Interrelations between pain and alcohol: An integrative review

Abstract

Pain and alcohol use are both highly prevalent in the general population, and pain-alcohol interrelations are of increasing empirical interest. Previous research has identified associations between pain and alcohol dependence, and the current review provides novel contributions to this emerging domain by incorporating studies that have tested relations between pain and low-to-moderate alcohol consumption, and by identifying potential psychosocial mechanisms of action. Specifically, we sought to integrate evidence of pain-alcohol relations derived from two directions of empirical inquiry (i.e., effects of alcohol on pain and effects of pain on alcohol use) across psychological, social, and biological literatures. We observed converging evidence that associations between alcohol consumption and pain may be curvilinear in nature. Whereas moderate alcohol use was observed to be associated with positive pain-related outcomes (e.g., greater quality of life), excessive drinking and alcohol use disorder appear to be associated with deleterious pain-related outcomes (e.g., greater pain severity). We also observed evidence that alcohol administration confers acute pain-inhibitory effects, and that situational pain may motivate alcohol consumption (e.g., drinking for pain-coping). Future research can inform theoretical and clinical applications through examination of temporal relations between pain and alcohol consumption, tests of hypothesized mechanisms, and the development of novel interventions.

Pain-related quality of life related to mental health and sociodemographic indicators in adolescents

“…A previous study reported a curvilinear association between alcohol consumption and pain 20 . Moderate alcohol consumption was associated with positive pain-related outcomes, such as higher QOL, whereas excessive consumption was associated with negative pain-related outcomes, such as higher pain severity 20 .…”

“…A previous study reported a curvilinear association between alcohol consumption and pain 20 . Moderate alcohol consumption was associated with positive pain-related outcomes, such as higher QOL, whereas excessive consumption was associated with negative pain-related outcomes, such as higher pain severity 20 . Another study showed that alcohol dependence and chronic pain share common neural circuits; therefore, pain sensitivity and alcohol use may exert reciprocal effects 57 .…”

“…Moderate alcohol consumption, as defined by The United States Department of Health and Human Services (2010), is associated with positive pain-related outcomes (e.g., higher QOL), whereas excessive consumption is associated with negative pain-related outcomes (e.g., higher pain severity) 20 . Zale et al proposed that alcohol consumption can relieve acute pain, but pain can motivate alcohol consumption 20 . In addition, pain is a significant predictor of heavy drinking lapses during treatment 21 .…”

(225) Differences in Mexican Americans’ prevalence of chronic pain and co-occurring analgesic medication and substance use relative to Non-Hispanic White and Black Americans: Results from NHANES 1999-2004

“…[18] Respondents reporting pain were handed cards that listed 31 bodily regions and were asked to identify to NHANES interviewers all regions where they experienced pain. Using the same criteria from a previous NHANES pain investigation, [12] we organized the 31 lateral pain region responses into the following seven pain locations: [1] back pain, [2] legs/feet pain, [3] arms/hands pain, [4] headache/migraine pain, [5] abdominal pain, [6] face/teeth pain, and [7] chest pain. These seven pain locations were coded as binary variables (1= present, 0 = not present) for analyses.…”

“…[4,5] Studies have found that, relative to pain-free individuals, those with chronic pain have higher rates of cigarette [5,6] and alcohol [7] use. The relationship between cocaine and other street drug use in the management of pain is less clear and has received less attention in the literature.…”