Exploring the Link Between Chronic Pain & Alcohol Use

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According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), more than one-quarter of people with chronic pain report drinking alcohol to alleviate their symptoms. (1) However, research has shown that using alcohol as an analgesic (pain reliever) is ineffective long-term, can increase pain levels, and cause alcohol use disorder and dependence. The healthcare field as a whole agrees that drinking alcohol as a way to treat long-term pain is both counterproductive and risky.

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Dangers of Drinking to Treat Chronic Pain

Any pain that persists for longer than three months can be considered “chronic,” but in some cases, it can last for much longer, even years or decades. (2) It can be caused by any number of issues, including musculoskeletal injuries and autoimmune disorders such as rheumatoid arthritis. Sometimes the cause of chronic pain is dubious or unknown. 

Regardless of its etiology, chronic pain can severely affect a person’s physical and mental well-being and has also been associated with disability, opioid dependence, depression, and anxiety. (3) 

According to a 2016 meta-analysis, between 3-4 standard drinks may, in fact, reduce moderate pain. (4) However, this amount exceeds dietary health guidelines widely considered “moderate” per-day drinking, or no more than one standard drink for women and two for men. (5) (6) Therefore, significant pain relief may require amounts that exceed those considered to be safe and do not contribute to significant health conditions. 

Regular heavy drinking for any reason also increases the risk of developing numerous severe and life-threatening health conditions. These include liver and heart disease, heart disease, stroke, high blood pressure, several forms of cancer, and many more.

Increased Risk of Alcohol Dependence

Drinking above safe standards to achieve pain relief can increase the risk of developing tolerance and chemical and emotional dependence. Moreover, alcohol’s analgesic effects “may contribute to alcohol dependence in those with persistent pain.” (7)

When tolerance develops, increasing amounts of alcohol are required to achieve the desired effects, further intensifying alcohol use and the adverse effects with which it’s associated. (8) Once an alcohol use disorder has fully developed, it can be challenging to break free without professional help. There are numerous reasons why using alcohol to cope with chronic pain is risky and ineffective. Alcohol dependence can result, while chronic pain remains and can even increase over time.

Why People Self-Medicate Chronic Pain with Alcohol

Although it appears alcohol can serve as a pain reliever “at least for…relatively short-term pain” (9), the reason for this is not wholly understood. Some have suggested its ability to reduce anxiety temporarily might be a factor, as well as blocking excitatory receptors in the central nervous system. (10)

Drinking to self-medicate physical or emotional pain occurs for many of the same reasons any substance misuse occurs, but also for some reasons rather unique to alcohol. For example, unlike illicit drugs, alcohol is both legally and easily obtainable. In contrast, opioid prescriptions are often limited to short-term pain and extremely expensive to acquire on the street. 

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Dangers of Combining Pain Medications & Alcohol

Alcohol can be extremely dangerous when combined with pain relievers, opioids, or other substances with sedative effects. Mixing alcohol with medicine as seemingly benign as acetaminophen can lead to liver damage and failure. Furthermore, aspirin and alcohol can result in gastric bleeding. 

Alcohol is the most dangerous when used concurrently with opioids and can lead to respiratory depression, coma, and death. It’s been estimated that alcohol contributes to approximately 22% of overdose deaths related to prescription opioids. (11)

Used independently, both opioids and alcohol (albeit to a much lesser extent) can lead to lethal overdoses by causing central nervous system depression. Using them together amplifies the sedative properties of each and is more likely to result in an overdose than either substance would alone.

Chronic Drinking Tends to Worsen Physical Pain

Chronic drinking appears to be related to increased pain and greater pain severity. (12) For example, it can cause small-fiber peripheral neuropathy, a neurological complication associated with alcoholism. (13) This condition causes pain, tingling, pins and needles, and other altered sensations in the extremities and feet. (14)

In addition, individuals detoxing from alcohol often experience increased pain sensitivity. This condition motivates some to continue or even intensify their drinking to reverse increases in withdrawal-related pain. (15)

Alcohol and opioids have similar mechanisms that reduce physical pain. As a result, regular use of one substance diminishes the other’s effects. When researchers examined opioid use after surgery in approximately 4000 patients, they found that frequent alcohol use was associated with increased opioid use for pain management. (16) Furthermore, opioid withdrawal, similar to alcohol withdrawal, often leads to dysphoria and negative emotional states.

Chronic Drinking Can Worsen Emotional Pain

People also frequently misuse alcohol to cope with emotional turmoil. Unfortunately, as with physical pain, any respite alcohol might offer can increase mental distress when alcohol’s effects subside. Chronic alcohol use can also cause persistent negative emotional states between drinking episodes. The resulting anxiety, irritability, and dysphoria can provoke further alcohol use. As with physical pain, regularly drinking alcohol to numb unwanted emotions will likely worsen psychological issues and alcohol dependence. (17)

Effectively & Safely Addressing Chronic Pain

If you experience chronic pain, it is possible to treat your condition holistically and manage your discomfort without using or misusing potentially addictive substances. The National Institutes of Health have advocated for more evidence-based strategies, such as cognitive behavioral therapy, to increase pain tolerance and lessen perceived pain intensity. There are several complementary approaches recommended by experts for managing chronic, painful conditions. (18)

Holistic Approaches to Chronic Pain Include:

  • Exercise.
  • Acupuncture.
  • Spine manipulation.
  • Hypnosis.
  • Mindfulness meditation.
  • Relaxation.
  • Music therapy.
  • Massage.
  • Tai chi.
  • Yoga.

Most importantly, individuals who experience chronic pain require a holistic pain management plan and effective strategies developed by medical and behavioral health experts.

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An Individual Recovery Program Can Help With Pain & Addiction

Guardian Recovery offers a comprehensive approach to treating alcohol addiction, which addresses health conditions like chronic pain and alcohol use disorders simultaneously. Using the knowledge and expertise of medical professionals and behavioral experts in a therapeutic, supportive environment is necessary to treat all aspects of a person’s health and wellness.

If you struggle with alcoholism, with or without chronic pain, we encourage you to contact us today. We will provide you with a free, no-obligation assessment and health benefits check. We will ensure you have access to the education, support, and resources you need to get sober, prevent relapse, and enjoy a healthy, substance-free life!

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

(1)https://pubs.niaaa.nih.gov/publications/PainFactsheet/painFact.htm

(2) (3) (14) (15) https://www.lhsfna.org/the-link-between-alcohol-use-and-chronic-pain/

(4) https://www.jpain.org/article/S1526-5900(16)30334-0/fulltext

(5) https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf

(6) https://www.niaaa.nih.gov/alcohols-effects-health/overview-alcohol-consumption/what-standard-drink
(7) (12) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385458/

(8)https://www.niaaa.nih.gov/sites/default/files/publications/Using_Alcohol_to_Relieve_Your_Pain_2.pdf

(9)https://www.iasp-pain.org/publications/relief-news/article/alcohol-pain-relief/

(10) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826830/

(11) https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics

(13) https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/peripheral_nerve/conditions/small_fiber_sensory_neuropathy.html

(15) (16) (17) https://niaaa.scienceblog.com/231/the-complex-relationship-between-alcohol-and-pain

(18) https://www.nccih.nih.gov/health/chronic-pain-in-depth

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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