Associations Between Pain Severity, Posttraumatic Stress Disorder Symptoms, and Substance Use and Related Problems Among Trauma-Exposed Treatment-Seeking Veterans

Prior research has linked chronic pain with posttraumatic stress disorder (PTSD) symptoms, but findings regarding the association between pain and substance use disorder (SUD) severity have been mixed. One explanation for the discrepant findings may be based on the ways in which SUD outcomes are measured. That is, it may be that pain has a different relationship with hazardous consumption (e.g., frequency and quantity) than it does with use-related problems, a nuance that prior work has not taken into consideration. Accordingly, the current study investigated the separate associations between pain severity and PTSD symptoms as well as between pain severity and hazardous alcohol or substance use and between pain severity and alcohol and substance use-related problems. An outpatient treatment-seeking sample of racially diverse trauma-exposed veterans (N = 140) completed self-report measures of pain, PTSD symptoms, and alcohol and substance use. Cross-sectional regression analyses indicated a positive and significant association between chronic pain severity and PTSD symptoms. However, no associations were found between chronic pain severity and hazardous alcohol or substance use or between pain severity and alcohol or substance use problems. Consistent with prior work, results suggest pain severity is associated with PTSD symptoms, but not alcohol and substance use outcomes. Future research should include comprehensive pain assessments, prospectively assess symptoms, and work to better understand how to best target these burdensome symptoms among veterans.