The impact of substance use on the work ability among persons with chronic pain: A scoping review

BackgroundChronic pain is a prevalent condition with profound impacts on occupational performance and work ability. Substance use for pain management is common, involving both pain medications and other substances such as cannabis and alcohol. While work ability in persons with chronic pain has been studied, limited research examines how substance use influences work ability.ObjectiveThis scoping review aimed to summarize research on the impact of substance use on work ability in persons with chronic musculoskeletal pain to identify knowledge gaps and inform interventions.MethodsA scoping review approach was employed. Keywords and databases were defined, followed by a comprehensive literature search. Studies were screened by title, abstract, and full text. Inclusion criteria focused on adults with chronic musculoskeletal pain, excluding pediatric and neuropathic pain populations.ResultsFrom 4903 identified studies, 3253 abstracts and 159 full texts were screened, yielding 53 relevant studies. Most originated from North America and Europe. Findings revealed a complex relationship between substance use and work ability. Opioid use was frequently associated with reduced work ability, increased absenteeism, and decreased likelihood of returning to work. Conversely, limited evidence suggested opioids and methadone could facilitate work ability in specific cases.ConclusionSubstance use significantly affects the work ability of persons with chronic pain, often diminishing occupational performance and increasing absenteeism. Addressing these challenges necessitates integrative health and social strategies and further exploration of comprehensive, interprofessional interventions.