Everybody Hurts: Intersecting and Colliding Epidemics and the Need for Integrated Behavioral Treatment of Chronic Pain and Substance Use

Abstract

Chronic pain and substance use disorders (SUDs) are common, debilitating, and often persist over the longer term. On their own, each represents a significant health problem, with estimates indicating a substantial proportion of the adult population has chronic pain or an SUD, and their co-occurrence is increasing. Chronic pain and SUD are often invisible, stigmatized disorders, and persons with both regularly have difficulty accessing evidence-based treatments, particularly those that offer coordinated and integrated treatment for both conditions. But there is hope. Research is unraveling the mechanisms of chronic pain and substance use, as well as their co-occurrence; integrated behavioral treatment options based on acceptance- and mindfulness-based approaches are increasingly being developed and tested; government agencies are devoting more funds and resources to research on chronic pain and SUD; and there have been growing efforts in training, dissemination, and implementation of evidence-based treatments. At the heart of the matter, though, is the need to recognize that everybody hurts sometimes and treatments must empower people to life effectively with these experiences of being human.