title: Pain, alcohol use disorders and risky patterns of drinking among people with chronic non-cancer pain receiving long-term opioid therapy.
abstract: BACKGROUND
  The utilisation of pharmaceutical opioids has increased internationally, and there is evidence of increasing risky alcohol consumption with ageing. This study examines the patterns and correlates of risky drinking among people with chronic non-cancer pain (CNCP) prescribed opioids, and the associations between alcohol consumption and pain.
  
  
  METHODS
  The Pain and Opioids IN Treatment cohort comprises 1514 people in Australia prescribed pharmaceutical opioids for CNCP. Participants reported lifetime, past year and past month alcohol use, as well as mental and physical health, other substance use, pain characteristics, and current opioid dose.
  
  
  RESULTS
  Less than one-tenth of the sample were 'lifetime abstainers' (7%); 34% were 'former drinkers'; 34% were 'non-risky drinkers' (i.e., past 12 month use ≤4 standard drinks); 16% were 'occasional risky drinkers'; and 8% were 'regular risky drinkers' (i.e., ≥weekly use of >4 standard drinks). Males reported greater levels of alcohol use, and a third (33%) of the total sample reported a lifetime alcohol use disorder. Controlling for demographics, mental health, physical health and substance use disorder history, 'former drinkers' (cf. 'non-risky drinkers') reported higher pain severity and interference ratings, and lower pain coping. 'Occasional risky drinkers' and 'regular risky drinkers' (cf. 'non-risky drinkers') reported higher levels of pain interference.
  
  
  CONCLUSIONS
  Among people with CNCP, those who abstained from alcohol or drank at risky levels reported poorer pain outcomes compared with moderate drinkers. Early identification and intervention for risky drinking among people is critical, particularly given the risks associated with co-administration of alcohol and opioids.
authors.affiliation: National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales, Australia. Electronic address: b.larance@unsw.edu.au.
authors.forename: Briony
authors.initials: B
authors.lastname: Larance
authors.affiliation: National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales, Australia.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Campbell
authors.affiliation: School of Medicine (Psychology), University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Amy
authors.initials: A
authors.lastname: Peacock
authors.affiliation: National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales, Australia; Drug and Alcohol Services, South East Sydney Local Health District (SESLHD), New South Wales, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Nielsen
authors.affiliation: School of Medicine (Psychology), University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Raimondo
authors.initials: R
authors.lastname: Bruno
authors.affiliation: School of Population Health, University of Queensland, Queensland, Australia.
authors.forename: Wayne
authors.initials: W
authors.lastname: Hall
authors.affiliation: Drug and Alcohol Services, South East Sydney Local Health District (SESLHD), New South Wales, Australia; University of Sydney, Addiction Medicine, Central Clinical School, Camperdown, New South Wales, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lintzeris
authors.affiliation: St. Vincent's Clinical School, UNSW Australia, Sydney, New South Wales, Australia.
authors.forename: Milton
authors.initials: M
authors.lastname: Cohen
authors.affiliation: National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales, Australia.
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology*; D019973:Alcohol-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001315:Australia / Q000453:epidemiology; D059350:Chronic Pain / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Alcohol; Alcohol use disorder; Chronic pain; Drinking; Pain