title: Reductions in physical pain predict lower risk of relapse following alcohol treatment.
abstract: OBJECTIVE
  Physical pain is considered a potential predictor of relapse in alcohol-dependent individuals after treatment. The aim of this study was to evaluate whether reductions in pain level during the follow-up period after treatment were associated with lower relapse risk.
  
  
  METHODS
  A sample of 366 participants was recruited from alcohol treatment centers in Warsaw, Poland. At baseline, information was obtained about pain level, demographics, childhood abuse, impulsivity, depressive symptoms, severity of alcohol and sleep problems. After finishing the alcohol treatment program, patients were followed for 12 months and alcohol drinking (relapse) as well as pain severity were evaluated.
  
  
  RESULTS
  In the followed-up group, 29.5% of patients confirmed that they drank any alcohol during past 4 weeks. Comparing follow-up to baseline pain, 48.6% of subjects reported an increased severity of pain, 28.8% reported the same level of pain, 22.6% reported decreased level of pain. There was a significant association between the decrease in level of pain and the lower risk of relapse. Other factors associated with relapse during 4 weeks prior to the follow-up were baseline severity of depressive symptoms, low baseline social support and number of drinking days during 4 weeks prior to entering treatment. In multivariate analysis, a decrease in pain level was associated with a lower likelihood of relapse (OR=0.159; 95%CI:0.04-0.62; p=0.008) even when controlled for other factors associated with relapse.
  
  
  CONCLUSIONS
  Decreases in pain level following treatment for alcohol dependence are associated with, and may contribute to, a lower risk of alcohol relapse.
authors.affiliation: Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska St., 00-665 Warsaw, Poland. Electronic address: ajakubczyk@wum.edu.pl.
authors.forename: A
authors.initials: A
authors.lastname: Jakubczyk
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, USA. Electronic address: marki@med.umich.edu.
authors.forename: M A
authors.initials: MA
authors.lastname: Ilgen
authors.affiliation: Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska St., 00-665 Warsaw, Poland. Electronic address: maciej.kopera@wum.edu.pl.
authors.forename: M
authors.initials: M
authors.lastname: Kopera
authors.affiliation: Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska St., 00-665 Warsaw, Poland. Electronic address: aleksandra.krasowska@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Krasowska
authors.affiliation: Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska St., 00-665 Warsaw, Poland. Electronic address: anna.klimkiewicz@mlodylekarz.pl.
authors.forename: A
authors.initials: A
authors.lastname: Klimkiewicz
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, USA. Electronic address: amybohne@med.umich.edu.
authors.forename: A
authors.initials: A
authors.lastname: Bohnert
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, USA. Electronic address: fredblow@med.umich.edu.
authors.forename: F C
authors.initials: FC
authors.lastname: Blow
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA. Electronic address: kbrower@med.umich.edu.
authors.forename: K J
authors.initials: KJ
authors.lastname: Brower
authors.affiliation: Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska St., 00-665 Warsaw, Poland; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA. Electronic address: marcin.wojnar@wum.edu.pl.
authors.forename: M
authors.initials: M
authors.lastname: Wojnar
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology*; D059408:Pain Management / Q000379:methods / Q000639:trends*; D011044:Poland / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D016320:Substance Abuse Treatment Centers / Q000379:methods / Q000639:trends*; D016896:Treatment Outcome
keywords: Alcohol dependence; Physical pain; Relapse