Pain and Use of Alcohol in Later Life

Abstract

Objective To determine whether (a) late-life pain predicts growth in older adults’ use of alcohol, and elevated risk of drinking problems; and (b) sociodemographic characteristics moderate these relationships. Method Five times over an 8-year interval, N = 5,446 Health and Retirement Study (HRS) participants provided information about their pain and alcohol use. Two-part latent growth modeling and logistic regression were used to analyze these data. Results Participants with more pain at baseline had lower initial levels and a faster rate of decline over the next 8 years in alcohol consumption, but they also were at elevated risk of having drinking problems. Income and African American background interacted with pain to predict 8-year change in alcohol consumption and presence of drinking problems. Discussion Late-life pain does not predict growth in older adults’ alcohol consumption, but is nonetheless linked to elevated risk of drinking problems, especially among African Americans.

Interrelations between pain and alcohol: An integrative review

“…In the same sample, results further indicated that greater pain unpleasantness was associated with more severe alcohol dependence, independent of relevant sociodemographic and mental health factors (Lawton & Simpson, 2009). Similar findings revealed that older adults who endorsed more severe pain and greater pain-related interference with daily activities (compared to those with no pain) were 20% and 50% more likely to also have endorsed current drinking problems, respectively (Brennan & Soohoo, 2013). Among older adults, a greater number of painful medical conditions has been associated with increased frequency of experiencing drinking problems (Brennan et al, 2011).…”

“…There is also evidence that men are more likely to drink alcohol to cope with stress (Esper & Furtado, 2013), and men have also been shown to endorse drinking to cope with pain (Brennan et al, 2005; Riley, Gilbert, & Heft, 2002). Although aging has generally been associated with decreased alcohol consumption (e.g., Shaw, Krause, Liang, & McGeever, 2011), there is some evidence to suggest that older adults who experience painful medical conditions may experience drinking problems more often than older adults without painful medical conditions (Brennan, Schutte, SooHoo, & Moos, 2011; Brennan & Soohoo, 2013), and the likelihood of experiencing chronic pain has been shown to increase with age (Tsang et al, 2008). With regard to race and ethnicity, relative to Caucasians, African-Americans who seek treatment for chronic pain tend to endorse more persistent pain and greater unpleasantness (e.g., Edwards, Fillingim, & Keefe, 2001).…”

“…Indeed, deficiencies in endogenous pain modulation appear to be common across pain conditions and have been implicated in both the onset and progression of chronic pain (e.g., Edwards, 2005). Researchers have also proposed that excessive drinking may contribute to the development of chronic pain via increased risk of traumatic injury and deleterious effects on the musculoskeletal system (Brennan et al, 2011; Brennan & Soohoo, 2013; Govindu & Babski-Reeves, 2013; Sá et al, 2011). …”

“…Conversely, there is some prospective evidence that older adults who endorse more severe pain or a greater number of painful conditions may ultimately go on to reduce their alcohol consumption (Bobo, Greek, Klepinger, & Herting, 2012; Brennan et al, 2011; Brennan & Soohoo, 2013). However, each of these studies sampled older adults who did not necessarily have chronic pain, reported low levels of baseline drinking, and whose patterns of alcohol use may not generalize to other age groups.…”

“…To our knowledge, all of the studies that examined prospective relations between pain and subsequent alcohol consumption were limited to samples consisting of older adults who reported low levels of baseline drinking and did not necessarily have chronic pain (Bobo et al, 2012; Brennan et al, 2011; Brennan & Soohoo, 2013). Future work in this area should test relations between pain and subsequent patterns of alcohol consumption using representative samples drawn from the general population, treatment-seeking chronic pain patients, and persons seeking treatment for AUD.…”