A new study finds people with moderate to severe pain have a 41 percent higher risk of opioid addiction, compared to those without pain.

Columbia University researchers surveyed more than 34,000 Americans, HealthDay reports. Males and younger adults were at increased risk for opioid abuse, the researchers report in the American Journal of Psychiatry.

“In evaluating patients who present with pain, physicians should also be attentive to addiction risk factors such as age, sex and personal or family history of drug abuse,” study senior author Mark Olfson, MD, MPH said in a news release. “If opioids are prescribed, it is important for clinicians to monitor their patients carefully for warning signs of opioid addiction.”