Decreased Pain Associated with Less Return to Drinking Following Alcohol Use Disorder Treatment

Persistent pain is associated with heavy drinking among people with alcohol use disorder. Researchers prospectively studied 366 adults who entered abstinence-based treatment for DSM-IV alcohol dependence and were interviewed approximately 12 months later. At entry, 75% reported any pain, but the presence of pain was not associated with subsequent drinking. At follow-up:

• 50% of the sample was lost.
• 30% reported past-month drinking (94% had heavy use).
• 91% reported any pain and 23% reported decreased pain.
• Decreased pain was associated with a lower odds of any drinking (odds ratio, 0.15) in an analysis adjusted for depressive symptoms, baseline drinking, social support, age, sex, and education; the association at follow-up was similar (0.34).

Comments:

With loss of half of the sample, it is difficult to interpret these results. Nonetheless, it is plausible and makes clinical sense that for some, pain plays a role in return to drinking. Whether interventions that reduce pain can improve outcomes for those with pain and alcohol use disorder is an important area for study.

Richard Saitz, MD, MPH

Reference:

Jakubczyk A, Ilgen MA, Kopera M, et al. Reductions in physical pain predict lower risk of relapse following alcohol treatment. Drug Alcohol Depend. 2016;158:167–171.