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Peer-reviewedCC BYFrontiers in psychology

Two dimensions of pain acceptance: divergent links to opioid misuse and readiness to change

  • Lara Rose LoBrutto1
  • Emily Donovan2
  • Sophia Burke3
  • Wally Smith3
  • Dace Svikis1
  • Taylor Crouch3
  1. 1Department of Psychology Virginia Commonwealth University , , ,
  2. 2VA James A Haley Hospital , , ,
  3. 3Department of Psychiatry Virginia Commonwealth University School of Medicine , , ,
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Abstract

More than 13 million Americans remain on long-term opioid therapy for chronic pain (CP) despite well-established risks and no quality evidence of long-term benefits. Pain acceptance, defined as willingness to experience pain and engage in valued life activities despite pain, has been consistently linked to improved pain outcomes and more recently identified as a protective factor against opioid misuse. This study examined the relationship between both factors of pain acceptance and opioid misuse behaviors and readiness to change opioid use among opioid-using individuals with CP. A community sample of adults with a variety of CP conditions using opioid medications (N = 157) were recruited through ResearchMatch.org. Participants completed self-report questionnaires, including the Chronic Pain Acceptance Questionnaire (CPAQ), Prescription Opioid Misuse Index (POMI), Brief Pain Inventory (BPI), and single-item Visual Analog Scale (VAS) measures of readiness and confidence to discontinue opioid use. Two CPAQ subscales (activity engagement and pain willingness) and pain severity were entered into a logistic regression predicting POMI score and multiple linear regression models predicting readiness and confidence to reduce opioid use. All three models were significant (p < 0.05). Activity engagement was associated with greater odds of opioid misuse, whereas pain willingness was associated with lower odds of misuse. In contrast, higher activity engagement and lower pain willingness predicted higher readiness and confidence to taper opioid use. Findings demonstrate nuances in the dimensions of pain acceptance and support the value of further exploring activity engagement and pain willingness in efforts to reduce opioid-related risks.

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Cite

BibTeXRIS
BibTeX
@article{lobrutto2026dimensions,
  title = {{Two dimensions of pain acceptance: divergent links to opioid misuse and readiness to change}},
  author = {Lara Rose LoBrutto and Emily Donovan and Sophia Burke and Wally Smith and Dace Svikis and Taylor Crouch},
  journal = {Frontiers in psychology},
  year = {2026},
  month = oct,
  doi = {10.3389/fpsyg.2026.1879837},
  url = {https://europepmc.org/article/PMC/PMC13719579},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Two dimensions of pain acceptance: divergent links to opioid misuse and readiness to change
AU  - Lara Rose LoBrutto
AU  - Emily Donovan
AU  - Sophia Burke
AU  - Wally Smith
AU  - Dace Svikis
AU  - Taylor Crouch
PY  - 2026
DA  - 2026/10/16
JO  - Frontiers in psychology
DO  - 10.3389/fpsyg.2026.1879837
UR  - https://europepmc.org/article/PMC/PMC13719579
AB  - More than 13 million Americans remain on long-term opioid therapy for chronic pain (CP) despite well-established risks and no quality evidence of long-term benefits. Pain acceptance, defined as willingness to experience pain and engage in valued life activities despite pain, has been consistently linked to improved pain outcomes and more recently identified as a protective factor against opioid misuse. This study examined the relationship between both factors of pain acceptance and opioid misuse behaviors and readiness to change opioid use among opioid-using individuals with CP. A community sample of adults with a variety of CP conditions using opioid medications (N = 157) were recruited through ResearchMatch.org. Participants completed self-report questionnaires, including the Chronic Pain Acceptance Questionnaire (CPAQ), Prescription Opioid Misuse Index (POMI), Brief Pain Inventory (BPI), and single-item Visual Analog Scale (VAS) measures of readiness and confidence to discontinue opioid use. Two CPAQ subscales (activity engagement and pain willingness) and pain severity were entered into a logistic regression predicting POMI score and multiple linear regression models predicting readiness and confidence to reduce opioid use. All three models were significant (p < 0.05). Activity engagement was associated with greater odds of opioid misuse, whereas pain willingness was associated with lower odds of misuse. In contrast, higher activity engagement and lower pain willingness predicted higher readiness and confidence to taper opioid use. Findings demonstrate nuances in the dimensions of pain acceptance and support the value of further exploring activity engagement and pain willingness in efforts to reduce opioid-related risks.
SN  - 1664-1078
ER  -