People with chronic pain often attempt to manage pain and concurrent emotional distress with analgesic substances. Habitual use of such substances-even when not opioid-based-can pose side effect risks. A negative reinforcement model has been proposed whereby relief of pain and emotional distress following medication consumption increases the likelihood that the experience of elevated pain and distress will spur further medication use. People with chronic low back pain (N = 105) completed electronic diary assessments 5 times/day for 14 consecutive days. Lagged and cross-lagged analyses focused on links between time 1 pain and negative affect (NA) and time 2 analgesic medication use and vice versa. Sex differences were also explored. Primary results were as follows: (1) participants on average reported taking analgesic medication during 41.3% of the 3-hour reporting epochs (29 times over 14 days); (2) time 1 within-person increases in pain and NA predicted time 2 increases in the likelihood of ingesting analgesic medications; (3) time 1 within-person increases in medication use predicted time 2 decreases in pain and NA; and (4) lagged associations between time 1 pain/NA and time 2 medication use were strongest among women. Findings suggest that the use of analgesic medications for many people with chronic pain occurs frequently throughout the day. Results support the validity of a negative reinforcement model where pain and distress lead to pain medication use, which in turn leads to relief from pain and distress.

中文翻译：

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止痛药使用、疼痛和负面影响之间的并发和滞后关联：对慢性腰痛患者的每日日记研究。

患有慢性疼痛的人经常尝试使用镇痛药物来控制疼痛和并发的情绪困扰。习惯使用此类物质（即使不是基于阿片类药物）也可能会带来副作用风险。已经提出了一种负强化模型，即服药后疼痛和情绪困扰的缓解增加了疼痛和痛苦加剧的经历刺激进一步用药的可能性。慢性腰痛患者 (N = 105) 连续 14 天每天完成 5 次电子日记评估。滞后和交叉滞后分析重点关注时间 1 疼痛和负面情绪 (NA) 与时间 2 镇痛药物使用之间的联系，反之亦然。还探讨了性别差异。主要结果如下：(1) 参与者在 3 小时报告周期中平均有 41.3% 报告服用镇痛药物（14 天内 29 次）； (2) 时间 1 时人体内疼痛增加，NA 预测时间 2 摄入镇痛药物的可能性增加； (3) 时间 1 内药物使用量的增加预测时间 2 疼痛和 NA 的减少； (4) 女性中，时间 1 疼痛/NA 与时间 2 药物使用之间的滞后关联最强。研究结果表明，许多慢性疼痛患者全天经常使用镇痛药物。结果支持负强化模型的有效性，其中疼痛和痛苦导致止痛药物的使用，进而导致疼痛和痛苦的缓解。