Analgesic effects of alcohol in adults with chronic jaw pain

Abstract

Background Although recent literature provides promising support for the analgesic properties of alcohol, potential differences in alcohol analgesia as a function of chronic pain status are not well understood. Thus, this study examined chronic pain status as a potential moderator of alcohol analgesia and distinguished between multiple aspects of pain experience and sensitivity: pain threshold, pain intensity, pain unpleasantness, and perceived relief. Methods Social drinkers with (N = 19) and without (N = 29) chronic jaw pain completed two testing sessions in a counterbalanced order: alcohol (target BrAC = 0.08 g/dl) and placebo. In each, pressure algometry was performed at the insertion of the masseter. Alcohol analgesia was assessed by examining the main and interactive effects of beverage condition, pressure level (4, 5, or 6 pound‐feet [lbf]), and chronic jaw pain status (chronic pain vs. pain‐free control) on quantitative sensory testing measures and pain relief ratings following noxious stimuli. Results Analyses indicated significant increases in pain threshold and pain relief and reductions in pain unpleasantness and pain intensity, under the alcohol condition. Chronic pain participants demonstrated lower pain thresholds and greater pain intensity and pain unpleasantness ratings than controls. There were no interactive effects of alcohol and pain conditions on any pain measure. Conclusions Findings provide experimental evidence of alcohol's analgesic and pain‐relieving effects and suggest that these effects do not significantly differ by chronic pain status. Individuals, who self‐medicate pain via alcohol consumption, irrespective of pain status, may be at increased risk to engage in hazardous drinking patterns and thus experience adverse alcohol‐related consequences.

Expectancy of alcohol analgesia moderates perception of pain relief following acute alcohol intake.

“…Although greater pain threshold ( p < .0001, η p 2 = .21) and lower pain intensity ( p = .04, η p 2 = .10) were reported in the alcohol than placebo condition (Vitus et al, 2022), bivariate correlation analyses (Pearson’s r ) demonstrated that alcohol-induced changes in pain threshold and pain intensity were not significantly correlated with relief ratings ( p > .49).…”

“…However, the expectancy that alcohol reduces pain sensitivity (AE VAS 2) was not significantly associated with perceived pain relief regardless of chronic pain status. In addition, alcohol-induced increases in pain threshold and reduction in pain intensity (Vitus et al, 2022) were not correlated with perceived pain relief. This finding provides additional evidence that alcohol-induced changes in pain sensitivity may not completely explain perceived pain relief (Edwards & Fillingim, 2007; Leknes et al, 2013), and thus may fail to sufficiently characterize the negative reinforcing effects of alcohol use for pain self-management.…”

“…We report all measures, manipulations, and data exclusions in the study. Our prior report regarding the primary analysis from this study (Vitus et al, 2022) provides additional information on the study sample. All data and analysis code are available upon reasonable request to the corresponding author.…”

“…Although previous studies have indicated that alcohol has analgesic effects, including reducing pain intensity and increasing pain threshold (i.e., pain sensitivity; Horn-Hofmann et al, 2015;Thompson et al, 2017;Vitus et al, 2022;Williams et al, 2021), there is also evidence suggesting alcohol-induced changes in pain intensity and pain sensitivity may not completely explain perceived pain relief (Edwards & Fillingim, 2007;Vitus et al, 2022). For example, Leknes et al (2013) demonstrated that the unpleasantness of pain and perceived relief is strongly influenced by the context in which pain is experienced.…”

The hidden risks of alcohol use for pain relief

“…A valuable meta-analysis constructed a dose-effect curve for alcohol analgesia in human subjects (Thompson et al, 2017) while issuing the warning that alcohol use near or above binge drinking levels is typically required for effective pain relief. An important recent study (Vitus et al, 2022) examined alcohol analgesia in chronic jaw pain sufferers at this exposure level (around 0.08 g/dl), which also corresponds to the legal driving limit in several jurisdictions. The major research question explored was whether the efficacy of alcohol to relieve pain might be altered in individuals with a history of chronic pain.…”