Date of Award

8-22-2025

Date Published

September 2025

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Advisor(s)

Joseph Ditre

Keywords

Chronic pain;Substance use

Subject Categories

Clinical Psychology | Psychology | Social and Behavioral Sciences

Abstract

Growing concern and research attention have focused on potential harms associated with widespread use of benzodiazepine (BZD) medications. Individuals with chronic pain bear a disproportionate burden, characterized by higher rates of BZD prescriptions, longer-term use, and increased dependence compared to the general population. Although theory and emerging evidence suggest that pain may play a role in the maintenance of BZD use, there is no extant data describing how individuals perceive interrelations between their pain and BZD use. The aims of the present study were to conduct a thematic analysis of interview data regarding perceptions of interrelationships between pain and BZD use and to integrate these findings with theory. Participants included 18 adults (Mage = 42.3, 66.7% female) with chronic pain who reported at least weekly BZD use and having a BZD prescription for ≥ 4 weeks. Interviews were conducted via videoconferencing and audio-recordings were transcribed and coded by two independent raters. Thematic analysis culminated in five themes, including: (1) use of BZDs for pain management; (2) pain as a barrier to discontinuing BZD use; (3) concurrent use of BZDs with other pain medications; (4) that BZDs are often prescribed in the context of medical complexity and uncertainty; and (5) that BZDs are perceived to be an enduring staple of pain treatment. These findings offer timely insight into the central role that BZDs play in pain management for some individuals with chronic pain. This is particularly relevant in the context of ongoing efforts to address BZD use and overuse among chronic pain populations.

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Open Access

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