Substance Use in the Performing Artist with Chronic Pain

Abstract

OBJECTIVES: To evaluate how performing artists (PAs) with chronic pain may differ on measures of substance use compared to non-PA controls. METHODS: 157 participants reporting chronic pain (89 PAs, 68 non-PA controls) completed an online cross-sectional survey. Participants were assessed for self-reported current pain severity using the Brief Pain Inventory Short-Form, opioid misuse risk using the Screener and Opioid Assessment for Patients with Pain–Revised, opioid withdrawal using the Subjective Opiate Withdrawal Scale, and symptoms of opioid use disorder (OUD) using a modified version of the DSM-V checklist. RESULTS: PAs had lower pain severity (p<0.05, t=2.196, df=155) and lower pain interference (p<0.05, t=2.194) than non-PA controls. 24% of PAs and 13% of controls reported using opioids within the past month. Among PAs, the number of days using opioids in the past month was positively associated with hours spent practicing per week (r=0.508, p<0.05). PAs (66%) were more likely to endorse current alcohol use than controls (44.1%, t=–2.136, X2=7.72, p<0.01). Importantly, PAs (19%) were more likely than controls (3%) to endorse symptoms of at least mild OUD (X2(3)=11.3, p<0.01) and higher ratings of opioid misuse risk (t=–2.166, p<0.05). Past month opioid withdrawal was also greater in PAs than controls (t=–2.136, p<0.05), and 5.6% of PAs and 1.5% of controls reported at least one prior incidence incident of opioid overdose in their lifetime (X2=1.80, NS). CONCLUSIONS: Among persons with chronic pain, PAs may have higher risk for opioid-related consequences, including OUD, and should be screened during health care encounters.