What's the root cause of the opioid epidemic? A strong case can be made for pain. Pain prompts people to ask their doctors for drugs. Pain keeps them taking those pills for so long that they get addicted.
So what's the source of all this suffering, as well as our inability to manage it without heavy-duty pharmaceuticals? Recent research provides a provocative answer.
It finds people who experienced more trauma and adversity in childhood and adolescence tend to experience greater pain as adults. Such people often are plagued by bad moods and/or poor sleep, which apparently intensifies their physical discomfort.
The study confirms and extends "a body of research showing a connection between early life adversity and pain," co-author Jennifer Graham-Engeland of Pennsylvania State University said in announcing the results. It further finds this effect is somewhat attenuated by maintaining an attitude of optimism, or feeling in control.
The study, led by Ambika Mathur, featured 265 residents of a housing complex in the Bronx, New York. Participants, who were between the ages of 25 and 65, were asked whether they ever experienced eight types of childhood adversity, including sexual abuse, major illness, drug use, or parental divorce. All reported experiencing at least one.
They also reported their levels of "depressive, angry, and anxious feelings over the past week; any difficulties falling or staying asleep; and their general level of optimism, and sense they were in control of their lives. Finally, on a 12-point scale, they noted their current level of pain, their average level over the past week, and the extent to which pain interfered with their daily activities."
"We found that higher levels of recalled early adversity were associated with higher recent pain intensity and interference," the researchers write in the Journal of Behavioral Medicine. Further analysis suggests these emotional traumas produced mood and sleep disturbances, which made it more difficult for them to cope with physical pain.
"Those who have experienced early life adversity are particularly likely to be struggling with not only mood, but concomitant sleep and pain issues," they conclude.
The good news is that a positive attitude helped them function better in spite of their discomfort. "The participants who felt more optimistic, or in control of their lives, may have been better at waking up with pain, but somehow managing to not let it ruin their day," Mathur said.
Of course, you can't undo a bad childhood. But you can deal with its effects—and, perhaps, regain your lost sense of being in control—by working with a therapist. Making such services more available and affordable, and reducing the stigma that sometimes still surrounds them, may help people avoid addiction later on.
Often, it seems, coming to terms with emotional pain allows one to live better with physical pain.