A Longitudinal Study of Anxious and Depressive Symptomology and Pain Medication Usage

Evidence suggests that depression and anxiety may be related to pain medication use in a bidirectional manner. Understanding the relationship of these factors is of heightened importance due to the extensive use of long-term opioid pain medication therapy for treatment of adults suffering from chronic pain. The present study, utilizing a large longitudinal sample from the National Survey of Midlife Development in the United States (MIDUS), examined the relationship between depression, anxiety, gender, and pain medication usage in individuals with chronic pain over an almost 20-year span. Structural equation modeling found stability of depression and anxiety in individuals with chronic pain. It also appears that both anxiety and depression may have a bidirectional positive relationship in this population. As expected, pain medication use predicted later use at 10 years. Surprisingly, pain medication use was not strongly related to later negative affect in this sample. However, heightened anxiety was associated with later pain medication use. Gender effects were nonsignificant. Implications for those who are prescribed pain medications over a long term are discussed.