The use of alcohol to address acute pain has a long history. Watch a couple of old Westerns on television and you are bound to see a character cope with a snake bite or a bullet wound by taking a swig of whiskey. The fact is that alcohol is readily available, and effective pain medication sometimes is not.
Unfortunately, people tend to try to medicate chronic pain with alcohol as well, and this can be extremely dangerous. An estimated 25 to 28% of people use alcohol to alleviate pain, whether it is the acute pain of an abscessed tooth or chronic pain from arthritis or an injury.
Why People Self-Medicate Pain with Alcohol
One reason people often self-medicate pain with alcohol, aside from the fact that it is so easy to obtain, is that they see alcohol as also a way to manage stress, and chronic pain and stress frequently go together. Though alcohol does not have any direct pain-relieving properties, it can affect the central nervous system in such a way that pain is not perceived to be as bad. Drinking enough alcohol to “relieve pain” can mean drinking to the point of blackout, and this is an exceptionally unhealthy way to deal with pain, whether acute or chronic.
Dangers of Combining Pain Medications and Alcohol
Many over-the-counter and prescription medications carry warnings not to take drugs with alcohol. In fact, alcohol can interact badly with a number of medications. For example, drinking alcohol while taking acetaminophen (Tylenol) raises the risk of possibly deadly liver failure. Drinking alcohol while taking aspirin increases a person’s risk of gastric bleeding.
Mixing alcohol with benzodiazepines is also dangerous because alcohol has an “agonist-like” effect (in that it initiates a physiological response) when paired with benzos like Xanax. Pairing the two increases risk of cardiac or respiratory problems, as well as increasing the risk of alcohol poisoning.
The combination of alcohol and opioid painkillers can be deadly, with alcohol increasing the risk of serious respiratory depression with opioids. These risks are higher in older people. In other words, the warning labels on prescription painkiller bottles to avoid alcohol are far more than mere suggestions; they can be life-saving.
Chronic Drinking Ultimately Makes Pain Worse
Alcohol use, which is not that good at addressing chronic pain anyway, ultimately makes the pain worse. When a person withdraws from chronic alcohol use, pain sensitivity is often increased. Sadly, this can motivate some to continue drinking or to drink even more. Additionally, prolonged, excess consumption of alcohol can actually cause small fiber peripheral neuropathy. This type of neuropathy causes symptoms like pain, tingling, “pins and needles” sensations in the extremities, or altered sensations, especially in the feet. Whatever short-term relief from pain alcohol may provide (at least at first), it is far outweighed by more pain over the long term.
Effectively and Safely Addressing Chronic Pain
With the opioid epidemic in America, and the dangers of trying to address pain with alcohol (including the danger or serious alcohol addiction), how is a person expected to deal with chronic pain? There is no single correct answer. A recent study found that increasing the dosage and duration of opioids for chronic pain was associated with worse outcomes.
The National Institutes of Health and the Institute of Medicine have called for more evidence-based behavioral strategies for managing chronic pain. Cognitive behavioral therapy is of particular interest, as well as mindfulness meditation, which can increase tolerance of pain and reduce perceived pain intensity.
Effective long-term pain relief requires the help of both physicians and behavioral health specialists rather than just one or the other. Of course, patient commitment is essential. There are countless reasons why alcohol use is an ineffective and dangerous approach to coping with chronic pain. Alcohol addiction can result, while pain ultimately fails to get better.
A comprehensive approach to the treatment of alcohol addiction, which considers chronic conditions like chronic pain, is necessary for effective treatment of both. The input of medical professionals and behavioral experts in a therapeutic, compassionate environment is essential to developing a personalized, long-term plan for recovery from alcohol addiction and effective strategies to address pain.
If you are struggling with alcohol addiction, with or without chronic pain, we encourage you to contact us at any time. Reaching out is the first step to recovery.
Hovaguimian, Alexandra, and Christopher H Gibbons. “Diagnosis and Treatment of Pain in Small-Fiber Neuropathy.” Current Pain and Headache Reports, U.S. National Library of Medicine, June 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3086960/.
MI., Linnoila. “Benzodiazepines and Alcohol.” Journal of Psychiatric Research, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/1980691/.
Morasco, Benjamin, et al. “Higher Prescription Opioid Dose Is Associated With Worse Patient-Reported Pain Outcomes and More Health Care Utilization.” The Journal of Pain, U.S. Association for the Study of Pain, 17 Dec. 2016, www.jpain.org/article/S1526-5900(16)30356-X/abstract.
Odell, Rochelle. “Do You Use Alcohol to Relieve Chronic Pain?” Pain News Network, Pain News Network, 29 July 2017, www.painnewsnetwork.org/stories/2017/7/29/do-you-use-alcohol-to-relieve-chronic-pain.
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