{
    "abstract": "Individuals with chronic low back pain (CLBP) are commonly prescribed long-term opioid therapy (LTOT) for analgesia, placing this population at increased risk for opioid misuse and opioid use disorder. Acceptance of aversive experiences (e.g., chronic pain) and awareness of automatic thoughts and behaviors (i.e., automaticity) are two facets of dispositional mindfulness that may serve as protective mechanisms against opioid misuse risk. Therefore, the aim of the current study was to examine the differential contributions of these constructs to opioid misuse risk among adults with CLBP receiving LTOT.\nData were obtained from a sample of 770 adults with opioid-treated CLBP. Bivariate correlations and hierarchical linear regression analyses were used to determine whether chronic pain acceptance and awareness of automatic thoughts and behaviors explained a statistically significant portion of variance in opioid misuse risk after accounting for the effects of other relevant confounders.\nHierarchical regression results revealed that chronic pain acceptance and awareness of automatic thoughts and behaviors contributed a significant portion in the variance of opioid misuse risk. Awareness of automatic thoughts and behaviors was negatively associated with opioid misuse risk, such that individuals with lower levels of awareness of automaticity were at higher risk of opioid misuse. By contrast, pain acceptance was not associated with opioid misuse.\nFindings suggest that awareness of automaticity may buffer against opioid misuse risk. Interventions designed to strengthen awareness of automaticity (e.g., mindfulness-based interventions) might be especially efficacious among this population.",
    "authors": [
        {
            "affiliation": "University of Utah, Center on Mindfulness and Integrative Health Intervention Development, College of Social Work,\u00a0395 1500 E,\u00a0Salt Lake City,\u00a0UT84112,\u00a0United States.",
            "firstname": "Anna",
            "initials": "A",
            "lastname": "Parisi"
        },
        {
            "affiliation": "Pennsylvania State University College of Medicine Department of Family and Community Medicine,\u00a090 Hope Drive,\u00a0Hershey,\u00a0PA17033,\u00a0United States.",
            "firstname": "Aleksandra E",
            "initials": "AE",
            "lastname": "Zgierska"
        },
        {
            "affiliation": "University of Wisconsin-Madison, School of Medicine and Public Health, Department of Family Medicine and Community Health,\u00a01100 Delaplaine Court,\u00a0Madison,\u00a0WI53715,\u00a0United States.",
            "firstname": "Cindy A",
            "initials": "CA",
            "lastname": "Burzinski"
        },
        {
            "affiliation": "Pennsylvania State University College of Medicine Department of Family and Community Medicine,\u00a090 Hope Drive,\u00a0Hershey,\u00a0PA17033,\u00a0United States.",
            "firstname": "Robert P",
            "initials": "RP",
            "lastname": "Lennon"
        },
        {
            "affiliation": "Harvard Medical School, Brigham and Women's Hospital, Departments of Anesthesiology, Perioperative and Pain Medicine and Psychiatry,\u00a0850 Boylston Street,\u00a0Chestnut Hill,\u00a0MA02467,\u00a0United States.",
            "firstname": "Robert N",
            "initials": "RN",
            "lastname": "Jamison"
        },
        {
            "affiliation": "University of Utah School of Medicine, Department of Anesthesiology, Division of Pain Medicine, Pain Research Center,\u00a0615 Arapeen Drive, Suite 200,\u00a0Salt Lake City,\u00a0UT84108,\u00a0United States.",
            "firstname": "Yoshio",
            "initials": "Y",
            "lastname": "Nakamura"
        },
        {
            "affiliation": "University of Wisconsin-Madison, School of Medicine and Public Health, Department of Family Medicine and Community Health,\u00a01100 Delaplaine Court,\u00a0Madison,\u00a0WI53715,\u00a0United States.",
            "firstname": "Bruce",
            "initials": "B",
            "lastname": "Barrett"
        },
        {
            "affiliation": "Harvard Medical School, Brigham and Women's Hospital, Departments of Anesthesiology, Perioperative and Pain Medicine and Psychiatry,\u00a0850 Boylston Street,\u00a0Chestnut Hill,\u00a0MA02467,\u00a0United States.",
            "firstname": "Robert R",
            "initials": "RR",
            "lastname": "Edwards"
        },
        {
            "affiliation": "University of Utah, Center on Mindfulness and Integrative Health Intervention Development, College of Social Work,\u00a0395 1500 E,\u00a0Salt Lake City,\u00a0UT84112,\u00a0United States. Electronic address: eric.garland@socwk.utah.edu.",
            "firstname": "Eric L",
            "initials": "EL",
            "lastname": "Garland"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2023 Elsevier B.V. All rights reserved.",
    "doi": "10.1016/j.drugalcdep.2023.109890\n10.1016/j.addbeh.2010.06.018\n10.1177/1073191105283504\n10.1037/pha0000225\n10.4088/JCP.15m09963\n10.31887/DCNS.2017.19.3/wberrettini\n10.1016/S0022-3999(01)00296-3\n10.1037/0022-3514.84.4.822\n10.1007/s10865-007-9130-7\n10.1016/j.cpr.2019.101785\n10.1016/j.jot.2021.07.005\n10.7326/M14-2559\n10.1136/bmj.g6380\n10.3390/ijerph18063054\n10.1007/BF02879899\n10.1146/annurev-psych-122414-033457\n10.1016/j.jad.2018.04.058\n10.1016/j.drugalcdep.2021.108602\n10.1086/694324\n10.1126/sciadv.abo4455\n10.1097/BRS.0b013e318241e5de\n10.1016/j.cpr.2015.01.006\n10.1016/j.jpainsymman.2007.10.003\n10.1016/j.jpain.2009.07.016\n10.1016/j.jpain.2014.07.007\n10.1016/j.jpain.2015.12.004\n10.1016/j.drugalcdep.2014.07.014\n10.1016/j.cpr.2011.04.006\n10.1016/j.drugalcdep.2015.08.026\n10.1176/appi.ajp.2020.20091375\n10.1016/j.drugalcdep.2015.10.017\n10.5055/jom.2007.0045\n10.1016/S0304-3959(98)00219-X\n10.1016/j.ejpain.2009.03.004\n10.1016/j.drugalcdep.2018.03.040\n10.1037/pas0000268\n10.1097/AJP.0000000000000870\n10.1007/s12671-021-01825-z\n10.1016/j.mayocp.2012.08.020\n10.1016/j.addbeh.2022.107495\n10.1111/joim.12345\n10.1037/0033-295X.97.2.147\n10.1016/j.jcbs.2020.08.011\n10.1016/j.paid.2005.11.025\n10.1016/j.ejpain.2008.09.003\n10.1111/acer.13594\n10.1093/pm/pnz155\n10.1016/j.cct.2021.106548",
    "journal": "Drug and alcohol dependence",
    "keywords": [
        "Acceptance",
        "Automaticity",
        "Chronic pain",
        "Dispositional mindfulness",
        "Opioids",
        "Trait mindfulness"
    ],
    "methods": null,
    "publication_date": "2023-05-12",
    "pubmed_id": "37167796\n20598809\n16443717\n30265061\n27574837\n29302220\n11832252\n12703651\n18203666\n17899351\n31751877\n34934626\n25581257\n25561513\n26977696\n33809628\n17447870\n26253543\n11074683\n29660645\n30429181\n33652377\n31682676\n27933366\n36223472\n35226053\n25469652\n32915027\n22146287\n25689576\n18619768\n19944648\n25092233\n26705974\n25113434\n28226333\n21802619\n26374990\n33135468\n26530502\n17520988\n10204741\n19349199\n36124231\n29754031\n27078183\n32769415\n31362588\n23274019\n36156453\n25556772\n2186423\n18574359\n25785523\n18926744\n29314075\n31340004\n34478870",
    "results": "Hierarchical regression results revealed that chronic pain acceptance and awareness of automatic thoughts and behaviors contributed a significant portion in the variance of opioid misuse risk. Awareness of automatic thoughts and behaviors was negatively associated with opioid misuse risk, such that individuals with lower levels of awareness of automaticity were at higher risk of opioid misuse. By contrast, pain acceptance was not associated with opioid misuse.",
    "title": "To be aware, or to accept, that is the question: Differential roles of awareness of automaticity and pain acceptance in opioid misuse.",
    "xml": "<Element 'PubmedArticle' at 0x788502c287c0>"
}