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Kara Link: Working to Understand the Connections Between Chronic Pain and Substance Misuse

By Susan Chandler

Body

Kara Link grew up in Snoqualmie, a small affluent town outside Seattle. Her father was a software engineer and her mother a nurse. When she started her freshman year at the University of Washington (UW) in downtown Seattle, Link realized how idyllic her hometown had been. “It really opened my eyes. I saw struggles that weren’t part of the community I was raised in,” she remembers. In between classes, Link volunteered at a shelter for young adults experiencing housing instability, some of whom also had problems with alcohol or substance use. 

 Link quickly noticed that shelter residents had very little say in their treatment plans, and some of them wished they had more input into their goals. That affected their motivation and engagement with treatment. “We all have a voice that is worth being heard,” she says. 

Halfway through college, Link changed her major from Spanish to psychology and sought out an opportunity to do research. She found one at nearby Seattle Children’s Hospital, which was investigating whether behavioral therapy like motivational interviewing could reduce the symptoms of attention deficit hyperactivity disorder (ADHD) in teens. She learned a lot about data analysis and manuscript preparation. 

When Link graduated in 2021, she looked for a full-time research position that would prepare her to apply to doctoral programs in clinical psychology. Link also wanted a job where she would work under a mentor. Again, the opportunity was close by, this time in the lab of Dawn Ehde, PhD, a clinical psychologist and professor of psychology and rehabilitation medicine at UW. Later that year, Link was hired as a full-time research coordinator in Ehde’s lab. 

 Ehde is also a veteran researcher in the field of rehabilitation psychology who always has several research projects running at the same time. Link began working with Ehde on a project funded through the Center for Rehabilitation Outcomes Research (CROR) at Shirley Ryan AbilityLab. The project examines whether telephone-delivered therapy can help people with disabilities, including multiple sclerosis (MS), stay employed. MS, a disease of the central nervous system, is characterized by chronic neuropathic pain, and many people eventually give up their jobs because of it.

During Link’s phone conversations with study participants, several mentioned using cannabis to ease their pain. “That sparked my interest,” she remembers. Link undertook a secondary analysis of a previous study to explore pain and cannabis use in people with MS. “Chronic pain can be quite debilitating, and people try a lot of ways to cope with it,” says Link. Link found that nearly 30% of people with MS were using cannabis for pain relief. She published her findings in 2023 in the journal Multiple Sclerosis and Related Disorders. “That’s what I appreciate about all of our work,” she says. “We look at the whole person, biological, social and psychological.” 

 These days, Link is preparing applications to PhD psychology programs with the goal of starting in 2024. She is interested in programs that will train her in both research and clinical work. “I look at Dawn and get to see her doing both. It’s an aspiration of mine. People tell me that research and clinical work aren’t 50/50. They’re 100/100. It’s basically two full-time jobs, but I’m alright with that.” 

One thing she is certain about is that her next move will take her out of the Pacific Northwest. “It’s non-negotiable that I will go somewhere other than Washington. I love the Southwest,” she says. “If I could make it there, that would be my dream.”

Read more from the Winter 2023 issue of CROR Outcomes