Cannabis use and its association with daily functioning in young adults with chronic pain: an ecological momentary assessment burst design - PROJECT SUMMARY/ABSTRACT Cannabis use among young adults has increased dramatically over the past decade, with nearly 1 in 3 young adults in the U.S. reporting past month use. Young adulthood is a high-risk period for the development of substance use problems in general and a subset of young people may be at especial risk: those with chronic pain. Chronic pain is a major public health concern associated with significant morbidity and mortality. Although underrepresented in pain research, epidemiological surveys and systematic reviews suggest that up to 20% of young adults experience recurrent or persistent pain problems that are associated with a wide range of negative outcomes, including poor sleep, physical activity limitations and reduced quality of life. Due to widespread beliefs about its pain-relieving properties, young adults with chronic pain may be using cannabis to manage their symptoms. Although cannabis has garnered considerable attention as a potential treatment for chronic pain, its therapeutic potential—especially in young adults—remains unknown. Further, the impact of naturalistic cannabis consumption on functional outcomes, including pain-related impairment, physical (in)activity, and sleep is poorly understood. The overall objective of the proposed study is to holistically examine how cannabis use is related to pain and functioning (i.e., pain-related disability, physical (in)activity, sleep) in the daily lives of young adults with chronic pain. The proposed research will use an innovative 6-month longitudinal measurement burst design to capture momentary experiences and changes over time in a projected sample of N = 60 cannabis-using young adults with chronic pain. We will examine relationships between naturalistic cannabis use, pain perception and functioning in participants’ daily lives during three 2-week ecological momentary assessment (EMA) periods each separated by approximately 8 weeks. This approach will enable the research team to track intraindividual change including nuanced daily associations and longer-term change with less burden to participants. We will test how daily pain and functioning vary as a function of cannabis use at the momentary and daily level and whether these relationships (as well as cannabis use patterns) change over time. The results of this study will allow us to determine the conditions under which cannabis may improve or impair daily functioning and well-being among young adults with chronic pain. These findings will directly inform the development of a larger study to identify adaptive and maladaptive cannabis use patterns of young adults and the longer-term impact of cannabis use on pain and pain-related functioning. Our ultimate goal is to identify and test novel targets or critical time points for effective chronic pain and substance misuse prevention, both of which represent national research priorities.
