Reductions in physical pain predict lower risk of relapse following alcohol treatment

Abstract

Objective Physical pain is considered a potential predictor of relapse in alcohol dependent individuals after treatment. The aim of this study was to evaluate whether reductions in pain level during the follow-up period after treatment were associated with lower relapse risk. Method A sample of 366 participants were recruited from alcohol treatment centers in Warsaw, Poland. At baseline information was obtained about pain level, demographics, childhood abuse, impulsivity, depressive symptoms, severity of alcohol and sleep problems. After finishing the alcohol treatment program patients were followed for 12 months and alcohol drinking (relapse) as well as pain severity were evaluated. Results In the followed group, 29.5% of patients confirmed that they drank any alcohol during last four weeks. Comparing follow-up to baseline pain 48.6% of subjects reported an increased severity of pain, 28.8% - the same level of pain, 22.6% - decreased level of pain. There was a significant association between the decrease in level of pain and the lower risk of relapse. Other factors associated with relapse during four weeks prior to the follow up were: baseline severity of depressive symptoms, low baseline social support and number of drinking days during 4 weeks prior to entering treatment. In multivariate analysis a decrease in pain level was associated with a lower likelihood of relapse (OR=0.159; 95%CI:0.04–0.62; p=0.008) even when controlled for other factors associated with relapse. Conclusions Decreases in pain level following treatment for alcohol dependence are associated with, and may contribute to, a lower risk of alcohol relapse.

Pain moderates changes in psychological flexibility but not substance use symptoms during substance use disorder treatment

“…SUD patients with both actue and chronic pain problems report more extensive drug use histories, greater severity of drug and alcohol problems, and more co-morbid psychiatric symptom sequelae than those without significant pain (Jakubczyk et al, 2015; Potter et al, 2008; Witkiewitz et al, 2015a, 2015b). Further, those in pain are less likely to attend or complete SUD treatment and reductions in pain predict lower risk of relapse following treatment (Jakubczyk et al, 2016). Co-morbidity of these conditions is also problematic due to the increasing prevalence of prescription pain medication abuse (Dworkin et al, 2007; Huang et al, 2006).…”

Relationships between components of emotional intelligence and physical pain in alcohol-dependent patients

“…Recent preliminary findings revealed that deficits in utilizing and regulating emotions were an independent predictor of relapse in AD patients,7 whereas chronic pain was shown to be associated with worse pain-related and substance-related outcomes among adults treated for substance use disorders 13,14,72. These observations underlie the clinical significance of further studies on emotional competencies and pain in AD individuals.…”

“…Despite the importance of understanding the intersection between pain and alcohol use, only limited work has been carried out in this area and most of this has been done from a neurobiological perspective. Of clinical importance, pain is a predictor of poor drug- and alcohol-related outcomes in those treated for addictive disorders, including AUDs,12,13 and self-reported decrease in pain following treatment for AD is associated with a lower risk of alcohol relapse 14…”

Alcohol and Drug Use and Aberrant Drug-Related Behavior Among Patients on Chronic Opioid Therapy

“…There is concern that patients may use alcohol as a self-medication strategy to control pain or to address other associated health problems such as insomnia (Jakubczyk et al, 2016; National Institute on Alcohol Abuse and Alcoholism, 2013; Witkiewitz et al, 2015; Woodrow & Eltherington, 1988). There is evidence to support this self-medication hypothesis (Brennan, Schutte, & Moos, 2005; Riley & King, 2009), although a recent study showed that men who reported pain at baseline experienced declining alcohol use over 10 years, compared to men who did not experience pain (Bobo, Greek, Klepinger, & Herting, 2013).…”