{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T02:53:33Z","timestamp":1764471213841,"version":"3.37.3"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T00:00:00Z","timestamp":1717718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008460","name":"National Center for Complementary and Integrative Health","doi-asserted-by":"publisher","award":["5UH3AT009758\u201005"],"award-info":[{"award-number":["5UH3AT009758\u201005"]}],"id":[{"id":"10.13039\/100008460","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Addict"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Risky substance use (RSU) is common among people with chronic pain and is associated with worse pain treatment outcomes. Nonopioid treatment is recommended, but it is unknown whether people with RSU use different or fewer pain treatment modalities. This study describes use of different pain treatments by veterans with and without RSU and those receiving versus not receiving opioid medication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Veterans (<jats:italic>N<\/jats:italic>\u2009=\u2009924) who filed service\u2010connected disability claims related to musculoskeletal conditions and rated their pain four or higher on the Numeric Rating Scale, reported on 25 different pain services in the preceding 90 days. Recent RSU was identified via Alcohol, Smoking, and Substance Involvement Test (ASSIST) cutoffs and\/or nail sample toxicology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, RSU was not associated with number of provider\u2010delivered or self\u2010delivered pain modalities. Over\u2010the\u2010counter medications (71%), self\u2010structured exercise (69%), and nonopioid prescription medications (38%) were the most used modalities. Veterans receiving prescribed opioids (8.4%) were more likely to see primary care, receive injections, and attend exercise and\/or meditation classes, compared to those without opioid prescriptions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>Opioid and nonopioid pain treatment utilization did not differ based on RSU, and those prescribed opioids were more likely to engage in other nonopioid pain treatments. Regardless of RSU, veterans appear willing to try provider\u2010delivered (58%) and self\u2010delivered (79%) pain treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Scientific Significance<\/jats:title><jats:p>In this first\u2010ever evaluation of 25 different pain treatment modalities among veterans with and without RSU, people with RSU did not use less treatment modalities.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajad.13620","type":"journal-article","created":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T03:43:17Z","timestamp":1717818197000},"page":"675-684","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Do veterans with risky substance use (RSU) use distinct pain treatment modalities?"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1719-3681","authenticated-orcid":false,"given":"Sarah","family":"Meshberg\u2010Cohen","sequence":"first","affiliation":[{"name":"Psychology Service\/Department of Psychiatry VA Connecticut Healthcare System West Haven Connecticut USA"},{"name":"Department of Psychiatry Yale University School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Gilstad\u2010Hayden","sequence":"additional","affiliation":[{"name":"Psychology Service\/Department of Psychiatry VA Connecticut Healthcare System West Haven Connecticut USA"},{"name":"Department of Psychiatry Yale University School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve","family":"Martino","sequence":"additional","affiliation":[{"name":"Psychology Service\/Department of Psychiatry VA Connecticut Healthcare System West Haven Connecticut USA"},{"name":"Department of Psychiatry Yale University School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine M.","family":"Lazar","sequence":"additional","affiliation":[{"name":"Psychology Service\/Department of Psychiatry VA Connecticut Healthcare System West Haven Connecticut USA"},{"name":"Department of Psychiatry Yale University School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Sellinger","sequence":"additional","affiliation":[{"name":"Psychology Service\/Department of Psychiatry VA Connecticut Healthcare System West Haven Connecticut USA"},{"name":"Department of Psychiatry Yale University School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc I.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Psychology Service\/Department of Psychiatry VA Connecticut Healthcare System West Haven Connecticut USA"},{"name":"Department of Psychiatry Yale University School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,7]]},"reference":[{"issue":"10","key":"e_1_2_8_2_1","first-page":"152","article-title":"Prevalence of chronic pain and related risk factors in military veterans: a systematic review","volume":"12","author":"Van Den Kerkhof EG","year":"2014","journal-title":"JBI Evidence Synthesis"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000567"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2011.01226.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pny071"},{"key":"e_1_2_8_6_1","unstructured":"Electronic Code of Federal Regulations. eCFR. 2024. 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