Alcohol And Chronic Pain

Using Alcohol To Cope With Chronic Pain

Pain brings more people into contact with medical professionals than any other condition. Acute pain is described as pain that happens quickly and subsides quickly, typically lasting no longer than six months. However, pain that persists for longer, halts daily activities, or causes permanent damage to the body is classified as chronic pain.

Each year, millions of Americans struggle with chronic pain; and while most are able to manage their pain via medications, therapies, or other methods, some turn to alcohol to self-medicate.

Understanding Chronic Pain

Chronic pain fundamentally differs from acute pain in that it persists well over six months and sometimes for decades. It can relate to an underlying disease or health condition, an injury, medical treatment (such as surgery), inflammation, a problem in the nervous system (neuropathic pain), or even an unknown cause.

More than 20% of the U.S. population lives with chronic pain, with an estimated annual cost related to treatment and lost productivity of more than $600 billion.

Chronic pain often affects quality of life and productivity and is accompanied by physical effects that include limited mobility, fatigue, sleep impairment, and changes in appetite. In addition, emotional effects such as depression, sadness, frustration, irritability, anger, anxiety, and fear are also common.

Common chronic pain conditions include but are not limited to:

• Migraine headaches
• Low back or neck pain
• Arthritis
• Cancer
• Fibromyalgia
• Neuropathy
• Psychogenic pain (pain without any observable signs of damage or disease)

Alcohol And Chronic Pain

The concept of using alcohol to relieve pain isn’t new. Research by the U.S. National Institute on Alcohol Abuse and Alcoholism suggests that as many as 28% of people experiencing chronic pain turn to alcohol to relieve it.

While alcohol does not directly decrease pain, as a central nervous system depressant it has a numbing effect that can temporarily lessen the subjective experience of pain sensations. However, with continued drinking over time, the body develops a tolerance to alcohol’s analgesic effects, meaning it takes more and more to produce the same results. Therefore, the need to progressively increase the amount of alcohol consumed is a key factor in the development of alcohol use disorder (AUD) and one of its fundamental diagnostic indicators.

Moreover, using alcohol to numb, escape from, or medicate chronic pain places people at risk for several additional serious health consequences, especially when mixed with pain medications.

Risks Of Mixing Alcohol And Pain Medications

If you have a chronic pain condition, discussing your drinking habits with your medical provider is extremely important. Alcohol can interact with medications in different ways depending on their chemical makeup. It is not recommended to mix alcohol with any medications, even over-the-counter ones. Doing so may result in a number of serious side effects, including the following:

• Mixing alcohol and acetaminophen can cause acute liver poisoning and even liver failure.
• Mixing alcohol and ibuprofen or aspirin increases the risk of gastric (stomach) bleeding.
• Alcohol increases the sedative effects of Opioids, elevating the risk of the misuse of alcohol and Opioids in combination, along with the potential for Opioid overdose.

Does Alcohol Make Chronic Pain Worse?

While alcohol may be seen as an avenue for some with chronic pain to self-medicate, the reality is it can make pain worse, not better. Alcohol is a popular choice for those who turn to substances to mitigate their pain; however, its effects on the body can be especially destructive for those with chronic pain.

Some of the ways in which alcohol can worsen pain include the following:

• Alcohol interferes with the circadian rhythm that governs our sleep cycle and suppresses REM (deep) sleep. As a result, you may fall asleep more readily after drinking, but you are more likely to experience interrupted and less restful sleep. Poor sleep quality hinders the body’s ability to recharge, refresh, and heal. which typically increases pain levels.
• Withdrawal from consistent alcohol use increases pain sensitivity which motivates people to continue or even increase their drinking to reverse withdrawal-related increases in pain.
• Over time, heavy alcohol use can generate a painful small fiber peripheral neuropathy; the most common neurological complication associated with alcohol addiction.

Addiction frequently begins as a way to escape from discomfort and pain, both physical and emotional, via mood-altering substances or behaviors (such as gambling, eating, sex, internet involvement, etc.) that become reinforced and habituated through repetition. All efforts to avoid painful thoughts, feelings, and physical sensations, no matter what methods are attempted, may work temporarily, but in the long run, only prolong those experiences and intensify the suffering connected to them.

Pain is an inevitable part of life and an essential aspect of being human. However, suffering is optional. Suffering is a function of people’s thoughts and emotions about the pain they experience and the beliefs they attach to it. Whenever the belief exists that someone shouldn’t be in pain, that it “isn’t fair,” or that pain must be avoided at all costs, they will experience suffering. And the more someone tries to avoid experiencing pain, the greater their suffering tends to be. This creates a vicious circle that only increases the level of pain people experience.

How To Better Manage Chronic Pain

First and most important, a physician should assess all chronic pain conditions. Beyond that, dealing effectively with chronic pain requires addressing both the pain and the suffering. This necessitates a bio-psycho-social strategy.

The goal is to improve functioning and overall quality of life through a combination of professionally administered and self-directed methods that reduce the pain experienced and provide the skills to accept and live with the pain that remains as gracefully as possible.

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Medication

Medications are often necessary to help manage chronic pain. Three primary types of medications are used for chronic pain, and each has strengths and weaknesses.

• Opioids are most appropriate for short-term use following injury or surgery, although they can be used for longer, more severe cancer-related pain. Common side effects are constipation, nausea, drowsiness, and other cognitive effects. Long-term use carries a significant risk of addiction and potential overdose.
• Antidepressants can be effective for nerve-related pain, sometimes combined with anticonvulsants such as gabapentin and pregabalin. However, they usually require a few weeks to achieve optimal results, and they, too, have various side effects.
• NSAIDs (non-steroidal anti-inflammatory drugs), like ibuprofen and naproxen, are generally more effective than acetaminophen for muscle and joint inflammation. Still, like aspirin, there is a risk of gastrointestinal bleeding with long-term use.

Complementary And Alternative Medicine (CAM)

A growing body of evidence indicates that physical therapy, chiropractic, acupuncture, clinical hypnosis, massage, tai chi, qi gong, and yoga can help ease pain conditions and improve functioning and range of motion.

Physical Movement And Exercise

When consistent with one’s capacity, physical exercise increases mobility, strength, and functioning, can decrease pain sensations over time, and improve quality of life. People usually avoid it when it hurts to move; however, being sedentary increases stiffness, making subsequent movement more painful. Even movement as simple and low-impact as stretching, chair-based exercise, and walking is beneficial.

Nutrition And Diet

Eating a diet rich in antioxidants and nutrients, including fresh fruits and vegetables, turmeric or curcumin, garlic, and ginger, and avoiding excess sugar, fat, sweets, and yes, alcohol, can decrease internal inflammation and make a positive difference in pain levels.

Spirituality And Spiritual Practices

Research shows that people with chronic conditions who maintain faith in a higher power and are involved in a spiritual support group (church, synagogue, mosque, 12-step program, etc.) tend to have less stress, fewer physical symptoms, and less suffering than those who do not.

Meditation And Other Mindfulness Practices

Mindfulness practices like meditation enable the ability to consciously observe pain sensations and the thoughts and emotions connected to them, be present with them, accept them, and make some peace with them rather than trying to avoid or fight against them. This can significantly reduce the stress and suffering connected to chronic pain. Moreover, slow, deep meditative breathing has been demonstrated to help calm the autonomic nervous system and decrease pain perceptions.

Psychotherapy

Psychotherapy can be extremely beneficial in dealing with chronic pain’s mental and emotional aspects. Because physical and emotional pain are related and activate one another, addressing depression, sadness, frustration, irritability, anger, anxiety, and fear has multi-level benefits. Additionally, by adjusting our thinking, it’s possible to change emotional responses and the level of suffering. Consequently, the subjective experience of pain also changes.

The premise that thoughts have significant effects on feelings and behavior and that shifts in thinking lead to emotional and behavioral changes is the basis of Cognitive Behavioral Therapy (CBT). CBT techniques help identify and change unhelpful cognitive patterns and beliefs, such as discounting the positive in a situation by focusing on the negative, thinking in rigid black-and-white/all-or-nothing extremes, and placing unreasonable and unrealistic expectations on oneself, other people, and situations. Getting caught in these cognitive traps escalates emotional and physical pain and invariably increases the experience of suffering.

Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT) are evidence-based adaptations of CBT that incorporate mindfulness practices. ACT emphasizes building psychological flexibility and features internal values-congruent practices, while DBT emphasizes the development of emotional regulation and distress tolerance skills.

These approaches transform our relationship with our thoughts, emotions, and physical sensations, including pain. This can change the quality of our experience in ways that reduce suffering and chronic pain.

Don’t Let Chronic Pain Lead To Addiction

Alcohol use is fraught with problems and is ultimately an ineffective, dangerous way of managing pain. There are no magic bullets or quick fixes when it comes to battling chronic pain or addiction. There are many approaches and practices that can have a positive impact, and all positive impacts, no matter how small, have meaning and value.

Focus on improving functioning and overall quality of life. Learn and practice the skills of accepting and living with the full range of life’s discomfort & uncertainty as gracefully as possible. We don’t have to like something to accept it. In fact, we can deeply dislike it and still come to a place of acceptance of it.

If you or someone you know is struggling with alcohol and chronic pain, the time to get help is now. To learn more about treatment options that are accessible to people with chronic pain, disabilities, or other mobility needs, contact a treatment provider today.