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Editor's e-Note
Pain management is a complex health issue that has long challenged professionals hoping to offer solutions for their clients’ relief. Researchers from the Substance Use, Pain, and Health Research Lab at Binghamton University have reviewed more than 100 studies on pain and substance use. They integrated the findings to propose a reciprocal model in which pain and substance use interact in a positive feedback loop, resulting in greater pain and continued substance use.

Read more about the research, other factors, and how the findings could influence current and future treatment approaches in this month’s E-News Exclusive.

We welcome your comments at Visit our website at, like our Facebook page, and follow us on Twitter.

— Marianne Mallon, editor
e-News Exclusive
Pain and Substance Use — A Reciprocal Model
By Lindsey Getz

Pain and substance use can interact in a cycle that can ultimately worsen and maintain both chronic pain and substance use and misuse, according to new research. This is important information for social workers to keep in mind as they work with clients who face these challenges.

In the research, recently published in the Annual Review of Clinical Psychology, researchers Joseph W. Ditre, PhD; Emily L. Zale, PhD; and Lisa R. LaRowe, MS, examined results from more than 100 studies on pain and substance use. The team then integrated these findings to propose a reciprocal model in which pain and substance use interact in the manner of a positive feedback loop, resulting in greater pain and continued substance use.

“Research studies usually examine either how substance use affects pain or how pain affects substance use,” explains Zale, an assistant professor in the department of psychology and director of the Substance Use, Pain, and Health Research Lab at New York’s Binghamton University. “But our reciprocal model puts these two different types of research together to understand how pain and substance use affect each other.”

On one hand, substance use can be a risk factor for chronic pain and may worsen pain over time. On the other hand, experiencing pain can motivate people to use substances and might make it harder to quit, Zale adds.

“We propose that the two conditions interact in the manner of a positive feedback loop, which means that they can increase each other over time,” she says. “Another way to think about this relationship is as a vicious cycle—substance use can worsen pain, pain can motivate escalations in substance use or make it harder to quit—and these repeated cycles can result in more severe pain and worsening addiction.”

Full story »
Letter to the Editor
“Bridging the Anti-Vax Gap — Helping Parents Navigate Anti-Vax Social Media and Online Information” by Lindsey Getz, the SWT August E-News Exclusive, addresses a timely issue. Getz advised not to dismiss families with anti-vax beliefs; rather, social workers should spend time understanding what is fueling the beliefs and tailor messages when educating and informing parents fearful of vaccines.

As a parent of two teenagers, this is a personal issue for me. My 13-year-old daughter, who received all her vaccinations, suddenly became ill, missing four months of 7th grade. Ten doctors and dozens of tests were inconclusive; no diagnosis. We were in anguish and emotionally fragile, though headstrong to find a solution. All 10 doctors were asked loads of questions, including whether a vaccine she received weeks before first signs of symptoms was related. All doctors disregarded this possibility. We eventually learned that every symptom is directly correlated to possible side effects of the vaccine. As parents we felt betrayed; our daughter has chronic conditions and therefore immunocompromised—conditions that science admits make her susceptible to severe side effects from vaccines. Our pediatrician did not inform us of potential consequences, in effect taking away the opportunity to make an informed decision—to decide between the risk of receiving the vaccine or declining a vaccination.

Vaccines may be safe for most, yet unsafe for some, as vaccines were for my daughter. As helping professionals, Getz is right; we should spend time understanding parents’ concerns and provide education. However, we should not assume that parents are making critical decisions based on faulty science or social media influence. Rather, parents may have done legitimate and thorough research to be informed about vaccines. Instead of trying to persuade families to vaccinate, social workers should consider what is in the best interest of a specific child—e.g., to teach families choosing not to vaccinate how to communicate with physicians, so that safety measures can be taken to reduce risks.

I applaud Getz for tackling this issue and urge my social worker colleagues to promote self-determination and remain open-minded that vaccines may be right for most—not necessarily for all.

— Barry Granek, LMHC
Tech & Tools
How Technology Shapes Mass Murder

In 1919, America had a problem with dynamite. Specifically, dynamite in bombs.

In April of that year, radical anarchists mailed at least 36 dynamite-filled bombs to prominent politicians, government officials, and others in the United States. In June, another nine were sent. Several people were killed and more were injured.

The response from the U.S. Congress? It passed the National Firearms Act, which, among other things, made it much more difficult for members of the public to buy dynamite.

“Our government took action on dynamite sales because that was what anarchists were using to try to kill public officials,” says Randolph Roth, PhD, a professor of history at The Ohio State University.

“That wasn’t the only time. Whenever new technology has been used to kill people, the government has stepped in to regulate it.”

Read more »
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