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Chronic Pain| Drinking Problems

Posted Dec 07 2008 6:02pm

Sunday, December 07, 2008

The intersection of pain and alcohol misuse by older adults has not been studied. This study involved older community-residing adults (n = 401) classified as problem and non-problem drinkers. At baseline and 3 years later they were asked to provide information about their pain, use of alcohol to manage pain, drinking behavior, chronic health problems and recent serious injury.   


At baseline, older problem drinkers reported (1) more severe pain, (2) more disruption of daily activities due to pain and (3) more frequent use of alcohol to manage pain than did older non-problem drinkers. More pain was associated with more use of alcohol to manage pain; this relationship was stronger among older adults with drinking problems than among those without drinking problems.  


Among older men and women, more baseline drinking problems interacted with use of alcohol to manage pain to predict more health problems and serious injury 3 years later. The results highlight the importance of monitoring the drinking behavior of older patients who present with pain complaints, especially patients who have pre-existing problems with alcohol. ( Brennan PL. Schutte KK. Moos RH: Pain and use of alcohol to manage pain: prevalence and 3-year outcomes among older problem and non-problem drinkers. Addiction. 100(6):777-86, 2005 Jun. 


This next study determined whether healthy subjects without a history of heavy alcohol use or a family history of alcoholism exhibited a concentration-dependent analgesic effect of ethanol. F orty-one healthy subjects received infusion of ethanol via computerized pump to achieve a steady-state ("clamp") ethanol high concentration (breathalyzer = 0.100 g/dl), ethanol low concentration (breathalyzer = 0.040 g/dl) or placebo. Noxious electrical stimulation and pain assessments were performed prior to start of placebo/ethanol infusion and at the 60-min infusion mark. Electrical   stimulation current strength was progressively increased until the pain was reported as 5 or higher on an 11-point Verbal Numeric Scale.


Outcome variables included measures of pain threshold and tolerance and Visual Analog Scales of mood states.  The findings support the hypothesis that in healthy subjects intravenous ethanol administration has a concentration effect on pain tolerance but not on pain threshold. Additional studies are planned to further elucidate the mechanisms of ethanol's analgesic effects. Perrino AC Jr. Ralevski E. Acampora G. Edgecombe J. Limoncelli D. Petrakis IL. Ethanol and pain sensitivity: effects in healthy subjects using an acute pain paradigm. Alcoholism: Clinical & Experimental Research. 32(6):952-8, 2008 Jun. 


alcoholism, analgesia, chronic pain, older adults, pain
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