Alcohol and chronic pain
Written by: Jonas I. Bromberg, Psy.D.
Published: Friday, January 07, 2011
Reviewed by: Kevin L. Zacharoff, MD, January 2015
People have been using alcohol to help cope with chronic pain for many years. Many people also may use alcohol as a way to manage stress, and chronic pain often can be a significant stressor. Research studies have found that as many as 28% of people with chronic pain use alcohol as a pain management strategy.
This research also indicates that men may be more likely to have used alcohol as a pain management strategy than women. People with higher income also may tend to use alcohol more to treat their chronic pain. In this study, the amount of alcohol used to help control pain seemed to be related to the frequency of pain, as those with more frequent pain used more alcohol. The use of alcohol was not related to how intense the pain was, or how long a person had been living with pain. It was the regularity of pain symptoms that seemed most related to the use of alcohol to relieve pain.
One theory about why alcohol may be used to manage chronic pain is because it affects the central nervous system in a way that may result in a mild amount of pain reduction. However, medical experts are quick to point out that alcohol has no direct pain-relieving value, even if the short-term affects provide some amount of temporary relief. In fact, using alcohol as a way to relieve pain can cause significant problems, especially in cases of excessive use, or when it is used with pain medication.
Alcohol and medications
The dangers of mixing alcohol with prescription pain medications are many and should be well known to the public because of the large amount of the publicity this has received in the mainstream media regarding overdose deaths involving prescription pain medications and alcohol. In addition, even many over-the-counter pain medications (such as aspirin, acetaminophen, naproxen sodium, and ibuprofen) contain warnings about their use with alcohol, including a significantly increased risk of problems like liver damage, stomach ulcers, and intestinal bleeding.
Many prescription pain medications can make you drowsy, with alcohol having a similar effect on the way the central nervous system functions. Therefore, the combination of alcohol and prescription pain medication has what’s called a “synergistic effect” meaning that when two substances are mixed together in the body, the effect is much greater than either one would be separately. Additionally, drinking alcohol when taking extended-release (or long-acting) prescription pain medications may cause disruption of the extended-release mechanism, releasing a dangerous amount into your bloodstream all at one time. Mixing alcohol and prescription pain medications can cause significant problems including decreased heart rate, decreased breathing, overdose, and even death.
It’s also important to know that alcohol can produce a similar effect when mixed with many common over-the-counter pain medications that may make you drowsy. So if you’re taking any over-the-counter medications to manage your pain, talk to your healthcare provider or pharmacist about any reactions that may result from mixing them with alcohol.
Alcohol, sleep, and pain
Chronic pain often can disrupt your sleep and drinking alcohol can further disrupt the normal sleep cycle. Researchers have found that the use of alcohol by people with chronic pain is one of the leading factors contributing to sleep disruption, particularly when drinking alcohol within an hour of going to bed. Lack of sleep, or poor sleep, hurts the body in many ways and can lead to irritability, depressed mood, and fatigue. This can have a negative effect on your ability to cope with your pain.
Alcohol tolerance can also lead to negative health outcomes. Over time, the body builds up a tolerance to the effects of alcohol so that it takes more alcohol to produce the same effects. The same thing can happen with pain medications. Increasing the use of alcohol to stay ahead of the effects of tolerance can lead to other problems, like the development of liver disease and alcohol dependency.
Paying attention to sleep, stress, and alcohol use is an important way to effectively cope with your pain. If you drink alcohol frequently, whether it’s to relieve your pain or not, it is important to learn about the potential adverse health effects. Ask your health care provider if any alcohol use is safe for you.
1. Using Alcohol to Relieve Your Pain: What Are the Risks? (National Institute on Alcohol Abuse and Alcoholism) http://pubs.niaaa.nih.gov/publications/PainFactsheet/Pain_Alcohol.pdf
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