{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:48:08Z","timestamp":1776826088862,"version":"3.51.2"},"reference-count":62,"publisher":"American Spinal Injury Association","issue":"Supplement1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To identify biopsychosocial factors associated with opioid use for neuropathic pain in adults with SCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We studied 283 adults with SCI who were enrolled in a collaborative project at 1 of 6 participating SCI Model System centers. Using International Spinal Cord Injury Pain Basic and Extended Data Sets, participants were asked about pain, current and prior pain medication use in the past year, and nonpharmacological pain treatment use in the past year, for up to 3 pain conditions. The relationship between active opioid use and neuropathic pain severity, adjusting for relevant clinical and demographic characteristics, was examined using logistic regression using odds ratios (OR) and 95% confidence intervals (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 104 opioid users and 179 nonusers. In multivariable regression models, employment was associated with a 33% reduction in opioid use compared to unemployment. Opioid users were more likely to use anti-epileptics, a combination of cannabis and anti-epileptics, or a combination of anti-epileptics and nonsteroidal anti-inflammatory drugs than nonusers. Individuals with paraplegia were almost twice as likely to use opioids compared to those with tetraplegia. After adjusting for these factors, the odds of using opioids increased 10% with every 1-point increase in reported worst neuropathic pain severity (0-10 numeric rating scale). This model has good ability to discriminate between opioid users and nonusers based on the area under the curve (AUC) of 0.74.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We have developed a biopsychosocial base model of opioid use in adults with chronic pain after SCI with good predictive performance cross-sectionally and identified key potential risk factors for opioid use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.46292\/sci25-00129","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:17:19Z","timestamp":1776824239000},"page":"118-126","source":"Crossref","is-referenced-by-count":0,"title":["Neuropathic Pain Severity Is Associated With Opioid Use in Adults With Traumatic Spinal Cord Injury: A Spinal Cord Injury Model System Study"],"prefix":"10.46292","volume":"32","author":[{"given":"Leslie R.","family":"Morse","sequence":"first","affiliation":[{"name":"Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, UHealth\/Jackson Rehabilitation Care, Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas N.","family":"Bryce","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Argyrios","family":"Stampas","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, UTHealth Houston McGovern Medical School, Houston, Texas"},{"name":"Spinal Cord Injury Medicine, TIRR Memorial Hermann, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Haubert","sequence":"additional","affiliation":[{"name":"Rancho Los Amigos National Rehabilitation Center, Downey, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Charlifue","sequence":"additional","affiliation":[{"name":"Craig Hospital, Englewood, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Dalal","sequence":"additional","affiliation":[{"name":"Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, UHealth\/Jackson Rehabilitation Care, Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo A.","family":"Battaglino","sequence":"additional","affiliation":[{"name":"Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, UHealth\/Jackson Rehabilitation Care, Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nguyen","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, UHealth\/Jackson Rehabilitation Care, Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, UHealth\/Jackson Rehabilitation Care, Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth R.","family":"Felix","sequence":"additional","affiliation":[{"name":"Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, UHealth\/Jackson Rehabilitation Care, Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"},{"name":"Research Service, Miami Veterans Affairs Medical Center, Miami, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"25425","reference":[{"issue":"5","key":"b1","series-title":"Arch Phys Med Rehabil","first-page":"638","article-title":"Symptom burden in persons with spinal cord injury","volume":"88","author":"Jensen MP","year":"2007","unstructured":"Jensen MP, Kuehn CM, Amtmann D, Cardenas DD. Symptom burden in persons with spinal cord injury. Arch Phys Med Rehabil. 2007;88(5):638-645. doi:10.1016\/j.apmr.2007.02.002."},{"issue":"6","key":"b2","series-title":"Spinal Cord","first-page":"548","article-title":"The CanPain SCI clinical practice guidelines for rehabilitation management of neuropathic pain after spinal cord injury: 2021 update","volume":"60","author":"Loh E","year":"2022","unstructured":"Loh E, Mirkowski M, Agudelo AR, et al. The CanPain SCI clinical practice guidelines for rehabilitation management of neuropathic pain after spinal cord injury: 2021 update. Spinal Cord. 2022;60(6):548-566. doi:10.1038\/s41393-021-00744-z."},{"issue":"3","key":"b3","series-title":"J Spinal Cord Med","first-page":"440","article-title":"Treatments perceived to be helpful for neuropathic pain after traumatic spinal cord injury: A multicenter cross-sectional survey study","volume":"47","author":"Bryce TN","year":"2024","unstructured":"Bryce TN, Tsai CY, Delgado AD, et al. Treatments perceived to be helpful for neuropathic pain after traumatic spinal cord injury: A multicenter cross-sectional survey study. J Spinal Cord Med. 2024;47(3):440-449. doi:10.1080\/10790268.2022.2108665."},{"issue":"1","key":"b4","series-title":"BMC Neurosci","first-page":"58","article-title":"Morphine-induced changes in the function of microglia and macrophages after acute spinal cord injury","volume":"23","author":"Terminel MN","year":"2022","unstructured":"Terminel MN, Bassil C, Rau J, et al. Morphine-induced changes in the function of microglia and macrophages after acute spinal cord injury. BMC Neurosci. 2022;23(1):58. doi:10.1186\/s12868-022-00739-3."},{"issue":"4","key":"b5","series-title":"Arch Phys Med Rehabil","first-page":"729","article-title":"Prevalence and impact of neuropathic and nonneuropathic pain in chronic spinal cord injury","volume":"103","author":"Felix ER","year":"2022","unstructured":"Felix ER, Cardenas DD, Bryce TN, et al. Prevalence and impact of neuropathic and nonneuropathic pain in chronic spinal cord injury. Arch Phys Med Rehabil. 2022;103(4):729-737. doi:10.1016\/j.apmr.2021.06.022."},{"issue":"5","key":"b6","series-title":"Spinal Cord","first-page":"520","article-title":"Treatments that are perceived to be helpful for non-neuropathic pain after traumatic spinal cord injury: A multicenter cross-sectional survey","volume":"59","author":"Tsai CY","year":"2021","unstructured":"Tsai CY, Bryce TN, Delgado AD, et al. Treatments that are perceived to be helpful for non-neuropathic pain after traumatic spinal cord injury: A multicenter cross-sectional survey. Spinal Cord. 2021;59(5):520-528. doi:10.1038\/s41393-021-00621-9."},{"issue":"4","key":"b7","series-title":"Spinal Cord","first-page":"282","article-title":"The International Spinal Cord Injury Pain Basic Data Set (version 2.0)","volume":"52","author":"Widerstrom-Noga E","year":"2014","unstructured":"Widerstrom-Noga E, Biering-Sorensen F, Bryce TN, et al. The International Spinal Cord Injury Pain Basic Data Set (version 2.0). Spinal Cord. 2014;52(4):282-6. doi:10.1038\/sc.2014.4."},{"issue":"11","key":"b8","series-title":"Spinal Cord","first-page":"1036","article-title":"The International Spinal Cord Injury Pain Extended Data Set (Version 1.0)","volume":"54","author":"Widerstrom-Noga E","year":"2016","unstructured":"Widerstrom-Noga E, Biering-Sorensen F, Bryce TN, et al. The International Spinal Cord Injury Pain Extended Data Set (Version 1.0). Spinal Cord. 2016;54(11):1036-1046. doi:10.1038\/sc.2016.51."},{"issue":"5","key":"b9","series-title":"Spinal Cord","first-page":"407","article-title":"Screening for neuropathic pain after spinal cord injury with the spinal cord injury pain instrument (SCIPI): A preliminary validation study","volume":"52","author":"Bryce TN","year":"2014","unstructured":"Bryce TN, Richards JS, Bombardier CH, et al. Screening for neuropathic pain after spinal cord injury with the spinal cord injury pain instrument (SCIPI): A preliminary validation study. Spinal Cord. 2014;52(5):407-412. doi:10.1038\/sc.2014.21."},{"issue":"10","key":"b10","series-title":"Eur J Pain","first-page":"1642","article-title":"Spinal Cord Injury Pain Instrument and painDETECT questionnaire: Convergent construct validity in individuals with Spinal Cord Injury","volume":"21","author":"Franz S","year":"2017","unstructured":"Franz S, Schuld C, Wilder-Smith EP, et al. Spinal Cord Injury Pain Instrument and painDETECT questionnaire: Convergent construct validity in individuals with Spinal Cord Injury. Eur J Pain. 2017;21(10):1642-1656. doi:10.1002\/ejp.1069."},{"issue":"5","key":"b11","series-title":"J Spinal Cord Med","first-page":"901","article-title":"Chronic opioid prescription in veterans with spinal cord injury: Prevalence and associated factors","volume":"48","author":"Strong C","year":"2025","unstructured":"Strong C, Burns SP, Arewasikporn A, et al. Chronic opioid prescription in veterans with spinal cord injury: Prevalence and associated factors. J Spinal Cord Med. 2025;48(5):901-911. doi:10.1080\/10790268.2024.2378556."},{"issue":"17","key":"b12","series-title":"Int J Environ Res Public Health","article-title":"Opioid pain medication prescription for chronic pain in primary care centers: The roles of pain acceptance, pain intensity, depressive symptoms, pain catastrophizing, sex, and age","volume":"17","author":"Ramirez-Maestre C","year":"2020","unstructured":"Ramirez-Maestre C, Reyes-Perez A, Esteve R, Lopez-Martinez AE, Bernardes S, Jensen MP. Opioid pain medication prescription for chronic pain in primary care centers: The roles of pain acceptance, pain intensity, depressive symptoms, pain catastrophizing, sex, and age. Int J Environ Res Public Health. 2020;17(17). doi:10.3390\/ijerph17176428."},{"issue":"2","key":"b13","series-title":"Pain Rep","first-page":"e570","article-title":"The dark side of opioids in pain management: Basic science explains clinical observation","volume":"1","author":"Rivat C","year":"2016","unstructured":"Rivat C, Ballantyne J. The dark side of opioids in pain management: Basic science explains clinical observation. Pain Rep. 2016;1(2):e570. doi:10.1097\/PR9.0000000000000570."},{"issue":"10","key":"b14","series-title":"Pain Med","first-page":"1838","article-title":"Patients\u2019 perspectives on tapering of chronic opioid therapy: A qualitative study","volume":"17","author":"Frank JW","year":"2016","unstructured":"Frank JW, Levy C, Matlock DD, et al. Patients\u2019 perspectives on tapering of chronic opioid therapy: A qualitative study. 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Progression of neuropathic pain after acute spinal cord injury: A meta-analysis and framework for clinical trials. J Neurotrauma. May 1 2019;36(9):1461-1468. doi:10.1089\/neu.2018.5960."},{"issue":"12","key":"b21","series-title":"Spinal Cord","first-page":"665","article-title":"Neuropathic pain after traumatic spinal cord injury-relations to gender, spinal level, completeness, and age at the time of injury","volume":"42","author":"Werhagen L","year":"2004","unstructured":"Werhagen L, Budh CN, Hultling C, Molander C. Neuropathic pain after traumatic spinal cord injury-relations to gender, spinal level, completeness, and age at the time of injury. Spinal Cord. 2004;42(12):665-673. doi:10.1038\/sj.sc.3101641."},{"key":"b22","series-title":"Am J Emerg Med","first-page":"144","article-title":"Cervical spine injuries in adults >\/= 65 years after low-level falls - A systematic review and meta-analysis","volume":"67","author":"McCallum J","year":"2023","unstructured":"McCallum J, Eagles D, Ouyang Y, et al. Cervical spine injuries in adults >\/= 65 years after low-level falls - A systematic review and meta-analysis. Am J Emerg Med. 2023;67:144-155. doi:10.1016\/j.ajem.2023.02.008."},{"issue":"1","key":"b23","series-title":"Physiol Rev","first-page":"259","article-title":"Neuropathic pain: From mechanisms to treatment","volume":"101","author":"Finnerup NB","year":"2021","unstructured":"Finnerup NB, Kuner R, Jensen TS. Neuropathic pain: From mechanisms to treatment. 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Treatments perceived to be helpful for neuropathic pain after traumatic spinal cord injury: A multicenter cross-sectional survey study. J Spinal Cord Med. 2024;47(3):440-449. doi:10.1080\/10790268.2022.2108665."},{"issue":"1","key":"b4","series-title":"BMC Neurosci","first-page":"58","article-title":"Morphine-induced changes in the function of microglia and macrophages after acute spinal cord injury","volume":"23","author":"Terminel MN","year":"2022","unstructured":"Terminel MN, Bassil C, Rau J, et al. Morphine-induced changes in the function of microglia and macrophages after acute spinal cord injury. BMC Neurosci. 2022;23(1):58. doi:10.1186\/s12868-022-00739-3."},{"issue":"4","key":"b5","series-title":"Arch Phys Med Rehabil","first-page":"729","article-title":"Prevalence and impact of neuropathic and nonneuropathic pain in chronic spinal cord injury","volume":"103","author":"Felix ER","year":"2022","unstructured":"Felix ER, Cardenas DD, Bryce TN, et al. Prevalence and impact of neuropathic and nonneuropathic pain in chronic spinal cord injury. Arch Phys Med Rehabil. 2022;103(4):729-737. doi:10.1016\/j.apmr.2021.06.022."},{"issue":"5","key":"b6","series-title":"Spinal Cord","first-page":"520","article-title":"Treatments that are perceived to be helpful for non-neuropathic pain after traumatic spinal cord injury: A multicenter cross-sectional survey","volume":"59","author":"Tsai CY","year":"2021","unstructured":"Tsai CY, Bryce TN, Delgado AD, et al. Treatments that are perceived to be helpful for non-neuropathic pain after traumatic spinal cord injury: A multicenter cross-sectional survey. Spinal Cord. 2021;59(5):520-528. doi:10.1038\/s41393-021-00621-9."},{"issue":"4","key":"b7","series-title":"Spinal Cord","first-page":"282","article-title":"The International Spinal Cord Injury Pain Basic Data Set (version 2.0)","volume":"52","author":"Widerstrom-Noga E","year":"2014","unstructured":"Widerstrom-Noga E, Biering-Sorensen F, Bryce TN, et al. The International Spinal Cord Injury Pain Basic Data Set (version 2.0). Spinal Cord. 2014;52(4):282-6. doi:10.1038\/sc.2014.4."},{"issue":"11","key":"b8","series-title":"Spinal Cord","first-page":"1036","article-title":"The International Spinal Cord Injury Pain Extended Data Set (Version 1.0)","volume":"54","author":"Widerstrom-Noga E","year":"2016","unstructured":"Widerstrom-Noga E, Biering-Sorensen F, Bryce TN, et al. The International Spinal Cord Injury Pain Extended Data Set (Version 1.0). 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Spinal Cord Injury Pain Instrument and painDETECT questionnaire: Convergent construct validity in individuals with Spinal Cord Injury. Eur J Pain. 2017;21(10):1642-1656. doi:10.1002\/ejp.1069."},{"issue":"5","key":"b11","series-title":"J Spinal Cord Med","first-page":"901","article-title":"Chronic opioid prescription in veterans with spinal cord injury: Prevalence and associated factors","volume":"48","author":"Strong C","year":"2025","unstructured":"Strong C, Burns SP, Arewasikporn A, et al. Chronic opioid prescription in veterans with spinal cord injury: Prevalence and associated factors. J Spinal Cord Med. 2025;48(5):901-911. doi:10.1080\/10790268.2024.2378556."},{"issue":"17","key":"b12","series-title":"Int J Environ Res Public Health","article-title":"Opioid pain medication prescription for chronic pain in primary care centers: The roles of pain acceptance, pain intensity, depressive symptoms, pain catastrophizing, sex, and age","volume":"17","author":"Ramirez-Maestre C","year":"2020","unstructured":"Ramirez-Maestre C, Reyes-Perez A, Esteve R, Lopez-Martinez AE, Bernardes S, Jensen MP. Opioid pain medication prescription for chronic pain in primary care centers: The roles of pain acceptance, pain intensity, depressive symptoms, pain catastrophizing, sex, and age. 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