The overall goal of this proposal is to advance knowledge about pain as a determinant of substance use, particularly alcohol and marijuana use. A substantial body of research indicates that self-medication of pain with alcohol and marijuana (i.e. use to cope with and/or manage pain) is common among pain patients, and epidemiological and observational studies suggest that pain can act as a potent motivator of substance use. Initial experimental evidence suggests that pain can increase urge and intention to consume alcohol, yet this relationship has not been replicated using clinically-relevant pain induction methods with greater ecological validity than typical experimental pain approaches. Further, despite similar pain-inhibitory effects and co- occurring use patterns of alcohol and marijuana, current research has not simultaneously examined the proximal effects of pain on alcohol and marijuana use. Thus, the proposed work will attempt to determine whether experimentally-induced musculoskeletal pain (i.e., delayed onset muscle soreness; DOMS) may increase alcohol and marijuana demand among co-users. An experimental study will be conducted, during which regular co-users of marijuana and alcohol will be assigned to either a DOMS (high-intensity eccentric exercise) or sham DOMS control condition (low-intensity concentric exercise). Overall, the proposed project has two specific aims: 1) to confirm that DOMS results in increased demand for alcohol and marijuana; and to investigate race and sex as moderating factors of this association, and 2) to identify psychosocial risk factors associated with change in demand for alcohol and marijuana after DOMS induction. Results may be used to assist in identification of pain patients at risk for hazardous alcohol and marijuana use. They may also inform development of novel interventions for reducing risk of substance use disorders, particularly among those with pain. The proposed training plan will provide the applicant with additional training beyond that included in her PhD program. Specifically, training goals include 1) hands-on training for experimental research approaches, including musculoskeletal pain induction, 2) coursework in the application of behavioral economic principles to health behaviors in addition to didactic training in administration and analysis of behavioral economic measures, 3) training in advanced statistical approaches, 4) development of professional development skills, and [5) [formal training in neuropharmacology of alcohol and marijuana use, as well as biopsychosocial mechanisms of pain]. The applicant is supported by a strong research environment with the necessary resources for completion of the project and professional development, as well as a productive mentoring team with specific expertise in the proposed areas of study.
Pain often motivates use of alcohol and marijuana, and co-use of these substances is common. The goal of the proposed project is to determine the effect of experimentally induced musculoskeletal pain on demand for alcohol and marijuana and characterize this association by examining relevant psychosocial variables. Results of this study will improve understanding of the causal relationship between pain and alcohol and marijuana use and may inform interventions to reduce risk of substance use disorders, particularly among pain patients.
