Associations Between Pain Acceptance and Opioid Use Among Adults Living with Chronic Pain: A Systematic Review

Clin J Pain. 2026 Oct 15. doi: 10.1097/AJP.0000000000001422. Online ahead of print.

ABSTRACT

OBJECTIVES: Pain acceptance is a psychological mechanism that may play a role in opioid use and misuse among adults living with chronic pain. This study aims to synthesize the available evidence exploring the association between pain acceptance and opioid use outcomes in adults with chronic pain.

METHODS: A systematic review was conducted in October 2025 by searching PubMed, PsycInfo, and Web of Science using predefined search terms and systematic review criteria to identify the published literature that explores association between pain acceptance and prescription opioid use or misuse.

RESULTS: A total of 14 studies were identified. Most studies indicated that pain acceptance may be negatively associated with opioid use (i.e., those with greater pain acceptance are less likely to report opioid use and misuse). This association was primarily supported through correlational research, with some preliminary intervention effects reported as well.

DISCUSSION: This systematic review highlights that pain acceptance may be a protective factor for attenuating opioid use and misuse among adults with chronic pain. Further clinical research is needed to explore whether pain acceptance can be leveraged to decrease opioid use and misuse.

PMID:42876162 | DOI:10.1097/AJP.0000000000001422