Nociplastic Pain and Pain-Motivated Drinking in Alcohol Use Disorder

Orman Trent Hall; Johnathan Rausch; Parker Entrup; Pooja Lagisetty; Craig Bryan; Lora Black; Jose Moreno; Stephanie Gorka; K Luan Phan; Daniel J Clauw

doi:10.1016/j.jpain.2024.01.332

Nociplastic Pain and Pain-Motivated Drinking in Alcohol Use Disorder

J Pain. 2024 Jan 12:104467. doi: 10.1016/j.jpain.2024.01.332. Online ahead of print.

Authors

Affiliations

¹ Department of Psychiatry & Behavioral Health, Wexner Medical Center, The Ohio State University, Columbus, Ohio.
² Division of General Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
³ Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, Michigan; Department of Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, Michigan.

PMID: 38219852
DOI: 10.1016/j.jpain.2024.01.332

Abstract

Heavy chronic alcohol use may produce pain amplification through neurochemical and neuroplastic changes at multiple levels of the nervous system. Similar changes are thought to underlie nociplastic pain. The American College of Rheumatology Fibromyalgia Survey has been used as a surrogate for nociplastic pain, including among individuals with alcohol use disorder (AUD). However, studies linking nociplastic pain to pain-motivated drinking are lacking. The present study aimed to determine if nociplastic pain is associated with pain-motivated drinking in AUD. To achieve this aim, a new scale-the Pain-Motivated Drinking Scale (PMDS)-was developed to measure how often participants were motivated by pain to drink alcohol. Measurement properties of this new scale were determined, including its factor structure, internal consistency reliability, and construct validity. In this cross-sectional observational study, participants with AUD (n = 138) were consecutively recruited from the patient pool at an academic addiction treatment facility. Seventy-two percent (95, 72.0%) reported they drank alcohol "to get relief from physical pain" at least some of the time, and over forty-two percent (56, 42.4%) reported pain relief motivated their drinking at least half of the time. PMDS had a single-factor structure, strong internal consistency reliability, and construct validity. A multiple hierarchical linear regression was run to determine if nociplastic pain was associated with pain-motivated drinking. Nociplastic pain was associated with PMDS even after controlling for potential confounders and pain severity. These findings suggest nociplastic pain is uniquely associated with pain-motivated drinking in AUD. PERSPECTIVE: Nociplastic pain is independently associated with pain-motivated drinking in alcohol use disorder (AUD). The Pain-Motivated Drinking Scale (PMDS) is a new scale to measure how often people drink to cope with pain. PMDS has promising psychometric properties. Nociplastic pain may be uniquely associated with pain-motivated drinking in AUD.

Keywords: Alcohol-related disorders; Alcoholism; Central nervous system sensitization; Chronic pain; Fibromyalgia.

Published by Elsevier Inc.