Is Smoking Associated with Alcohol-Drug Dependence in Patients with Pain and Chronic Pain Patients? An Evidence-Based Structured Review

Fishbain, David A.; Cole, Brandly; Lewis, John E.; Gao, Jinrun

doi:10.1111/j.1526-4637.2012.01446.x

Cited by 19 publications

(11 citation statements)

References 61 publications

(78 reference statements)

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“…In contrast to other studies conducted in opioid-using individuals (Fishbain et al, 2012), we did not find a significant association between tobacco smoking and severity of physical pain. Considering the well-established analgesic effect of smoking (Girdler et al, 2005), this observation may be considered surprising.…”

Section: Discussioncontrasting

confidence: 56%

Physical Pain in Alcohol-Dependent Patients Entering Treatment in Poland—Prevalence and Correlates

Jakubczyk

Ilgen

Bohnert

et al. 2015

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: Chronic pain and problematic alcohol use commonly co-exist, as the use of alcohol is commonly considered a useful pain self-management strategy. The purpose of this study was to characterize pain and pain-related problems in a group of primary alcohol-dependent individuals entering treatment facilities. Method: A sample of 366 (73.5% men and 26.5% women) alcohol-dependent (according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria) subjects was recruited in alcohol treatment centers in Warsaw, Poland. Information was obtained about demographics, social functioning, sexual and physical abuse during childhood, and severity of alcohol and sleep problems as well as level of impulsivity and general psychopathology. The study group was divided into a "mild or no pain" group and a "moderate or greater pain" group. Results: Among the study group, 34.4% of individuals reported moderate or greater physical pain during the last 4 weeks. The statistical analysis revealed that the experience of physical pain was significantly associated with lower level of education, unemployment, experience of sexual abuse before 18 years of age, and severity of alcohol dependence as well as other potential predictors of relapse (impulsivity, sleep problems, general psychopathology). When entered into logistic regression analysis with other dependent variables, the level of general psychopathology, severity of sleep problems, age, and education were all significantly associated with pain severity. Conclusions: Physical pain is a prevalent and potentially impairing experience in adults seeking treatment for alcohol dependence.

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Section: Discussioncontrasting

confidence: 56%

Physical Pain in Alcohol-Dependent Patients Entering Treatment in Poland—Prevalence and Correlates

Jakubczyk

Ilgen

Bohnert

et al. 2015

J. Stud. Alcohol Drugs

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“…Relative to the general population, smokers are four times more likely to be dependent on alcohol, 25 and are more likely to experience severe pain 23,42 . Research has further shown that co‐use of tobacco and alcohol is highly prevalent among individuals with chronic pain, 43,44 and the current findings suggest that pain severity may be one factor that contributes to the maintenance of problem drinking among smokers. Future research would benefit from examining whether associations between pain severity and hazardous patterns of drinking are more prevalent/pronounced among concurrent alcohol and tobacco users (vs alcohol users who do not smoke cigarettes).…”

Section: Discussionmentioning

confidence: 50%

Pain Severity and Alcohol Use Among Daily Tobacco Cigarette Smokers

2020

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Background and Objectives Pain is associated with hazardous alcohol use. Drinkers have reported using alcohol for pain‐coping, and negative affect may be a key mechanism in pain‐induced motivation to drink. However, no previous study has examined pain severity in relation to alcohol consumption, dependence, and alcohol‐related consequences. Moreover, no studies have examined pain‐alcohol interrelations among tobacco cigarette smokers. These secondary analyses tested the hypotheses that greater past 4‐week pain severity would be positively associated with indices of hazardous drinking (ie, quantity/frequency, harmful use, and dependence), and that the current pain intensity would be positively/indirectly associated with the urge to drink via negative affect. Methods Participants included 225 daily smokers (43% female; MCPD = 22) who completed the baseline session for a larger experimental study. Results Every one‐point increase in pain severity was associated with a 47% increased likelihood of hazardous drinking, and pain severity was positively associated with quantity/frequency of alcohol consumption, harmful patterns of drinking, and alcohol dependence level (Ps < .05). Pain intensity was indirectly associated with urge to drink via negative affect (P < .05). Conclusions These findings provide initial evidence that smokers with greater pain severity may also report hazardous patterns of alcohol use. Scientific Significance This is the first study to demonstrate that past 4‐week pain severity may be one factor that maintains three conceptually distinct patterns of hazardous drinking among smokers. The current results also provide the first evidence that greater pain intensity may be associated with an increased urge to drink alcohol, via negative affect. (Am J Addict 2020;29:134–140)

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“…Smoking status appears to be an indicator of risk for problems with opioids, including aberrant opioid use 14 and the development of opioid dependence among chronic pain patients. 15 To our knowledge, this study is the first to examine whether current, former, and never smokers with chronic non-cancer pain attribute different problems and concerns to using prescription opioids.…”

Section: Discussionmentioning

confidence: 98%

“…13 Further, smoking status may be an indicator of risk for problems with prescription opioids, including aberrant prescription opioid use (e.g., forging prescriptions, doctor shopping) 14 and development of opioid dependence among chronic pain patients. 15 …”

Section: Introductionmentioning

confidence: 99%

Smoking Status and Opioid-related Problems and Concerns Among Men and Women on Chronic Opioid Therapy

Young-Wolff

Klebaner

Weisner

et al. 2017

The Clinical Journal of Pain

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Objectives Smokers on chronic opioid therapy for non-cancer pain use prescription opioids at higher dosages and are at increased risk for opioid misuse and dependence relative to non-smokers. The current study aims to assess whether smoking is associated with problems and concerns with chronic opioid therapy from the perspective of the patient. Methods In a large sample (N = 972) of adult patients prescribed opioids for chronic noncancer pain, we examined sex-specific associations between smoking status and patient perceptions of problems and concerns with chronic opioid therapy using regression analyses, adjusting for covariates. Results The sample self-identified as 27% current smokers, 44% former smokers, and 29% never smokers. Current smoking (vs. never smoking) was associated with increased odds of an opioid use disorder among males and females, and higher daily opioid dose among males only. Current and former smokers reported significantly fewer problems with opioids relative to never smokers, and this was driven primarily by lower endorsement of problems that are affected by the stimulant properties of nicotine (e.g., difficulties thinking clearly, felt less alert or sleepy). Discussion This study contributes to an understanding of perceived problems and concerns with chronic opioid therapy among current, former, and never smokers with chronic noncancer pain. Results suggest that current and former smokers may be a difficult population to target to decrease chronic opioid therapy, given that they perceive fewer problems with prescription opioid use, despite higher odds of having an opioid use disorder (males and females) and greater opioid doses (males only).

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Is Smoking Associated with Alcohol-Drug Dependence in Patients with Pain and Chronic Pain Patients? An Evidence-Based Structured Review

Abstract: There is limited consistent indirect evidence that smoking status in patients with pain and CPPs is associated with alcohol-drug and opioid dependence. Smoking status could be a red flag for opioid-dependence development on opioid exposure.

Cited by 19 publications

References 61 publications

Physical Pain in Alcohol-Dependent Patients Entering Treatment in Poland—Prevalence and Correlates

Physical Pain in Alcohol-Dependent Patients Entering Treatment in Poland—Prevalence and Correlates

Pain Severity and Alcohol Use Among Daily Tobacco Cigarette Smokers

Smoking Status and Opioid-related Problems and Concerns Among Men and Women on Chronic Opioid Therapy

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