Alcohol for chronic pain

There’s a common assumption that chronic pain can be alleviated or self-medicated with alcohol and in fact, studies in the US have found that more than one in four people with chronic pain turn to alcohol in the hope of alleviating their pain.

For what it’s worth, my own experience of people suffering chronic pain is that the vast majority actually avoid alcohol, or are only light, occasional drinkers, citing one or both of the following reasons:

They’re shattered 24/7 – chronic pain robs you of sleep and drains you of energy and the very last thing you can even contemplate is an alcoholic drink;
It’s a poor ‘mixer’ with medication – adding alcohol to your daily cocktail of medication can cause or contribute to unwelcome side-effects. For this reason, many people are advised by those treating them to avoid alcohol altogether whilst on pain and other medication.

However, a large-scale study published recently in the journal, Pain Medicine, is just the latest to suggest that drinking alcohol might be an effective, if potentially risky, method of treating chronic pain. The research, which was carried out at the University of Michigan, involved “2,583 new chronic pain patients presenting at a university pain clinic”, roughly a third of whom reported symptoms of fibromyalgia (FM).

The researchers’ stated aim “was to assess associations between pain, fibromyalgia symptoms, and moderate alcohol use in a large chronic pain sample.” And the results were certainly interesting. Moderate drinkers (defined here as those consuming between 7 and 14 units of alcohol per week) reported less pain and other symptoms than non-drinkers. The researchers concluded that:

“Moderate alcohol consumption in chronic pain patients was associated with decreased pain severity and interference, fewer painful body areas, lower somatic and mood symptoms, and increased physical function. A similar effect was observed in non-FM patients, but to a lesser extent in FM patients, suggesting chronic pain patients with less centralized forms of pain may benefit most from moderate alcohol consumption.”

Earlier studies

A number of earlier studies examining the effect of alcohol consumption on chronic pain have focused on people with rheumatoid arthritis. However, a similar but smaller study published in 2013 focused exclusively on people with fibromyalgia. The results mirrored the recent Michigan study, with the researchers concluding that “low and moderate alcohol consumption was associated with lower fibromyalgia symptoms and better [quality of life] compared to no alcohol consumption.”

Can alcohol relieve chronic pain?

Whilst scientists do not entirely understand how alcohol produces these effects, there is a theory that a neurotransmitter called gamma-aminobutyric acid (GABA) may be involved. GABA works to block certain impulses between nerve cells in the brain and nervous system. It is thought that alcohol may either stimulate the production of GABA or in itself act on the brain and nervous system in a similar way.
Either way, this calming down of the nervous system may produce the beneficial effects reported.

Alcohol on prescription?

Of course that isn’t going to happen. But equally, neither are most clinicians likely to recommend to their patients that they self-medicate with alcohol. Certainly, the potential for harm, particularly when combined with other medications is very real. And it’s not just the more noticeable side-effects that are the problem. Alcohol can heighten or even lessen the intended action of some medications.

Another issue is that, sadly, it’s not unusual for pain to become more severe over time. Somebody self-medicating with alcohol may therefore feel the need to consume more alcohol to combat higher levels of pain. A person’s tolerance to alcohol is also likely to increase, requiring a greater level of consumption to achieve the same level of effect.

There’s also another problem. Research has shown that excessive use of alcohol can cause a condition called small-fibre peripheral neuropathy, which can actually increase the sensation of pain.

Conclusions

All in all it’s difficult to say what definite conclusions can be drawn from all of this. Clearly, on the one hand there may be some situations where moderate levels of alcohol consumption can have a beneficial effect on the symptoms of, and associated with, chronic pain. On the other hand, for a whole host of reasons, long-term, regular alcohol consumption is universally discouraged. And that is the crux of the problem here. Chronic pain means long-term pain and self-medicating with alcohol would therefore mean long-term, regular consumption. I suppose that in itself answers the question!