Pain as a predictor of heavy drinking and any drinking lapses in the COMBINE study and the UK Alcohol Treatment Trial.
OBJECTIVE
To test the association between pain and heavy drinking lapses during and following treatment for alcohol use disorders (AUD).


METHODS
Secondary data analysis of data from two clinical trials for AUD.


METHODS
Participants included 1383 individuals from the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) Study in the United States [69.0% male, 76.8% non-Hispanic White average age=44.4, standard deviation (SD) = 10.2] and 742 individuals from the UK Alcohol Treatment Trial (UKATT) in the United Kingdom [74.1% male, 95.6% White, average age=41.6 (SD=10.1)].


METHODS
Form-90 (a structured assessment interview) was used to assess the primary outcome: time to first heavy drinking day. The Short Form Health Survey and Quality of Life measures were used to assess pain interference and pain intensity.


RESULTS
Pain was a significant predictor of heavy drinking lapses during treatment in UKATT [odds ratio (OR)=1.19, 95% confidence interval (CI)=1.08, 1.32, P=0.0003] and COMBINE (OR=1.12, 95% CI=1.03, 1.21, P=0.009), and was a significant predictor of heavy drinking lapses following treatment in COMBINE (OR=1.163, 95% CI=1.15, 1.17, P<0.00001). After controlling for other relapse risk factors (e.g. dependence severity, self-efficacy, temptation, psychiatric distress), pain remained a significant predictor of heavy drinking lapses during treatment in UKATT (OR=1.19, 95% CI=1.06, 1.34, P=0.004) and following treatment in COMBINE (OR=1.44, 95% CI=1.07, 1.92, P=0.01).


CONCLUSIONS
Among people treated for alcohol use disorder, being in physical pain appears to predict heavy drinking lapses during or after treatment.
Department of Psychology, University of New Mexico, Albuquerque, NM, USA.|Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, NM, USA.
Katie
K
Witkiewitz
Department of Psychology, University of New Mexico, Albuquerque, NM, USA.
Kevin E
KE
Vowles
Department of Psychology, University of New Mexico, Albuquerque, NM, USA.
Elizabeth
E
McCallion
Department of Psychology, University of New Mexico, Albuquerque, NM, USA.|Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, NM, USA.
Tessa
T
Frohe
Department of Psychology, University of New Mexico, Albuquerque, NM, USA.|Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, NM, USA.
Megan
M
Kirouac
Department of Psychology, Syracuse University, Syracuse, NY, USA.
Stephen A
SA
Maisto
D000077443:Acamprosate; D000328:Adult; D000427:Alcohol Deterrents / Q000627:therapeutic use; D000428:Alcohol Drinking / Q000009:adverse effects / Q000517:prevention & control*; D019973:Alcohol-Related Disorders / Q000150:complications / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods; D059350:Chronic Pain / Q000209:etiology*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009271:Naltrexone / Q000627:therapeutic use; D010147:Pain Measurement; D012008:Recurrence; D013654:Taurine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome
D000427:Alcohol Deterrents; D013654:Taurine; D009271:Naltrexone; D000077443:Acamprosate
Alcohol relapse; COMBINE study; United Kingdom Alcohol Treatment Trial; alcohol treatment outcomes; latent transition analyses; pain