The Role of Childhood Trauma in Chronic Pain and Substance Use Among Individuals Receiving Methadone Treatment for Opioid Use Disorder.

Abstract

This study explored the correlations between childhood trauma, chronic pain, and substance use among individuals receiving methadone for opioid use disorder (OUD). We hypothesized that, among individuals with OUD, a history of childhood trauma would correlate with more severe pain and substance use compared with those without such history. We conducted a cross-sectional study of 82 individuals receiving methadone for OUD. Participants completed the Childhood Trauma Questionnaire (CTQ) to assess childhood trauma exposure, the Brief Pain Inventory (BPI) to characterize chronic pain, and the Timeline Followback (TLFB) method to assess substance use in the past 28 days. Correlation analyses and ANOVA examined the relationships between these variables. Higher childhood trauma scores correlated with greater pain severity (r = 0.27, P = 0.03), increased alcohol consumption (r = 0.25, P = 0.04), and earlier age of cannabis initiation (r = -0.45, P < 0.001). Among trauma subscales, emotional abuse most closely correlated with greater pain severity (r = 0.33, P = 0.008) and interference (r = 0.28, P = 0.03), and alcohol consumption (r = 0.28, P = 0.02). Individuals who used cannabis reported significantly higher levels of emotional abuse ( P = 0.04), sexual abuse ( P = 0.03), and physical neglect ( P = 0.02) compared with those who did not. Conversely, our analysis did not reveal significant correlations between childhood trauma and heroin, tobacco, cocaine, or stimulant use. Childhood trauma correlated with greater pain severity and interference, higher alcohol use, earlier cannabis initiation, and increased likelihood of cannabis use among individuals receiving methadone for OUD. These findings suggest the importance of integrating trauma-focused assessment and treatment into OUD treatment programs.