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 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.
He has previously worked as a consultant statistician in the area of patient-reported outcomes in the US. He enjoys research examining the neurophysiological foundations of pain and exploring the potential for technology in pain management. In the meantime, while chronic pain should always be evaluated by a medical professional, there are many options for medication/opioid-based treatment, drawing on complementary and alternative approaches.
- When levels of inflammatory proteins were measured, the researchers discovered that while inflammation pathways were elevated in both dependent and non-dependent mice, specific molecules were only increased in dependent mice.
- Overall, these results suggest that alcohol does deliver effective relief from pain – at least for the type of relatively short-term pain induced in the laboratory.
- Roberto’s group is continuing studies on how these molecules might be used to diagnose or treat alcohol-related chronic pain conditions.
- Their aim is to uncover fresh molecular targets that can differentiate between different types of pain and could eventually be employed to create new treatments.
- Even in people who are not struggling with alcohol use disorder, drinking alcohol can affect other psychiatric conditions.
Drinking to Ease Chronic Pain Ultimately Makes It Worse
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Gift Ideas for Individuals Living With Chronic Pain
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.
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.
Dysfunctional Descending Pain Pathways.
For pain ratings, pain was rated at around 5/10 in the control condition, which was reduced by around 25% after administration of alcohol. A dose-response relationship was also observed, with increasing levels of alcohol resulting in increasing analgesia (with alcohol dosages ranging from the equivalent of around half a pint of lager to three pints). They also found increased levels of IL-6 and activation of ERK44/42 in mice with alcohol withdrawal-related allodynia, but not in mice with alcohol-induced neuropathic pain. When Roberto’s group then measured levels of inflammatory proteins in the animals, they discovered that while inflammation pathways were elevated in both dependent and non-dependent animals, specific molecules were only increased in dependent mice. It also suggests which inflammatory proteins may be useful as drug targets to combat alcohol-related pain. Given the general level of interest in this area, there were fewer studies than we expected.
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.
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).
Analgesic doses of alcohol exceed levels recommended in the Dietary Guidelines for Americans, 2020-2025
A systematic search found 18 eligible experimental studies, involving a combined total of 404 healthy participants. All those taking part were exposed to painful experimental stimulation after being allocated to an alcohol or a no-alcohol control condition. Pain was assessed in a variety of ways, including pain ratings (0-10) and pain threshold (the point at which pain is first experienced). Studies were generally of good methodological quality; many reported randomisation of participants to conditions, precise measurements of blood alcohol and use of placebo groups who were given negligible levels of alcohol to reproduce its taste and smell.
Opioids in particular may not be appropriate for managing pain in individuals with AUD, as they probably engage the same brain reward pathways as in AUD. Indeed, there is evidence for the involvement of the endogenous cannabinoid system in the pharmacological and behavioral effects of alcohol (Perra et al., 2005). However, gabapentin, a GABA analogue anticonvulsant medication that also is used to treat pain, has been shown to have the benefit of reducing cravings and to significantly delay relapse in individuals with AUD (Brower et al., 2008). When levels of inflammatory proteins were measured, the researchers discovered that while inflammation pathways were elevated in both dependent and non-dependent mice, specific molecules were only increased in dependent mice. It also indicates which inflammatory proteins may be useful as potential targets for intervention to combat alcohol-related pain. Follow-up studies are focused on how these molecules might be used to diagnose and more effectively treat alcohol-related chronic pain conditions.
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.
- It is also hard to know whether the same level of analgesia observed for experimental pain extends to chronic pain complaints (e.g. back pain), as these two types of pain differ in their emotional, cognitive and physical components.
- But when morning comes, the pain is back — stronger, more stubborn, and now with a headache to match.
- Given the analgesic effects of alcohol on pain, pervasiveness of alcohol use as a pain management strategy has proven to be substantial among individuals exhibiting pain.
- A 2024 report from the American Association for Cancer Research concluded that more than 5% of all cancers in the U.S. are attributable to alcohol use.
In people with nerve pain, even moderate alcohol use can damage the nerves further and intensify symptoms. And for those dealing with back or spine issues, alcohol-related inflammation or muscle relaxation can sometimes increase the risk of injury or instability. Pain Alcohol and Pain perception is a subjective, complex, and distributed process that involves multiple structures involved in sensory, emotional, and cognitive processing that interact together concurrently to form the perceived pain experience (Chapman, 2005).
Alcohol’s Direct Impact on 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.
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.
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.