Anxiety sensitivity is associated with increased opioid misuse among adults with chronic pain, according to new research published in The American Journal of Drug and Alcohol Abuse.

“Opioid use is a significant public health epidemic that is dominating the media. We were interested in understanding why some people may be able to use opioids responsibility for chronic pain, and why others may go on to misuse their opioids,” said study author Andrew H. Rogers, a graduate student in Clinical Psychology at the University of Houston.

“We examined this question from a psychological perspective, given that mental health problems, such as anxiety and depression, as associated with more severe substance use problems. We specifically examined anxiety sensitivity, or fear of anxiety-related physical sensations, to understand if this may be one reason why people may use opioids in a problematic manner.”

The study, which surveyed 429 adults with chronic pain who were currently using opioid medications, found that anxiety sensitivity was linked to opioid misuse.

Those who agreed with statements such as “It scares me when my heart beats rapidly,” “When I cannot keep my mind on a task, I worry that I might be going crazy,” and “It scares me when I blush in front of people” tended to have a higher severity of opioid dependence and reported using more opioids to get high in the previous month.

“Even among people with chronic pain, pain itself doesn’t seem to be driving opioid-related problems. It’s other characteristics, and in this case, anxiety sensitivity, that seems to be driving it,” Rogers told PsyPost.

“Specifically, someone who may be more sensitive to these anxiety-related sensations (HR increase, rapid breathing, upset stomach), may be at higher risk of misusing their prescription opioids, and it may be important to identify these high risk individual prior to initiating opioids for pain management.”

The study — like all research — includes some limitations.

“The major caveat for this study is that all of the data were collected at 1 time point. We did find that anxiety sensitivity was related to opioid misuse, but it is still important to see if anxiety sensitivity may be a risk factor over time for these opioid related problems,” Rogers explained.

The study, “Anxiety sensitivity and opioid misuse among opioid-using adults with chronic pain“, Andrew H. Rogers, Brooke Y. Kauffman, Jafar Bakhshaie, R. Kathryn McHugh, Joseph W. Ditre, and Michael J. Zvolensky.