{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T15:48:35Z","timestamp":1782402515120,"version":"3.54.5"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on\nAlcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U01AA020784"],"award-info":[{"award-number":["U01AA020784"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on\nAlcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U24AA020778"],"award-info":[{"award-number":["U24AA020778"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on\nAlcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U24AA020779"],"award-info":[{"award-number":["U24AA020779"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on\nAlcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["P01AA029546"],"award-info":[{"award-number":["P01AA029546"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on\nAlcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["P30AI042853"],"award-info":[{"award-number":["P30AI042853"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes\nof Health Research","doi-asserted-by":"publisher","award":["171259"],"award-info":[{"award-number":["171259"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on\nDrug Abuse","doi-asserted-by":"publisher","award":["R25DA033211"],"award-info":[{"award-number":["R25DA033211"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["AIDS Behav"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Pain is prevalent among people with HIV (PWH), and many PWH who\nexperience pain also use substances (illicit drug and\/or unhealthy alcohol use).\nWhile cocaine use and cocaine and alcohol co-use are prevalent in this population,\ntheir effects on pain in PWH are unknown. This study aims to investigate the\nassociation of cocaine use and co-use of cocaine and alcohol with pain interference\namong PWH. We completed a secondary analysis of the Boston Alcohol Research\nCollaboration on HIV\/AIDS (ARCH) study, a longitudinal cohort of PWH with a history\nof substance use. The outcome was pain interference (Brief Pain Inventory).\nExposures were recent cocaine use (Addiction Severity Index) and recent unhealthy\nalcohol use (Timeline Follow Back). Generalized Estimating Equation (GEE) ordinal\nlogistic regression models were employed, adjusted for demographic factors,\nillicit\/non-medical opioid use and cannabis use. Among 251 participants,\n22.3% reported unhealthy alcohol use only, 11.1% reported cocaine use\nonly, and 13.2% reported use of both. Cocaine use was associated with greater\npain interference (adjusted odds ratio [aOR]: 1.73, 95% confidence interval\n[CI]: 1.15\u20132.60), whether or not participants had unhealthy alcohol use\n(interaction term,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.695).\nParticipants reporting both cocaine and unhealthy alcohol use had greater pain\ninterference than participants reporting neither (aOR: 2.27, 95%CI:\n1.35\u20133.79). Cocaine use was associated with greater pain interference as was\nco-use of cocaine and unhealthy alcohol among PWH. Considering patterns of substance\nuse can inform clinicians conversations with PWH who may be using substances for\npain management.\n                  <\/jats:p>","DOI":"10.1007\/s10461-025-05012-2","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T20:42:24Z","timestamp":1767645744000},"page":"1876-1882","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cocaine Use, Unhealthy Alcohol Use, and Pain\nInterference Among People with HIV"],"prefix":"10.1007","volume":"30","author":[{"given":"Jonah","family":"Sheinin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas D.","family":"Brothers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Stein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Winter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tibor P.","family":"Palfai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara M.","family":"Magane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scarlett","family":"Bellamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Asbridge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa W.","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"5012_CR1","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1097\/j.pain.0000000000000462","volume":"157","author":"JM Jiao","year":"2016","unstructured":"Jiao JM, So E, Jebakumar J, George MC, Simpson DM, Robinson-Papp J.\nChronic pain disorders in HIV primary care: clinical characteristics and\nassociation with healthcare utilization. Pain. 2016;157:931. https:\/\/doi.org\/10.1097\/j.pain.0000000000000462.","journal-title":"Pain"},{"key":"5012_CR2","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1016\/j.jpain.2011.04.002","volume":"12","author":"C Miaskowski","year":"2011","unstructured":"Miaskowski C, Penko JM, Guzman D, Mattson JE, Bangsberg DR, Kushel\nMB. Occurrence and characteristics of chronic pain in a community-based cohort\nof indigent adults living with HIV infection. J Pain. 2011;12:1004\u201316. https:\/\/doi.org\/10.1016\/j.jpain.2011.04.002.","journal-title":"J Pain"},{"key":"5012_CR3","doi-asserted-by":"publisher","first-page":"1870","DOI":"10.1111\/pme.12799","volume":"16","author":"LA Uebelacker","year":"2015","unstructured":"Uebelacker LA, Weisberg RB, Herman DS, Bailey GL, Pinkston-Camp MM,\nStein MD. Chronic pain in HIV-infected patients: relationship to depression,\nsubstance use, and mental health and pain treatment. Pain Med.\n2015;16:1870\u201381. https:\/\/doi.org\/10.1111\/pme.12799.","journal-title":"Pain Med"},{"key":"5012_CR4","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1093\/bjaceaccp\/mku044","volume":"15","author":"A Feizerfan","year":"2015","unstructured":"Feizerfan A, Sheh G. Transition from acute to chronic pain. Contin\nEduc Anaesth Crit Care Pain. 2015;15:98\u2013102. https:\/\/doi.org\/10.1093\/bjaceaccp\/mku044.","journal-title":"Contin Educ Anaesth Crit Care Pain"},{"key":"5012_CR5","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/j.pain.0000000000001384","volume":"160","author":"R-D Treede","year":"2019","unstructured":"Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al.\nChronic pain as a symptom or a disease: the IASP classification of chronic pain\nfor the international classification of diseases (ICD-11). Pain. 2019;160:19. https:\/\/doi.org\/10.1097\/j.pain.0000000000001384.","journal-title":"Pain"},{"key":"5012_CR6","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1097\/PSY.0000000000001119","volume":"84","author":"HM Derry-Vick","year":"2022","unstructured":"Derry-Vick HM, Johnston CD, Brennan-Ing M, Burchett CO, Glesby N,\nZhu Y-S, et al. Pain is associated with depressive symptoms, inflammation, and\npoorer physical function in older adults with HIV. Psychosom Med. 2022;84:957. https:\/\/doi.org\/10.1097\/PSY.0000000000001119.","journal-title":"Psychosom Med"},{"key":"5012_CR7","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1080\/09540121.2020.1748866","volume":"33","author":"DP Serota","year":"2021","unstructured":"Serota DP, Capozzi C, Lodi S, Colasanti JA, Forman LS, Tsui JI, et\nal. Predictors of pain-related functional impairment among people living with\nHIV on long-term opioid therapy. AIDS Care. 2021;33:507\u201315. https:\/\/doi.org\/10.1080\/09540121.2020.1748866.","journal-title":"AIDS Care"},{"key":"5012_CR8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0230408","volume":"15","author":"E Behar","year":"2020","unstructured":"Behar E, Bagnulo R, Knight K, Santos G-M, Coffin PO.\n\u201cChasing the pain relief, not the high\u201d: experiences managing pain\nafter opioid reductions among patients with HIV and a history of substance use.\nPLoS ONE. 2020;15: e0230408. https:\/\/doi.org\/10.1371\/journal.pone.0230408.","journal-title":"PLoS ONE"},{"key":"5012_CR9","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1111\/pme.12701","volume":"16","author":"JS Merlin","year":"2015","unstructured":"Merlin JS, Walcott M, Kerns R, Bair MJ, Burgio KL, Turan JM. Pain\nself-management in HIV-infected individuals with chronic pain: a qualitative\nstudy. Pain Med. 2015;16:706\u201314. https:\/\/doi.org\/10.1111\/pme.12701.","journal-title":"Pain Med"},{"key":"5012_CR10","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1186\/s12889-021-10566-6","volume":"21","author":"B Ngo","year":"2021","unstructured":"Ngo B, Liebschutz JM, Cheng DM, Colasanti JA, Merlin JS, Armstrong\nWS, et al. Hazardous alcohol use is associated with greater pain interference\nand prescription opioid misuse among persons living with HIV and chronic pain.\nBMC Public Health. 2021;21:564. https:\/\/doi.org\/10.1186\/s12889-021-10566-6.","journal-title":"BMC Public Health"},{"key":"5012_CR11","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.jana.2006.07.003","volume":"17","author":"L Robinson","year":"2006","unstructured":"Robinson L, Rempel H. Methamphetamine use and HIV symptom\nself-management. J Assoc Nurses AIDS Care. 2006;17:7\u201314. https:\/\/doi.org\/10.1016\/j.jana.2006.07.003.","journal-title":"J Assoc Nurses AIDS Care"},{"key":"5012_CR12","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1111\/acer.14282","volume":"44","author":"EW Yeung","year":"2020","unstructured":"Yeung EW, Lee MR, McDowell Y, Sher KJ, Gizer IR. The association\nbetween alcohol consumption and pain interference in a nationally representative\nsample: the moderating roles of gender and alcohol use disorder symptomatology.\nAlcohol Clin Exp Res. 2020;44:645\u201359. https:\/\/doi.org\/10.1111\/acer.14282.","journal-title":"Alcohol Clin Exp Res"},{"key":"5012_CR13","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6834a2","author":"RM Gladden","year":"2019","unstructured":"Gladden RM. Changes in opioid-involved overdose deaths by opioid\ntype and presence of benzodiazepines, cocaine, and methamphetamine \u2014 25\nstates, July\u2013December 2017 to January\u2013June 2018. MMWR Morb Mortal\nWkly Rep. 2019. https:\/\/doi.org\/10.15585\/mmwr.mm6834a2.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"5012_CR14","doi-asserted-by":"publisher","first-page":"108750","DOI":"10.1016\/j.drugalcdep.2021.108750","volume":"225","author":"JC Strickland","year":"2021","unstructured":"Strickland JC, Stoops WW, Dunn KE, Smith KE, Havens JR. The\ncontinued rise of methamphetamine use among people who use heroin in the united\nStates. Drug Alcohol Depend. 2021;225:108750. https:\/\/doi.org\/10.1016\/j.drugalcdep.2021.108750.","journal-title":"Drug Alcohol Depend"},{"key":"5012_CR15","doi-asserted-by":"publisher","first-page":"bqab108","DOI":"10.1210\/endocr\/bqab108","volume":"162","author":"WK Samson","year":"2021","unstructured":"Samson WK, Salvemini D, Yosten GLC. Overcoming stress, hunger, and\npain: cocaine- and amphetamine-regulated transcript peptide\u2019s promise.\nEndocrinology. 2021;162:bqab108. https:\/\/doi.org\/10.1210\/endocr\/bqab108.","journal-title":"Endocrinology"},{"key":"5012_CR16","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2021.113380","volume":"235","author":"GLC Yosten","year":"2021","unstructured":"Yosten GLC, Haddock CJ, Harada CM, Almeida-Pereira G, Kolar GR,\nStein LM, et al. Past, present and future of cocaine- and amphetamine-regulated\ntranscript peptide. Physiol Behav. 2021;235:113380. https:\/\/doi.org\/10.1016\/j.physbeh.2021.113380.","journal-title":"Physiol Behav"},{"key":"5012_CR17","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1080\/08897077.2021.1903654","volume":"43","author":"CM Beliveau","year":"2022","unstructured":"Beliveau CM, McMahan VM, Arenander J, Angst MS, Kushel M, Torres A,\net al. Stimulant use to treat pain among safety-net patients with chronic\nnon-cancer pain. Subst Abus. 2022;43:179\u201386. https:\/\/doi.org\/10.1080\/08897077.2021.1903654.","journal-title":"Subst Abus"},{"key":"5012_CR18","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.drugalcdep.2018.07.025","volume":"192","author":"Y Liu","year":"2018","unstructured":"Liu Y, Guazzelli Williamson V, Setlow B, Cottler LB, Knackstedt LA.\nThe importance of considering polysubstance use: lessons from cocaine research.\nDrug Alcohol Depend. 2018;192:16\u201328. https:\/\/doi.org\/10.1016\/j.drugalcdep.2018.07.025.","journal-title":"Drug Alcohol Depend"},{"key":"5012_CR19","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1046\/j.1360-0443.2002.00158.x","volume":"97","author":"EJM Pennings","year":"2002","unstructured":"Pennings EJM, Leccese AP, Wolff FAD. Effects of concurrent use of\nalcohol and cocaine. Addiction. 2002;97:773\u201383. https:\/\/doi.org\/10.1046\/j.1360-0443.2002.00158.x.","journal-title":"Addiction"},{"key":"5012_CR20","doi-asserted-by":"publisher","first-page":"2089","DOI":"10.1111\/acer.15447","volume":"48","author":"TP Palfai","year":"2024","unstructured":"Palfai TP, Winter MR, Magane KM, Heeren TC, Bernier LB, Murray GE,\net al. Pain and unhealthy alcohol use among people living with HIV: a\nprospective cohort study. Alcohol Clin Exp Res. 2024;48:2089\u201398. https:\/\/doi.org\/10.1111\/acer.15447.","journal-title":"Alcohol Clin Exp Res"},{"key":"5012_CR21","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1007\/BF02257405","volume":"111","author":"EF McCance-Katz","year":"1993","unstructured":"McCance-Katz EF, Price LH, McDougle CJ, Kosten TR, Black JE, Jatlow\nPI. Concurrent cocaine-ethanol ingestion in humans: pharmacology, physiology,\nbehavior, and the role of cocaethylene. Psychopharmacology.\n1993;111:39\u201346. https:\/\/doi.org\/10.1007\/BF02257405.","journal-title":"Psychopharmacology"},{"key":"5012_CR22","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1016\/S0196-0644(96)70114-2","volume":"28","author":"V Vanek","year":"1996","unstructured":"Vanek V, Dickeywhite H, Signs S, Schechter M, Buss T, Kulics A.\nConcurrent use of cocaine and alcohol by patients treated in the emergency\ndepartment. Ann Emerg Med. 1996;28:508\u201314. https:\/\/doi.org\/10.1016\/S0196-0644(96)70114-2.","journal-title":"Ann Emerg Med"},{"key":"5012_CR23","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1080\/09540121.2021.1981819","volume":"34","author":"E Moitra","year":"2022","unstructured":"Moitra E, Stein MD, Busch AM, Pinkston MM, Abrantes AM, Baker JV,\net al. Acceptance of chronic pain in depressed patients with HIV: correlations\nwith activity, functioning, and emotional distress. AIDS Care.\n2022;34:1338\u201346. https:\/\/doi.org\/10.1080\/09540121.2021.1981819.","journal-title":"AIDS Care"},{"key":"5012_CR24","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1097\/QAI.0000000000003372","volume":"95","author":"TW Kim","year":"2024","unstructured":"Kim TW, Bertholet N, Magane KM, Lloyd-Travaglini C, Winter MR,\nSamet JH, et al. Alcohol consumption and illicit drug use: associations with\nfall, fracture, and acute health care utilization among people with HIV\ninfection. JAIDS J Acquir Immune Defic Syndr. 2024;95:391. https:\/\/doi.org\/10.1097\/QAI.0000000000003372.","journal-title":"JAIDS J Acquir Immune Defic Syndr"},{"key":"5012_CR25","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1080\/09540121.2017.1384532","volume":"30","author":"TW Kim","year":"2018","unstructured":"Kim TW, Walley AY, Ventura AS, Patts GJ, Heeren TC, Lerner GB, et\nal. 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