Native American/Alaska Native, 2.7% multiracial, 0.9% Asian/Pacific Islander, and 1.1% other. Of the 431, 176 were current cannabis users, and 30.2% reported cannabis use problems. Of the 431, 186 were lifetime cannabis users. Results indicated a significant indirect relationship between cannabis use problems and anxiety, depression, and suicidal ideation via emotion dysregulation. Tests of specificity suggested a potential for a bi- directional effect only for suicidal ideation. These initial findings suggest that emotion dysregulation may be an important mechanism for the relationship between cannabis use problems and mental health among adults with chronic pain.