Rausch, Johnathan, Harte, Steven E, Williams, David A et al. · Journal of addictive diseases · 2025 · DOI
This study looked at how often chronic pain conditions occur together in people struggling with opioid addiction. Researchers found that people with opioid use disorder have much higher rates of several overlapping pain conditions—including ME/CFS, fibromyalgia, chronic migraines, and chronic back pain—than would be expected in the general population. Understanding this connection may help doctors treat both the pain and addiction more effectively.
This study provides epidemiological evidence that ME/CFS is substantially more prevalent in people with opioid use disorder than in the general population, suggesting an important bidirectional relationship between nociplastic pain conditions and substance use. For ME/CFS researchers and patients, these findings highlight the urgent need to investigate shared biological mechanisms and develop integrated treatment approaches that address both pain and addiction simultaneously.
This cross-sectional study cannot establish causality or determine whether chronic pain conditions lead to opioid use disorder, whether OUD causes these pain conditions, or whether a common underlying mechanism drives both. The study is descriptive and observational, so it does not prove that treating one condition will improve the other, nor does it identify specific treatment interventions. Recruitment from syringe exchange programs may not represent all individuals with OUD, limiting generalizability.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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