Characteristics and impact of chronic pain and pain management in older adults

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PROJECT SUMMARY/ABSTRACT Chronic pain and addiction are highly prevalent and frequently co-occurring conditions that produce synergistic effects on individuals, providers, and health-care systems. However, no studies to date have conducted a comprehensive evaluation of the co-occurrence of chronic pain and substance use among older adults (age ≥65). Focusing on older adults is critical given that this population is more susceptible to deleterious pain- and substance use-related effects, has higher rates of multimorbidity and polypharmacy, and experiences age- related changes in pharmacokinetics and pharmacodynamics. Therefore, research evaluating the prevalence and impact of co-occurring chronic pain and substance use among this population is sorely needed. In the parent R01 (AG064947), the research team is conducting a longitudinal population-based study of chronic pain in older adults. We recruited a nationally representative sample of older adults (N=2038) from NORC at the University of Chicago’s internally developed AmeriSpeak® Panel. Participants have already been invited to complete two waves of data collection. In this administrative supplement, we will leverage the infrastructure of the parent R01 to include a comprehensive assessment of co-occurring chronic pain and substance use in older adults during Wave 3 of data collection. Specifically, we will add measures to assess quantity/frequency of opioid and nonopioid (i.e., alcohol, cannabis, nicotine) substance use and the presence/severity of problematic patterns of substance use. This approach will allow us to determine the prevalence and characteristics of substance use among older adults with versus without chronic pain. In addition, we will examine the effects of chronic pain, problematic substance use, and their co-occurrence on important patient-reported outcomes (i.e., physical and cognitive function and quality of life). Finally, we will explore theoretically informed biopsychosocial moderators of the hypothesized effects of chronic pain status on substance use. This project will be the first comprehensive study of chronic pain and substance use conducted with a nationally representative sample of older adults. The information obtained from this study will provide a critical scientific starting point to understand the prevalence and impact of co-occurring chronic pain and substance use among older adults. Findings will inform future descriptive and intervention studies to address co-occurring chronic pain and substance use and improve patient-reported outcomes in the growing and highly vulnerable population of older adults with chronic pain.