Affiliation:
1. Department of Physical Medicine & Rehabilitation, University of Michigan , Ann Arbor, MI 48109, United States
Abstract
Abstract
Objective
Consumption of psychoactive substances—alcohol, nicotine, caffeine, opioids, and cannabis—is common among people with fibromyalgia. Associations between the use of substances and somatic symptoms could reflect efforts to cope with symptoms, aggravation or alleviation of symptoms after the use of substances, or a combination of these. To date, no study has provided insight into temporal associations between the consumption of psychoactive substances and fluctuations in somatic symptoms. We explored whether changes in ratings of pain and fatigue (mental and physical) predicted the later use of psychoactive substances or vice versa (substance use predicting later change in symptoms).
Design
Micro-longitudinal design.
Setting/subjects
Fifty adults (88% female, 86% White, mean age of 44.9 years) with fibromyalgia.
Methods
Participants completed ecological momentary assessments of substance use, pain intensity, and physical/mental fatigue 5 times per day for 8 days.
Results
Results of multilevel models indicated that momentary increases in fatigue showed a consistent association with greater odds of later use of psychoactive substances, whereas momentary increases in pain were related to lower odds of later cannabis and nicotine use and higher odds of later alcohol use. Only nicotine use predicted later mental fatigue.
Conclusion
Findings highlight the importance of individualized interventions for symptom management or problems related to the use of psychoactive substances. We observed that although somatic symptoms predicted later use of substances, use of substances did not show appreciable effects with regard to alleviating somatic symptoms in people with fibromyalgia.
Funder
National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Institutes of Health
University of Michigan’s Advanced Rehabilitation Research Training Program in Community Living and Participation
National Institute of Disability, Independent Living, and Rehabilitation Research, Administration for Community Living
NIDILRR
Mentor-Based Postdoctoral Fellowship Program in Rehabilitation Research
National Multiple Sclerosis Society
NIH
Publisher
Oxford University Press (OUP)
Subject
Anesthesiology and Pain Medicine,Neurology (clinical),General Medicine