(183) Alcohol withdrawal induced hyperalgesia and alcohol craving in young adult binge drinkers

      Previous studies have found that alcohol craving can influence motivation to drink, which in turn could lead to problematic drinking, such as binge drinking. This effect of craving is particularly strong during acute alcohol withdrawal, when individuals are motivated to drink more to gain relief from withdrawal symptoms. Studies in animals and preliminary data from our human laboratory have demonstrated hypersensitivity to pain during the withdrawal phase; therefore, pain could also enhance craving behavior and subsequent motivations to drink. No studies to date have examined whether pain is associated with enhanced alcohol craving in humans. The goal of the present study was to examine whether heightened pain sensitivity during alcohol withdrawal was associated with enhanced alcohol craving. Participants included binge drinkers who either drank within 48 hours (n=33, 36% female) or did not (n=14, 61% female). Binge drinking was defined as having 4+ (females) / 5+ (males) drinks per episode. Craving was not different between these groups, F (1,45)=1.14, p=.291. As expected, hangover symptoms were greater in those with a recent drinking episode (M=9.6, SD=6.9) than those without (M=4.1, SD = 4.1), F (1, 45)=3.64, p=.063. The result of hierarchical regression indicated that greater craving was predicted by more hangover symptoms (β=.342, p=.020, r2=. 12). After controlling for hangover symptoms, enhanced craving was predicted by lower tactile pain threshold (β=-.344, p=.028, r2=.12), but not by heat or pressure pain threshold (ps>.337). Bootstrap analysis with 2000 sampling method indicated these findings as replicable (p=.014). These results indicate that mechanical hyperalgesia is associated with greater alcohol craving in binge drinkers and this effect is significant above and beyond hangover symptoms. To further examine the causal relationship, we are currently examining alcohol craving, with pain testing before and after alcohol administration. Although preliminary, these findings suggest that pain could influence the acquisition and maintenance of problematic drinking.