Data Sheet 1_Associations between COVID-19 impact and subsequent substance use in adolescents with chronic pain.docx

ObjectiveThe current cross-sectional study retrospectively investigated associations between COVID-19-related factors and subsequent substance use in adolescents with chronic pain.
MethodsA total of 243 adolescents with diagnosed pain disorders were retrospectively surveyed from September 2021 to May 2024. Descriptive statistics summarized past-month and past-year substance use; COVID-19 exposures, impact, and distress; mental health; and pain-related indicators. Logistic regressions estimated the odds of substance use based on COVID-19 exposures, impact, and distress, controlling for demographics, mental health, and pain.
ResultsOf the 243 adolescents (Mage = 16.9, SD = 1.42 years; 68.44% female), 39.9% reported past-year substance use, and 28.4% reported past-month substance use. All participants reported COVID-19 exposures (M = 9.68, SD = 3.53), impact (M = 34.00, SD = 10.11), and distress (M = 5.25, SD = 2.19). No differences in Exposures or Distress emerged between youth with vs. without substance use (p’s > 0.05). Youth with past-month (U = 2,522, p < 0.001) and past-year (U = 3,998, p < 0.001) substance use reported more Impact, compared with those without use. COVID-19 social impact predicted odds of past-year (OR = 1.25, 95% CI = 1.13–1.38) and past-month (OR = 1.27, 95% CI = 1.14–1.42) substance use, controlling for gender, anxiety, depression, stress, pain intensity, pain interference, and functional disability.
DiscussionThe social impact of COVID-19 uniquely predicted subsequent substance use, over and above mental and physical health symptoms in adolescents with chronic pain. Incorporating socially focused interventions into multidisciplinary pain treatment and prevention efforts may better support the health and wellness of youth with chronic pain.