Physical Pain Linked to Increased Risks for Alcohol Relapse
People who achieve abstinence during alcohol treatment are substantially more likely to relapse back into excessive drinking when they have significant physical pain, according to recent findings from a group of American researchers.
As a rule, people affected by diagnosable alcohol abuse and/or alcoholism consume alcohol in amounts that exceed public health recommendations for moderate drinking. Many individuals with serious alcohol problems successfully achieve abstinence while enrolled in a treatment program. In a study published in April 2015 in the journal Addiction, researchers from two American universities explored the impact that physical pain has on the odds that any given person will relapse back into a pattern of excessive drinking during or after alcohol treatment.
Alcohol Problems and Excessive Drinking
In the U.S., public health officials commonly define excessive or heavy drinking in gender-specific terms. Under current accepted guidelines, men drink excessively or heavily when they consume more than four alcohol servings (with 0.6 oz of pure alcohol per serving) in one day, or more than 14 alcohol servings in one week. Women drink excessively or heavily when they consume more than three alcohol servings in one day or more than seven servings in one week. The primary risk of consuming heavy amounts of alcohol is the development of diagnosable symptoms of alcohol abuse and/or alcohol dependence (i.e., alcoholism). Figures compiled by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) indicate a 20 percent rate of diagnosable problems in people who drink too much alcohol just once a month. Roughly 33 percent of people who drink too much alcohol once a week will experience diagnosable problems, while the rate in people who drink heavily more than once a week reaches 50 percent.
Issues related to alcohol abuse and issues related to alcoholism frequently overlap in affected individuals. For this reason, the American Psychiatric Association officially views alcohol abuse symptoms and alcoholism symptoms as part of a singular condition called alcohol use disorder. Recent figures from the NIAAA show that roughly 17 million American adults meet the criteria for diagnosis of a mild, moderate or severe case of this disorder.
Abstinence from alcohol use is a common goal in alcohol treatment programs, as well as in mutual self-help groups such as Alcoholics Anonymous. Unfortunately, relapse is a frequent feature of the recovery process. Several known factors help explain the relapse risks in recovering drinkers (and other substance users). For example, newly recovering drinkers can experience serious or even life-threatening withdrawal symptoms that prompt a desire to rapidly return to alcohol use. After the withdrawal period ends, people in recovery still commonly experience strong urges or cravings to return to drinking. Alcohol-related urges often grow worse in the presence of reminders of a prior drinking life, including such things as locations or functions previously associated with alcohol use (e.g., bars, parties, etc.), emotional states previously associated with alcohol use and the presence of former drinking partners.
Impact of Physical Pain
In the study published in Addiction, researchers from the University of New Mexico and Syracuse University used data from a U.S. project called the COMBINE Study and a British project called the United Kingdom Alcohol Treatment Trial to assess the influence of physical pain on the odds that any given person treated for alcohol problems will experience a relapse and return to a pattern of excessive drinking. The COMBINE Study included 1,383 adults with an average age of 44, while the United Kingdom Alcohol Treatment Trial included 742 adults with an average age of 42. The researchers used two screening tools to evaluate the prevalence and seriousness of physical pain symptoms in both groups of participants.
After completing their analysis of the American and British participants, the researchers concluded that the presence of significant physical pain increases the odds that a person in alcohol recovery will relapse back into excessive drinking by about 12 percent to 19 percent. They also concluded that the presence of significant physical pain increases the odds that a person who completes alcohol treatment will relapse back into excessive drinking by roughly 16 percent.
After statistically accounting for all other major influences on the odds of experiencing an alcohol relapse, the researchers found that physical pain specifically increased the in-treatment risks for the British group of study participants and also specifically increased the post-treatment risks for the larger American group of study participants.