• Health Psychology, Addiction Psychology, Behavioral Medicine
• Substance Use Disorders and Chronic Medical Conditions (co-occurrence and reciprocity)
  • (e.g., Nicotine/Tobacco, Alcohol, Cannabis, Opioids, Chronic Pain, Cancer, HIV)
• Comorbid Psychopathology and Cognitive-Affective Factors
  • (e.g., Anxiety/Depression, Catastrophizing, Coping, Fear Avoidance, Expectancies)
• Human Experimental Models of Pain and Substance Use
  • (e.g., Psychosocial, Pathophysiological, and Neurobiological Mechanisms of Action)
• Translation of Basic Research to Inform the Development of Novel Treatments
  • (e.g., Integrated/Sequential, Personalized Feedback, and Cue Exposure Interventions)
• Integrated Healthcare and Primary Care-Based Research/Intervention Development
  • (e.g., Center for Integrated Healthcare, US Department of Veterans Affairs)

Dr. Joseph W. Ditre is a Professor in the Department of Psychology at Syracuse University. He is a licensed clinical psychologist and holds secondary appointments in the Department of Medicine at Upstate Medical University, and in the Center for Integrated Healthcare at the Syracuse VA Medical Center. He is also Director of the Pain and Addiction Research Lab and the Program for Advancing Health Equity in Pain and Addiction.

Dr. Ditre’s clinical translational research applies a multi-method approach to address complex interplay between the experience of acute/chronic pain, use/misuse of addictive substances (prescription opioids, nicotine/tobacco, alcohol, cannabis, benzodiazepines), comorbid psychopathology (anxiety, depression), and social determinants of health (driving factors for health disparities in racial/ethnic and socioeconomically disadvantaged populations).

Dr. Ditre’s research cuts across basic and applied work in the areas of health psychology and behavioral medicine, with an emphasis on the intersection of addictive behaviors and comorbid medical disorders. At the broadest level, this research examines how the use of substances may influence the onset and progression of comorbid medical disorders, and how the symptoms and sequelae of medical disorders may influence the use of addictive substances. More specifically, he has established a programmatic line of research that applies a multi-method approach to the study of complex interrelations between pain, affect, comorbid psychopathology, and the maintenance of addiction.

Dr. Ditre’s has published over 100 scholarly works, and his program of research has been funded by National Institutes of Health since 2007, with a primary focus on conceptualizing and testing bi-directional relations between the experience of acute and chronic pain and the self-administration of nicotine, tobacco, alcohol, cannabis, benzodiazepines, and prescription opioids.

Pain and substance use are highly prevalent and co-occurring conditions that continue to garner increasing clinical and empirical interest. Although nicotine/tobacco, alcohol, and cannabis can each confer acute analgesic effects, frequent/heavy use may contribute to the development and progression of chronic pain, and pain may be heightened during abstinence. Additionally, pain can be a potent motivator of substance use and may contribute to escalating use and poorer substance-related treatment outcomes. We integrated converging lines of evidence to propose a reciprocal model in which pain and substance use are hypothesized to interact in the manner of a positive feedback loop, resulting in the exacerbation and maintenance of both conditions over time.

Examples of completed and ongoing grant-funded projects include: development of mHealth intervention to address hazardous drinking and alcohol-opioid co-use among adults with chronic pain (R01AA028639, MPI: Ditre, Zvolensky); examination of complex interrelations between the experience of pain and the consumption of alcohol (R01AA024844, MPI: Ditre, Maisto); testing the effects of situational pain on smoking urge and behavior (F31DA023728, PI: Ditre); testing the effects of nicotine deprivation on experimental pain reactivity (R21DA034285, PI: Ditre); and applying these data to develop novel treatments for individuals with co-occurring pain, prescription opioid misuse, and substance use disorders (R21DA038204, PI: Ditre; F31DA039628, PI: Zale).

In addition to directing the PAR Lab, Dr. Ditre serves as instructor and research mentor for undergraduate students and graduate students in the clinical psychology doctoral program at Syracuse University. He is also a member of the editorial board for Psychology of Addictive Behaviors, and is a standing member of the Lifestyle Change and Behavioral Health (LCBH) Study Section, Center for Scientific Review, National Institutes of Health.

R01AA028639 (MPI: Ditre, Zvolensky)
09/2020 - 06/2024
NIH / NIAAA
Personalized Feedback Intervention to Address Hazardous Drinking and Alcohol-Opioid Interactions Among Adults with Chronic Pain
The goal of this study is to develop (Phase IA) and test (Phase IB) a brief, integrated, single-session, computer-based personalized feedback intervention (PFI) designed to enhance knowledge of adverse pain-alcohol-opioid interrelations, increase motivation and intention to reduce hazardous drinking, and reduce positive attitudes/intention regarding the concurrent use of alcohol and prescription opioid medications.

P50MD0173472 (Wilkins, Weiss, Miller-Hughes, & Cox)
09/2021-06/2026
NIH / NIMHD
Southeast Collaborative for Innovative and Equitable Solutions to Chronic Disease Disparities
Accelerating Health Equity via Just-In-Time Adaptive Interventions (JITAIs): Scalable and High Impact mHealth Precision Smoking Relapse Prevention
This project will evaluate effectiveness for smoking cessation and relapse prevention via pragmatic remote SMART design: 1) QuitBuddy, a mobile app guided by GPS and AI/ML to personalize and automate proactive treatment delivery, and 2) an SDoH augmentation intervention designed to enhance resource access and equitable healthcare. Exploratory Aims will test the mechanisms of action (e.g., resilience, engagement, cessation fatigue), potential moderators (e.g.,SDoHs, chronic disease diagnoses), and generalizability across representative samples of vulnerable populations (race/ethnicity and sex).

F31DA054717 (PI: Powers; Sponsor: Ditre)
09/2021 – 09/2023
NIH / NIDA
Longitudinal Associations Between Pain and Use of Cigarettes and E-Cigarettes in the Population Assessment of Tobacco and Health (PATH) Study
The goal of this Predoctoral NRSA is to conduct the first longitudinal study of pain and use/co-use of e-cigarettes and tobacco cigarettes utilizing four waves of nationally representative cohort data collected for the Population Assessment of Tobacco and Health (PATH) Study.

R21DA052729 (PI: Sweitzer)
8/2021-7/2023
NIH / NIDA
Using Very Low Nicotine Content Cigarettes as a Strategy to Disrupt the Pain-Smoking Reinforcement Cycle
This project will examine whether switching to Very Low Nicotine Content (VLNC) cigarettes can disrupt the pain-smoking reinforcement cycle and attenuate withdrawal-induced hyperalgesia among smokers with chronic pain.

P30 (Montez)
7/2020 – 6/2025
NIH / NIA
Demographic, Geographic, and Temporal Trends in Co-Occurring Use Disorders and Mortality from Opioids, other Drugs, and Alcohol among Middle-Age and Older Adults
P30 Center for Aging and Policy studies, an NIA Center on the Demography and Economics of Aging.

R01AA024844 (MPI: Ditre, Maisto)
07/2016 – 06/2022
NIH / NIAAA
The Alcohol-Pain Connection: Mechanisms and Genetic/Psychological Correlates
The goal of this study is to employ an innovative, multi-method approach to examine complex and potentially bidirectional relations between pain and the consumption of alcohol in one overarching experimental paradigm. This research may enhance our understanding of complex pain-alcohol relations, challenge current clinical practice paradigms, and catalyze future work in this emerging domain.

CUSE Grant (PI: Ditre)
05/2019 - 06/2021
Syracuse University
Effects of Nicotine Replacement and Acceptance on Smoking Abstinence-Induced Hyperalgesia
Collaboration for Unprecedented Success and Excellence (CUSE) Grant Program.

R21DA038204 (PI: Ditre)
07/2014 – 06/2022
NIH / NIDA
PFI for Smoking and Analgesic Misuse among Older Adults with HIV and Chronic Pain
The goal of this study was to adapt and pilot test a brief, integrated, computer-based personalized feedback intervention (PFI) for older adults with comorbid HIV and chronic pain aimed at increasing intentions to quit smoking and decreasing intentions to misuse prescription analgesic medications.

F31DA039628 (PI: Zale; Sponsor: Ditre)
06/2015 – 05/2017
NIH / NIDA
Increasing Cessation Motivation and Treatment Engagement among Smokers in Pain
The goal of this Predoctoral NRSA was to test a brief intervention for smokers with co-occurring pain that is designed to increase knowledge of pain-smoking interrelations, enhance motivation to engage a serious quit attempt, and increase engagement in available smoking cessation treatment.

R21DA034285 (PI: Ditre)
08/2012 – 03/2016
NIH / NIDA
Effects of Smoking Abstinence on Pain Reactivity: A Human Experimental Model
Increased pain or hyperalgesia as a function of smoking abstinence may precipitate relapse and undermine the goals of treatment for both pain and tobacco dependence. The goal of this study was to manipulate smoking abstinence to determine whether nicotine deprivation and subsequent withdrawal effects may increase pain sensitivity/reactivity among current daily smokers.

F31DA023728 (PI: Ditre)
09/2007 – 09/2009
NIH / NIDA
Pain as a Motivator of Smoking: Mechanisms of Action
The goal of this study was to identify potential targets for intervention by testing whether several constructs derived from social cognitive theory may moderate the causal pathway between the experience pain and increased motivation to smoke tobacco.

Click on CV link above or view NIH My Bibliography or Google Scholar

Ditre, J. W., Zale*, E. L., & LaRowe*, L. R. (2019). A Reciprocal Model of Pain and Substance Use: Transdiagnostic Considerations, Clinical Implications, and Future Directions. Annual Review of Clinical Psychology, 15(1), 503-528. doi: 10.1146/annurev-clinpsy-050718-095440.

Nicotine/Tobacco

Ditre, J. W., LaRowe*, L.R., Powers*, J. M., & *Hooker, J.E. (2022). Nicotine, Tobacco Smoking, and E-Cigarettes. In G. Asmundson and G. Crombez (Eds.), Comprehensive Clinical Psychology, 2nd Edition. Hardcover ISBN: 9780128186978

Ditre, J. W., Heckman, B. W., LaRowe*, L. R., & Powers*, J, M. (2021). Pain Status as a Predictor of Smoking Cessation Initiation, Lapse, and Relapse. Nicotine & Tobacco Research. https://doi.org/10.1093/ntr/ntaa111

Powers*, J.M., LaRowe*, L.R., Lape*, E.C., Zvolensky, M.J., & Ditre, J.W. (2021). Anxiety Sensitivity, Pain Severity, and Co-Use of Cigarettes and E-Cigarettes among Adults with Chronic Pain. Journal of Behavioral Medicine, 44,3, 392-401. doi: 10.1007/s10865-021-00210-4.

LaRowe*, L. R. & Ditre, J. W. (2020). Pain, Nicotine, and Tobacco Smoking: Current State of the Science. Pain. 161(8), 16881693. doi: 10.1097/j.pain.0000000000001874.

Zale*, E. L., Maisto, S. A., De Vita*, M. J., Hooten, W. M., & Ditre, J. W. (2020). Increasing Cessation Motivation and Treatment Engagement Among Smokers in Pain: A Pilot Randomized Controlled Trail. Experimental and Clinical Psychopharmacology. http://dx.doi.org/10.1037/pha0000424.

De Vita*, M. J., Maisto, S. A., Ansell, E. B., Zale*, E. L., & Ditre, J. W. (2019). Pack-Years of Tobacco Cigarette Smoking as a Predictor of Spontaneous Pain Reporting and Experimental Pain Reactivity. Experimental and Clinical Psychopharmacology. doi:10.1037/pha0000258

Powers*, J.M., LaRowe*, L.R., Heckman, B.W., & Ditre, J.W. Pain Characteristics and Nicotine Deprivation as Predictors of Performance during a Laboratory Paradigm of Smoking Cessation. Psychology of Addictive Behaviors.

Zvolensky, M. J., Bakhshaie, J., Shepherd, J. M., Mayorga, N. A., Giraldo-Santiago, N., Peraza, N., Rogers, A. H., Ditre, J. W., & Berger-Cardoso, J. (2019). Pain intensity and tobacco smoking among Latinx Spanish-speaking adult smokers. Addictive Behaviors, 93, 115-121. doi:10.1016/j.addbeh.2019.01.036

Zvolensky, M. J., Garey, L., Mayorga, N. A., Peraza, N., Rogers, A. H., Ditre, J. W., & Orr, M. F. (2019). Pain severity and anxiety sensitivity interplay among exclusive and dual electronic cigarette users. Journal of Studies on Alcohol and Drugs, 80(2), 211–219. doi: 10.15288/jsad.2019.80.211.

Ditre, J. W., Zale*, E. L., LaRowe*, L. R., Kosiba*, J. D., & De Vita*, M. J. (2018). Nicotine deprivation increases pain intensity, neurogenic inflammation, and mechanical hyperalgesia among daily tobacco smokers. Journal of Abnormal Psychology, 127(6), 578-589. doi: 10.1037/abn0000353.

Alcohol

White*, K.M., LaRowe*, L.R., Powers*, J.M., Paladino*, M.B., Maisto, S.A., Zvolensky, M.J., Glatt, S.J., & Ditre, J.W. (2022). Family History of Alcohol Use Disorder as a Predictor of Endogenous Pain Modulation Among Moderate to Heavy Drinkers. The Journal of Pain. doi: 10.1016/j.jpain.2021.12.005.

Hooker*, J.E., LaRowe*, L.R., Powers*, J. M., & Ditre, J. W. (2022). Pain intensity, emotion dysregulation, and hazardous drinking among adults with chronic pain. Journal of Studies on Alcohol and Drugs, 83(2), 223–230.

LaRowe*, L.R., Maisto, S.A., & Ditre, J.W. (2021). A Measure of Expectancies for Alcohol Analgesia: Preliminary Factor Analysis, Reliability, and Validity. Addictive Behaviors. doi: https://doi.org/10.1016/j.addbeh.2021.106822.

LaRowe*, L. R., Powers*, J. M., Garey, L., Rogers, A. H., Zvolensky, M. J., & Ditre, J. W. (2020). Pain-Related Anxiety, Sex, and Co-Use of Alcohol and Prescription Opioids among Adults with Chronic Pain. Drug and Alcohol Dependence, 214, 108171. doi: 10.1016/j.drugalcdep.2020.108171.

Powers*, J. M., Zvolensky, M. J., & Ditre, J. W. (2019). An Integrative Review of Personalized Feedback Interventions for Pain and Alcohol. Current Opinion in Psychology, 30, 48-53. doi:10.1016/j.copsyc.2019.01.013

Zale, E. L., LaRowe*, L. R., Boissoneault, J., Maisto, S. A., & Ditre, J. W. (2019). Gender differences in associations between pain-related anxiety and alcohol use among adults with chronic pain. The American Journal of Drug and Alcohol Abuse, 1-9. doi:10.1080/00952990.2019.1578968

Rogers, A. H., Shepherd, J. M., Paulus, D. J., Orr, M. F., Ditre, J. W., Bakhshaie, J., & Zvolensky, M. J. (2019). The interaction of alcohol use and cannabis use problems in relation to opioid misuse among adults with chronic pain. International Journal of Behavioral Medicine.

Moskal*, D., Maisto, S. A., De Vita*, M., Ditre, J. W. (2018). Effects of experimental pain induction on alcohol urge, intention to consume alcohol, and alcohol demand. Experimental and Clinical Psychopharmacology. 26(1), 65-76. http://dx.doi.org/10.1037/pha0000170.

Paulus, D. J., Ditre, J.W., Viana, A.G., Bakhshaie, J., Garza, M., Valdivieso, J., Ochoa-Perez, M., Lemaire, C., & Zvolensky, M.J. (2018). Pain and alcohol use among Latinos in primary care: Examining rumination as an explanatory factor. Substance Use & Misuse, 53(4), 686-693, DOI: 10.1080/10826084.2017.1361998.

Zale*, E. L., Maisto, S. A., & Ditre, J. W. (2015). Interrelations between pain and alcohol: An integrative review. Clinical Psychology Review, 37, 57-71. doi: 10.1016/j.cpr.2015.02.005

Cannabis

Goodhines*, P. A., LaRowe*, L. R., Gellis, L. A., Ditre, J. W., & Park, A. (2020). Sleep-Related Cannabis Expectancy Questionnaire (SR-CEQ): Initial Development among College Students. Journal of Psychoactive Drugs; 1–11.

Kosiba*, J. D., Maisto, S. A., & Ditre, J. W. (2019). Patient-Reported Use of Medical Cannabis for Pain, Anxiety, and Depression Symptoms: Systematic Review and Meta-Analyses. Social Science & Medicine. doi: 10.1016/j.socscimed.2019.06.005.

Kosiba*, J.D., Mitzel*, L.D., Zale*, E.L., Zvolensky, M.J., & Ditre, J.W. (2019). A Preliminary Study of Associations between Discomfort Intolerance, Pain Severity/Interference, and Frequency of Cannabis Use among Individuals with Chronic Pain. Addiction Research and Theory, 1-6. doi:10.1080/16066359.2019.1590557

Orr, M. F., Rogers, A. H., Shepherd, J. M., Buckner, J. D., Ditre, J. W., Bakhshaie, J., & Zvolensky, M. J. (2019). Is there a relationship between cannabis use problems, emotional dysregulation, and mental health problems among adults with chronic pain? Psychology, Health, and Medicine. doi: 10.1080/13548506.2019.1653485.

Rogers, A. H., Shepherd, J. M., Paulus, D. J., Orr, M. F., Ditre, J. W., Bakhshaie, J., & Zvolensky, M. J. (2019). The interaction of alcohol use and cannabis use problems in relation to opioid misuse among adults with chronic pain. International Journal of Behavioral Medicine.

Manning, K., Rogers, A. H., Bakhshaie, J., Hogan, J. B., Buckner, J. D., Ditre, J. W., & Zvolensky, M. J. (2018). The association between perceived distress tolerance and cannabis use problems, cannabis withdrawal symptoms, and self-efficacy for quitting cannabis: The explanatory role of pain-related affective distress. Addictive Behaviors, 85, 1-7. doi: 10.1016/j.addbeh.2018.05.009.

Hill, K. P., Palastro, M. D., Johnson, B., & Ditre, J. W. (2017). Cannabis and Pain: A Clinical Review. Cannabis and Cannabinoid Research, 2(1), 96–104. doi: 10.1089/can.2017.0017.

Opioids and Prescription Pain Medications

Powers*, J. M., Lape*, E. C., LaRowe*, L. R., Hooker*, J. E., Heckman, B. W., & Ditre, J. W. (2022). Initial Validation of the Intentions to Co-Use Alcohol and Opioids Scale. Journal of Psychoactive Drugs. doi: 10.1080/02791072.2022.2075713.

Zale, E. L., Powers*, J. M., & Ditre, J. W. (2021). Cognitive-Affective Transdiagnostic Factors Associated with Vulnerability to Alcohol and Prescription Opioid Use in The Context of Pain. Alcohol Research, 41,1. doi: 10.35946/arcr.v41.1.08.

Rogers, A. H., Zvolensky, M. J., Ditre, J. W., Buckner, J. D., & Asmundson, G. J. G. (2021). Association of opioid misuse with anxiety and depression: A systematic review of the literature. Clinical Psychology Review. doi: 10.1016/j.cpr.2021.101978.

LaRowe*, L. R., Powers*, J. M., Garey, L., Rogers, A. H., Zvolensky, M. J., & Ditre, J. W. (2020). Pain-Related Anxiety, Sex, and Co-Use of Alcohol and Prescription Opioids among Adults with Chronic Pain. Drug and Alcohol Dependence, 214, 108171. doi: 10.1016/j.drugalcdep.2020.108171.

Rogers, A. H., Orr, M. F., Shepherd, J. M., Bakhshaie, J., Ditre, J. W., Buckner, J. D., & Zvolensky, M. J. (2020). Anxiety, depression, and opioid misuse among adults with chronic pain: The role of emotion dysregulation. Journal of Behavioral Medicine. doi: 10.1007/s10865-020-00169-8.

Ditre, J. W., LaRowe*, L. R., Vanable, P. A., De Vita*, M. J., & Zvolensky, M. J. (2019). Computer-based personalized feedback intervention for cigarette smoking and prescription analgesic misuse among persons living with HIV (PLWH). Behaviour Research and Therapy, 115, 83-89. https://doi.org/10.1016/j.brat.2018.10.013

Rogers, A. H., Shepherd, J. M., Paulus, D. J., Orr, M. F., Ditre, J. W., Bakhshaie, J., & Zvolensky, M. J. (2019). The interaction of alcohol use and cannabis use problems in relation to opioid misuse among adults with chronic pain. International Journal of Behavioral Medicine.

Rogers, A.H., Kauffman, B.Y., Bakhshaie, J., McHugh, R.K., Ditre, J.W., Zvolensky, M.J. (2019). Anxiety Sensitivity and Opioid Misuse among Opioid-using Adults with Chronic Pain. The American Journal of Drug and Alcohol Abuse, 1-9. doi:10.1080/00952990.2019.1569670

Rogers, A.H., Bakhshaie, J., Orr, M.F., Ditre, J.W., Zvolensky, M.J. (2019). Health Literacy, Opioid Misuse, and Pain Experience among Adults with Chronic Pain. Pain Medicine, doi:10.1093/pm/pnz062.

Bakhshaie, J., Rogers, A. H., Kauffman, B. Y., Tran, N., Buckner, J. D., Ditre, J. W., & Zvolensky, M. J. (2019). Emotion dysregulation as an explanatory factor in the relation between negative affectivity and non-medical use of opioid in a diverse young adult sample. Addictive Behaviors, 95, 103-109. doi:10.1016/j.addbeh.2019.02.025

Rogers, A. H., LaRowe*, L. R., Ditre, J. W., & Zvolensky, M. J. (2018). Opioid Misuse and Perceived Smoking-Pain Relationships among HIV+ Individuals with Pain: An Exploratory Study of Negative Affect Responses to Pain. Addictive Behaviors.

LaRowe*, L. R. Chilcott*, L. N., Zvolensky, M. J., Vanable, P. A., Flood, K. & Ditre, J. W. (2018). Associations between Pain-Related Anxiety, Gender, and Prescription Opioid Misuse among Tobacco Smokers Living with HIV/AIDS. Substance Use and Misuse. doi: 10.1080/10826084.2018.1464028.

Rogers, A.H., Bakhshaie, J., Lam, H., Langdon, K.J., Ditre, J.W., Zvolensky, M.J. (2018). Pain-related anxiety and opioid misuse in a racially/ethnically diverse young adult sample with moderate/severe pain. Cognitive Behaviour Therapy. doi: 10.1080/16506073.2018.1436085