The findings of this study indicated that the incidence of MDE carries a substantial burden in ALC men and women, independently of whether or not they suffer from chronic back/neck pain or frequent/severe headaches. We also found that, although the incidence of PDD was comparable in men and women with ALC, and significantly higher than in CTRL men and women, the incidence of MDE was higher in ALC women independently of the presence or absence of chronic pain. Results of this study may play a pivotal role in explaining the incidence of depressive disorders in individuals suffering from chronic pain disorders and who have an ALC history. Such screening can assist in understanding the relationships between ALC and depression as comorbidities in association with chronic pain disorders, thereby tailoring treatment strategies to enhance positive outcomes 47. The goal of the current review was to integrate evidence derived from relevant psychological, social, and biological empirical literatures to generate testable hypotheses that may inform future research and the development of novel interventions. The current review extends previous work by examining associations between pain and various levels of alcohol consumption (including low-to-moderate levels of drinking), and by identifying psychosocial mechanisms that may underlie these relations.
NIDA had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. Preparation of this review was partially supported by funds from the National Institute on Alcohol Abuse and Alcoholism (AA008459, AA012602, AA006420, AA007456, and AA020608, GFK), a National Research Service Award (AA018250, SE), and by the Pearson Center for Alcoholism and Addiction Research at The Scripps Research Institute. If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.For more information or tips please see ‘Downloading to a citation manager’ in the Help menu.
Impact of Alcohol Use on Pain
- These studies suggest that conditions for developing tolerance to alcohol analgesia vary, and that experiencing sustained or exaggerated analgesic effects in response to alcohol may involve learning mechanisms as observed with tolerance to other actions of alcohol.
- For all chronic disease categories for which detailed data are available, those data show that women have a higher risk of these conditions than men who have consumed the same amount of alcohol; however, the differences are small at lower levels of drinking (Rehm et al. 2010a).
- Despite these limitations, our findings may have important implications for understanding the underlying factors contributing to depressive disorders in chronic pain patients.
- Further, they discuss pharmacotherapies and psychotherapies that may target both conditions, potentially improving both AUD and chronic pain outcomes simultaneously.
- Several classes of prescribed pain medications can interact with alcohol, including anti-inflammatory agents, muscle relaxants, and opioid analgesics; these therapies can be harmful to patients with AUD.
- Future research should test whether engagement of effective pain-coping strategies (e.g., in the context of pain treatment) decreases motivation to drink alcohol over time.
We looked at the temporal relations between the ages of onset of each of the depressive disorders to determine if onset of ALC, preceded onset of MDE, MDD, or PDD. We found that there were no significantly different temporal patterns in onset of any of the depressive disorders relative to ALC onset. The comparability between ages of onset of alcohol abuse and depressive disorders may be suggestive of overlapping genetic predispositions for these disorders 34.
Individuals may come to hold beliefs that alcohol will help them manage pain if they have previously perceived a reduction in their pain (or pain-related distress) when drinking. Given evidence that alcohol expectancies may be influenced by socially shared and transmitted beliefs (Donovan, Molina, & Kelly, 2009), it is possible that expectancies for alcohol-induced analgesia may be shaped by social depictions of alcohol as a stress-coping agent. However, we are not aware of any studies that have attempted to assess whether participants held expectancies that drinking may mitigate pain in the context of laboratory pain induction.
Experimental Investigations of Pain and Alcohol Consumption
Interestingly, people with fibromyalgia symptoms who drank moderately reported decreased pain severity and depression but saw no effect on how widespread their pain was or other symptoms such as cramps, headache, fatigue, unrefreshing sleep and cognitive dysfunction. Of the study participants, more than half reported use of opioid medication, which carries serious risks when combined with alcohol. Despite these benefits, this new study found that overall, people with chronic pain tend to drink less than the general population. “People with chronic pain may drink less due to the stigma and because they are being told not to drink while on pain medication,” says Scott. If you feel that you sometimes drink too much alcohol, or your drinking is causing problems, or if your family is concerned about your drinking, talk with your health care provider. Other ways to get help include talking with a mental health professional or seeking help from a support group such as Alcoholics Anonymous or a similar type of self-help group.
Health Topics: Pain and Alcohol
Another facet of this relationship is revealed in studies showing that people experiencing chronic pain turn to alcohol presumably for relief (e.g., Brennan et al., 2005; fetal alcohol syndrome celebrities Riley and King, 2009). One of the important risk factors for relapse to drinking and for the development of AUD and other substance use disorders, is impulsivity. Impulsivity is multidimensional construct referring to a predisposition for individuals to react quickly in response to an internal or external stimulus, without consideration of the possible negative consequences (Lejuez et al., 2010). While not a prominent trait in chronic pain patients, impulsivity may be especially relevant to individuals with AUD who suffer from chronic pain. These individuals would be in a situation that is analogous to what has been described for opioid analgesic misuse risk in chronic, low-back pain patients who had been prescribed opioid analgesics (Marino et al., 2013).
Short-Term Pain-Inhibitory Effects of Acute Alcohol Administration
This finding suggests that continued alcohol consumption, even in low doses, after the onset of liver or pancreas disease, increases the risk of severe consequences. The molecular and biochemical mechanisms by which chronic alcohol consumption leads to the development of cancers of various organs are not fully understood. In addition, the International Agency for Research on Cancer group concluded that acetaldehyde—which is produced when the body breaks down (i.e., metabolizes) beverage alcohol (i.e., ethanol) but also is ingested as a component of alcoholic beverages— itself is carcinogenic. It likely plays an important role in the development of cancers of the digestive tract, especially those of the upper digestive tract (Lachenmeier et al. 2009; Seitz and Becker 2007). Recently, the Monograph Working Group of the International Agency for Research on Cancer concluded that there was sufficient evidence for the carcinogenicity of alcohol in animals and classified alcoholic beverages as carcinogenic to humans (Baan et al. 2007). In particular, the group confirmed, or newly established, the causal link between alcohol consumption and cancer of the oral cavity, pharynx, larynx, esophagus, liver, colorectum, and female breast.
Studies also have shown that alcohol has less of an impact on pain as the BAC drops, due to metabolism, excretion, or evaporation (Duarte, McNeill, Drummond, & Tiplady, 2008; Horn-Hofmann et al., 2015; Zacny, Camarillo, Sadeghi, & Black, 1998). The relationship between alcohol consumption and HIV infection and acquired immunodeficiency syndrome (AIDS) is different from that with other infectious diseases. To become infected with HIV, people must exchange body fluids, in most cases either by injecting drugs with a contaminated needle or, more commonly in low-income societies, engaging in unsafe sex. Researchers frequently have pointed out that personality characteristics, such as a propensity for risk-taking, sensation-seeking, and sexual compulsivity, may be involved in the risk of HIV infection.