Chronic Pain and Alcohol Use Disorders
Summary
Chronic pain and alcohol use disorders frequently co-exist, creating a multifaceted public health challenge. Persistent pain engages neural circuits that overlap with reward and stress systems implicated in addictive behaviours, fostering a cycle of self-medication and physiological adaptation. Individuals with unremitting pain may increase alcohol consumption to obtain temporary analgesia, yet chronic exposure promotes neuroplastic changes that amplify nociceptive signalling and emotional distress. This bidirectional relationship is driven by central sensitisation, hyperalgesia and alterations in stress-responsive pathways, which together exacerbate pain perception and heighten the risk of uncontrolled drinking. The global burden encompasses diminished quality of life, increased disability, heightened risk of opioid misuse and substantial healthcare costs. Effective management demands integration of pain neuroscience, addiction medicine and psychosocial interventions to disrupt reinforcing loops, address comorbid mood disturbances and tailor multimodal therapies that mitigate both pain and harmful alcohol use.
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Chronic Pain and Alcohol Use Disorders publication trend
The graph below shows the total number of articles in chronic pain and alcohol use disorders across all publications each year (not limited to Nature Index journals).
Technical terms
Nociplastic pain: Pain arising from altered nociception without clear evidence of tissue damage or peripheral inflammation.
Central sensitisation: Increased responsiveness of central neurons to input, resulting in hypersensitivity and prolonged pain states.
Hyperalgesia: Enhanced pain response to normally painful stimuli, often induced by prolonged opioid or alcohol exposure.
Pain interference: The extent to which pain disrupts physical, emotional and social functioning in daily life.
References
- Nociplastic Pain and Pain-Motivated Drinking in Alcohol Use Disorder. Journal of Pain (2024).
- Central sensitization in opioid use disorder: a novel application of the American College of Rheumatology Fibromyalgia Survey Criteria. PAIN Reports (2022).
- Hazardous alcohol use is associated with greater pain interference and prescription opioid misuse among persons living with HIV and chronic pain. BMC Public Health (2021).
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