Using alcohol as a pain reliever can lead to many issues (which we’ll go into more detail on later). What started out as an injury that just needed time to heal can become a lingering and chronic issue. The 2025 Global Year will examine pain management and education beyond low- and middle-income countries to include low-income settings and priority populations. This indicates that the inflammatory pathways involved are different and could potentially lead to the development of targeted therapies in the future. It’s almost as if life itself is inviting us to embrace difficulty—not as punishment but as a design feature.
Analgesic doses of alcohol exceed levels recommended in the Dietary Guidelines for Americans, 2020-2025
- This review seeks to describe neuroanatomical links and major mediating influences between AUD and chronic pain, in the service of identifying factors that predict the risk of chronic pain in precipitating or facilitating AUD.
- The chronic intermittent ethanol vapor-two bottle choice (CIE-2BC) mouse model used in this study paves the way for more research in this area.
- Moreover, recent research suggests that as many as 28 percent of people experiencing chronic pain turn to alcohol to alleviate their suffering.
Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. Whether it’s a glass of red wine with dinner or a celebratory cocktail on the weekend, drinking in moderation has long been considered not only socially acceptable but also perhaps even healthy. Ultimately, clinicians like Stafford and Humphreys said they hope people who decide to drink alcohol do it consciously, armed with knowledge about its risks. The health risks of alcohol develop because ethanol, the type of alcohol found in beverages, metabolizes into a compound called acetaldehyde, which damages DNA and other cellular components. When acetaldehyde builds up in the body, it can damage cells throughout the digestive system and beyond.
Decades ago, large surveys of adults began showing an association between how much alcohol someone drank and their risk of death. People who said they drank heavily had an increased risk, but those who drank nothing at all also had an increased risk compared with those who drank one or two servings of alcohol per day. Alcohol can dull pain temporarily, which Alcohol and Pain is why people usually reach for a drink when they’re hurting. It can relax muscles, lower stress in the moment and even trigger a short-lived mood boost.
Alcohol’s Role in Chronic Pain
Recurrent pain is highly prevalent among treatment seeking problem drinkers (Boissoneault, Lewis, & Nixon, 2018; Sheu et al., 2008), and alcoholism is considered a risk factor, both for the development of chronic pain in patients who suffer from AUD, and for relapse in those attempting to remain abstinent. AUD patients with pain also are likely to report current opioid use (Witkiewitz & Vowles, 2018). But despite numerous reports on the associations between chronic pain and AUD, the underlying mechanisms involved in linking them remain elusive.
At the Intersection of Alcohol Use Disorder and Chronic Pain
To date, the lack of preclinical, or animal, models of alcoholic neuropathic pain limited the investigation of pathological mechanisms underlying the onset of neuropathic pain in people with alcohol use disorder. Over half of people with alcohol use disorder experience significant, persistent pain. This phenomenon is more common in women, affecting around 60% of cases, than in men, in whom it affects around 50% of cases. According to the National Survey on Drug Use and Health, 29.5 million people aged 12 years and older had alcohol use disorder — also known as alcohol abuse, alcohol dependence, or alcohol addiction — in 2021. Psychotherapy be extremely beneficial in dealing with chronic pain’s mental and emotional aspects.
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Study limitations and next steps
Stafford and his colleagues said the choice to tip back a beer or forgo alcohol — like many lifestyle decisions — should involve weighing the risks and benefits of your behaviors. But they think the public should be made more aware of those risks, which include an increased risk of cancer from drinking moderate amounts of alcohol. If you’re struggling with chronic pain and using alcohol to cope, reach out to a pain specialist today.
Roberto’s group is continuing studies on how these molecules might be used to diagnose or treat alcohol-related chronic pain conditions. LA JOLLA, CA—Chronic alcohol consumption may make people more sensitive to pain through two different molecular mechanisms—one driven by alcohol intake and one by alcohol withdrawal. That is one new conclusion by scientists at Scripps Research on the complex links between alcohol and pain. Laboratory studies confirm that alcohol does indeed reduce pain in humans and in animals. Moreover, recent research suggests that as many as 28 percent of people experiencing chronic pain turn to alcohol to alleviate their suffering. Despite this, using alcohol to alleviate pain places people at risk for a number of harmful health consequences.
Alcohol use disorder (AUD), which encompasses the conditions commonly called alcohol abuse, alcohol dependence and alcohol addiction, affects 29.5 million people in the U.S. according to the 2021 National Survey on Drug Use and Health. Over time, AUD can trigger the development of numerous chronic diseases, including heart disease, stroke, liver disease and some cancers. In fact, chronic pain and alcohol consumption often combine to create a vicious circle wherein people with chronic pain drink to feel less uncomfortable, but drinking ultimately increases their pain. Pain is a widespread symptom in patients suffering from alcohol dependence and it’s also a reason why people are driven to drink more. A meta-analysis of the data from these studies provided robust support for the painkilling effects of alcohol. A mean blood alcohol content (BAC) of approximately 0.08% (around two pints of lager/medium glasses of wine) produced a small elevation of pain threshold and a moderate-to-large reduction in pain ratings.
Family Life: Tips for Individuals Living With Chronic Pain
Research suggests that alcohol has a pain-dampening effect and can relieve hyperalgesia — increased sensitivity to pain — even at nonintoxicating doses. People with alcohol use disorder are unable to stop or control their alcohol consumption, even when it causes problems to their health, relationships, and work. Chen’s research has shown how alcohol affects people of East Asian descent who have a genetic variation, ALDH2, which interferes with their ability to metabolize acetaldehyde. These people — about 8% of the world’s population — often experience facial flushing and a rapid heartbeat after just one drink. Surgeon General’s Advisory reported that among 100 women who have less than one drink per week, about 17 will develop an alcohol-related cancer. Among 100 women who have one drink a day, 19 will, and among 100 women who have two drinks a day, about 22 will.
Bidirectional associations between alcohol use disorder (AUD) and chronic pain syndromes also have been reported (Apkarian, Bushnell, Treede, & Zubieta, 2005; Apkarian et al., 2013; Brennan, Schutte, & Moos, 2005; Egli et al., 2012; Zale, Maisto, & Ditre, 2015). The prevalence of AUD is increased in adult patients suffering from chronic pain conditions, partly due to its analgesic properties (Hoffmann, Olofsson, Salen, & Wickstrom, 1995), which may be heightened among individuals with alcohol dependence (Cutter, Maloof, Kurtz, & Jones, 1976). Egli and colleagues (Egli et al., 2012) have even proposed that alcohol dependence itself may stem from aberrant neurobiological substrates of pain, and have conceptualized alcohol dependence as a chronic pain disorder. For instance, while alcohol consumption initially potentiates GABA, a major inhibitory neurotransmitter, the number of GABA receptors declines with excessive drinking over a long period of time (Davies, 2003; Oscar-Berman & Marinkovic, 2003; Valenzuela, 1997). This also may interfere with efficiency in descending pain inhibition at the midbrain level and precipitate development of chronic pain conditions in which deficiency in descending pain modulatory system is thought to be a central cause (Ossipov et al., 2014). Because pain can be a significant risk factor for relapse in those recovering from AUD, there is an urgent need to understand the links between AUD and development of chronic pain.
- Indeed, there is evidence for the involvement of the endogenous cannabinoid system in the pharmacological and behavioral effects of alcohol (Perra et al., 2005).
- The potential of alcohol to act as a painkiller has been recognized for a long time, and many drinkers report that they consume alcohol to moderate pain.
- In fact, chronic pain and alcohol consumption often combine to create a vicious circle wherein people with chronic pain drink to feel less uncomfortable, but drinking ultimately increases their pain.
- The interrelationship between chronic pain and AUD resides in the intersection of etiological influences, mental experiences, and neurobiological processes.
- With so much data and so many variables, public health recommendations concerning alcohol differ around the world.
Together, research findings support the importance of including both pain and drinking behavior jointly in the context of treatment for AUD. Consideration of conjoint treatment of AUD and pain is essential, especially given the bidirectional relationship between the two, including the dampening effect of alcohol on pain perception, which may lead to drinking as a coping mechanism, and thus, poor AUD treatment outcomes. This point may be particularly relevant for individuals exhibiting pain within the context of a more severe health problem, such as HIV or sickle cell disease (Levenson et al., 2007; Merlin et al., 2015; Merlin et al., 2014).
It’s been a long week, and you finally settle in on the couch with a glass of wine, hoping to unwind. The warmth spreads through you, taking the edge off that persistent ache in your back — the one that’s been nagging you for days. But when morning comes, the pain is back — stronger, more stubborn, and now with a headache to match. At specific time points, the researchers measured allodynia in each mouse by using von Frey filaments, a set of calibrated nylon fibers of varying thickness and length.
One of the important risk factors for relapse to drinking and for the development of AUD and other substance use disorders, is impulsivity. Impulsivity is multidimensional construct referring to a predisposition for individuals to react quickly in response to an internal or external stimulus, without consideration of the possible negative consequences (Lejuez et al., 2010). While not a prominent trait in chronic pain patients, impulsivity may be especially relevant to individuals with AUD who suffer from chronic pain. These individuals would be in a situation that is analogous to what has been described for opioid analgesic misuse risk in chronic, low-back pain patients who had been prescribed opioid analgesics (Marino et al., 2013). The experience of physical pain also has been reported to be elevated in alcohol dependent patients having high levels of impulsivity, with physical pain being an independent correlate of both subjectively reported and objectively measured levels of impulsivity (Jakubczyk, Brower, et al., 2016). In particular, there seems to be a role for an attention dimension of impulsivity that represents heightened distractibility and compromised cognitive control, both in AUD (Jakubczyk, Brower, et al., 2016) and in opioid analgesic misuse in chronic pain patients (Marino et al., 2013).
Factors including age, genetics, body size and existing health conditions all influence how alcohol affects a person. Even in people who are not struggling with alcohol use disorder, drinking alcohol can affect other psychiatric conditions. For decades, studies suggested that moderate alcohol intake could protect the heart, reduce diabetes risk or even help you live longer. Alcohol can interact negatively with many pain medications, including opioids, muscle relaxants, antidepressants, and anti-inflammatories. These combinations can increase the risk of dangerous side effects like drowsiness, dizziness, liver damage, and even respiratory depression, which can be life-threatening.