Pain As a Predictor of Heavy Drinking and Any Drinking Lapses in the COMBINE Study and the UK Alcohol Treatment Trial

Overview

Journal Addiction

Specialty Psychiatry

Date 2015 Apr 29

PMID 25919978

Citations 46

Authors

Katie Witkiewitz

Kevin E Vowles

Elizabeth McCallion

Tessa Frohe

Megan Kirouac

Stephen A Maisto

Affiliations

Soon will be listed here.

Abstract

Aims: To test the association between pain and heavy drinking lapses during and following treatment for alcohol use disorders (AUD).

Design: Secondary data analysis of data from two clinical trials for AUD.

Setting And Participants: 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)].

Measurements: 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.

Findings: 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.

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