Abstract
This study examined the occurrence of alcohol use to manage pain in community-dwelling
adults with tooth pain, jaw joint/face pain, and arthritis. Race/ethnicity, sex, and
age were examined to determine their associations with alcohol use for pain. Community-dwelling
adults from South Florida with tooth pain (n = 1,767), jaw joint/face pain (n = 1,199),
or arthritis pain (n = 1,355) completed a structured telephone interview. Logistic
regression models indicted that, similar to population rates, nonHispanic whites and
males were the most likely to use alcohol to manage pain. In addition, alcohol use
for pain was highest in younger adults. Individuals who self-managed oral pain with
alcohol were more likely to use prescription and over-the-counter pain medications,
but this association was not found for arthritis. Additional characteristics of individuals
who self-medicated regardless of pain condition included greater pain frequency, depression,
and higher levels of education. Being married was protective against the use of alcohol
to manage pain symptoms. Use of alcohol for pain should be assessed during treatment
evaluation so that physicians and other health care providers are aware of their patient's
concomitant use of alcohol and pain medication, assess for psychosocial impairment,
and make the appropriate referrals and adjustment to treatment.
Perspective
Self-medication of pain with alcohol is most common among younger nonHispanic white
males and associated with pain frequency, depression, and use of pain medications.
Alcohol use for pain needs to be assessed so that health care providers can make appropriate
referrals and adjustments to treatment.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of PainAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Headache prevalence related to smoking and alcohol use. The Head-HUNT Study.Eur J Neurol. 2006; 13: 1233-1238
- Impact of chronic pain on health care seeking, self care, and medication. Results from a population-based Swedish study.J Epidemiol Community Health. 1999; 53: 503-509
- Predictors of incident chronic widespread pain among veterans following the first Gulf War.Clin J Pain. 2006; 22: 554-563
- Gender and ethnic differences in alternative and conventional arthritis remedy use among community-dwelling rural adults with arthritis.Arthritis Care Res. 1996; 9: 384-390
- How does the general population treat their pain? A survey in Catalonia, Spain.J Pain Symptom Manage. 2002; 23: 318-328
- Using binary logistic regression models for ordinal data with non-proportional odds.J Clin Epidemiol. 1998; 51: 809-816
- Survey of select practice behaviors by primary care physicians on the use of opioids for chronic pain.Curr Med Res Opin. 2006; 22: 1859-1865
- Endogenous opioids. Histochemistry, neurophysiology, and pharmacology.Psychiatr Clin North Am. 1983; 6: 365-375
- Self-management of chronic pain: A population-based study.Pain. 2005; 113: 285-292
- Alcohol use self report in chronic back pain—relationships to psychosocial factors, function performance, and medication use.Disabil Rehabil. 2003; 25: 1271-1277
- Pain and use of alcohol to manage pain: Prevalence and 3-year outcomes among older problem and non-problem drinkers.Addiction. 2005; 100: 777-786
- Role of age, sex, and obesity in the higher prevalence of arthritis among lower socioeconomic groups: A population-based survey.Arthritis Rheum. 2007; 57: 553-561
- Acculturation and drinking patterns among U.S. Hispanics.British Journal of Addiction. 1987; 82: 789-799
- Trends in situational norms and attitudes toward drinking among Whites, Blacks, and Hispanics: 1984-1995.Drug and Alcohol Dependence. 1999; 54: 45-56
- Centers for Disease Control and Prevention (2005). State prevalence of self-reported doctor-diagnosed arthritis and arthritis-attributable activity limitation. United States, 2003.MMWR Morb Mortal Wkly Rep. 2006; 54: 119-123
- Suffering: The contributions of persistent pain.Lancet. 1999; 353: 2233-2237
- Pretesting survey instruments: an overview of cognitive methods.Qual Life Res. 2003; 12: 229-238
- The use and effect of analgesics in patients who regularly drink alcohol.Am J Manag Care. 2001; 7: S597-601
- Impact of age at first drink on stress-reactive drinking.Alcohol Clin Exp Res. 2007; 31: 69-77
- The association between stress and drinking: Modifying effects of gender and vulnerability.Alcohol and Alcoholism. 2005; 40: 453-460
- Ethanol potentiation of aspirin-induced prolongation of the bleeding time.New England Journal of Medicine. 1982; 306: 852-854
- Alcohol and the elderly.Clinics in Geriatric Medicine. 1992; 8: 127-141
- Pain coping and social support as predictors of long-term functional disability and pain in early rheumatoid arthritis.Behav Res Ther. 2003; 41: 1295-1310
Fisher JA, Riley III JL: Oral Health Disparities: Actions taken about pain: Results of pilot testing of survey instrument and prediction models. Presented at the University of Florida College Dentistry Research Day, Gainesville, FL, May 2004
- High blood alcohol levels in women: The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism.N Engl J Med. 1990; 322: 95-99
- Evaluation of bias and logistics in a survey of adults at increased risk for oral health decrements.J Public Health Dent. 1997; 57: 48-58
- Selection of analgesic therapies in rheumatoid arthritis: The role of opioid medications.Arthritis Carc Res. 1993; 6: 223-228
- Why genes don't count (for racial differences in health).Am J Public Health. 2000; 90: 1699-1702
- Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions.Arch Gen Psychiatry. 2004; 61: 807-816
- Race and chronic pain: A comparative study of young black and white Americans presenting for management.J Pain. 2003; 4: 176-183
- Nonresposne rates and nonresionse bias in household surveys.Public Opinion Quarterly. 2006; 70: 646-675
- Predictors of opioid misuse in patients with chronic pain: A prospective cohort study.BMC Health Serv Res. 2006; 6: 46
- The effect of acetaminophen (four grams a day for three consecutive days) on hepatic tests in alcoholic patients: A multicenter randomized study.BMC Med. 2007; 5: 13
- Chronic pain in a couples context: A review and integration of theoretical models and empirical evidence.J Pain. 2006; 7: 377-390
- Estimated prevalence and distribution of reported orofacial pain in the United States.J Am Dent Assoc. 1993; 124: 115-121
- Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis.Arthritis Rheum. 1989; 32: 37-44
- Applied Logitic Regression, 1st Edition.Sage Publications, Thousand Oaks, CA1995
- Comorbidity for alcoholism and depression.Psychiatr Clin North Am. 1990; 13: 613-632
- Comorbidity and co-transmission of alcoholism, anxiety and depression.Psychol Med. 1994; 24: 69-80
- Plan and operation of the health and nutrition examination survey. United States 1971–1973.Vital Health Stat. 1973; 10a: 1-46
- Cultural mistrust, ethnic identity, racial identity, and self-esteem among ethnically diverse Black university students.Journal of Counseling and Development. 2001; 79: 209-216
- Stress and alcohol interaction: An update of human research.Alcoholism: Clinical and Experimental Research. 1991; 15: 438-459
- Psychophysical approaches to measurement of the dimension and stages of pain.in: Turk D.C. Melzack R. Handbook of Pain Assessment, 2nd Edition. Guilford Press, New York, NY2001: 53-75
- The protective effects of ethnic identity for alcohol and marijuana use among Black young adults.Cultur Divers Ethnic Minor Psychol. 2007; 13: 187-193
- Orofacial pain: Racial and sex differences among older adults.J Public Health Dent. 2002; 62: 132-139
- Racial/ethnic differences in the experience of chronic pain.Pain. 2002; 100: 291-298
- Validation of a surveillance case definition for arthritis.J Rheumatol. 2005; 32: 340-347
- Stress-related problem drinking and alcohol problems: A longitudinal study and extension of Marlatt's model.Canadian Journal of Behavioral Science. 1993; 25: 446-464
- Does drinking reduce stress?.Alcohol Res Health. 1999; 23: 250-255
- Analysis of Incomplete Multivariate Data, 1st Edition.Chapman & Hall, London, UK1997
- Ethnicity as a variable in epidemiological research.Br Med J. 1994; 309: 327-330
- Body pain area and pain-related negative affect predict clinical pain intensity in patients with fibromyalgia.J Pain. 2004; 5: 338-343
- Disability, social support, and distress in rheumatoid arthritis: Results from a thirteen-year prospective study.Arthritis Rheum. 2006; 55: 736-744
- Substance Abuse and Mental Health Services Administration [SAMHSA], 2004 Results from the 2003 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H–25, DHHS Publication No. SMA 04–3964).Weshsler, Rockville, MD2002
- Regular use of prescribed opioids: Association with common psychiatric disorders.Pain. 2005; 119: 95-103
- Alcohol elimination and simulator performance of male and female aviators: A preliminary report.Aviat Space Environ Med. 1996; 67: 407-413
- Gender differences in alcohol metabolism. Physiological responses to ethanol.Recent Developments in Alcoholism. 1995; 12: 163-179
US Census. Available online at http://www.census.gov/main/www/access.html. Accessed November 15, 2007
- Assessing the stages of pain processing: A multivariate analytical approach.Pain. 1996; 68: 157-167
- Alcohol and medication interactions.Alcohol Res Health. 1999; 23: 40-54
- Trends in college binge drinking during a period of increased prevention efforts. Findings from 4 Harvard School of Public Health College Alcohol Study surveys: 1993-2001.Journal of American College Health. 2002; 50: 203-217
- The concept of race and health status in America.Public Health Rep. 1994; 109: 26-41
- Gender differences in alcohol consumption and adverse drinking consequences: cross-cultural patterns.Addiction. 2000; 95: 251-265
- Patterns and perceptions of care for treatment of back and neck pain: Results of a national survey.Spine. 2003; 28: 292-297
- Acetaminophen (paracetamol) hepatotoxicity with regular intake of alcohol: Analysis of instances of therapeutic misadventure.Hepatology. 1995; 22: 767-773
Article info
Publication history
Accepted:
March 10,
2009
Received in revised form:
February 18,
2009
Received:
December 22,
2008
Footnotes
Support was provided by National Institutes of Health Grants RO1-015581 (JR) and T32-NS045551 (CK). The authors have no conflict of interests.
Identification
Copyright
© 2009 American Pain Society. Published by Elsevier Inc. All rights reserved.
