Below are four sources of the unexpected finding that significant alcohol consumption lowers pain and disability from the pain:
Treating chronic pain with a glass of wine or beer may not sound like a good idea, but an intriguing new study in the U.K. found that alcohol consumption is associated with lower levels of disability in pain patients.
- Drinkers overall reported less disability than people who never drank alcohol, but
- it was the heaviest drinkers who reported the least disability.
- They were 67% less likely to experience disability than the teetotalers.
Researchers at the University of Aberdeen in Scotland surveyed over 2,200 people with fibromyalgia and other chronic widespread pain conditions about their alcohol consumption. About a quarter of the respondents were teetotalers, the rest drank rarely, moderately or heavily – the latter consuming as much as 21 to 35 “units” of alcohol a week.
A “unit” was defined as 10 ounces of beer, a small glass of wine or a single beverage with hard liquor – meaning the heaviest drinkers averaged three to five drinks a day.
“As well as an association between alcohol consumption and lower levels of disability in pain patients, we also found that the population prevalence of chronic pain was lower in drinkers than in non-drinkers.
It’s clear that non-drinkers are more likely to have pain, and more likely to be disabled by it if they have it, compared to drinkers,” said Marcus Beasley, study coordinator at the University of Aberdeen.
Does alcohol act as an analgesic and simply dull pain sensations? Or does it treat and help prevent chronic pain? The researchers are cautious about drawing any conclusions.
“The design of this study cannot tell us whether drinking causes people to have less problems with pain, or if people who have pain make the choice not to drink. In any case people that drink are very different on a wide range of health measures than those that do not drink,” said Beasley.
“For primary care practitioners these findings mean that the fact a patient does not drink could be considered a potential marker for having other health problems, including with chronic pain. Otherwise, the advice that practitioners give to patients should remain the same – drink less if possible, and if consuming alcohol then do so within recommended safe limits.”
This means not drinking alcohol is a risk factor for health problems.
Previous research has linked moderate alcohol consumption with a lower risk of heart disease, stroke and diabetes. But drinking too much alcohol can lead to a variety of serious health problems.
According to the Mayo Clinic,moderate alcohol consumption for healthy adults means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.
These U.S. limits of 7 units/week for women and 14 units/week for most men are below the amounts that were found helpful in the study.
The UK study isn’t the first to find an association between alcohol and a reduced risk of chronic pain. A large study conducted in Sweden, published in the British Medical Journal, found that women who had more than three drinks a week had about half the risk of developing rheumatoid arthritis than non-drinkers.
Another study, published in Arthritis Research & Therapy, found that low and moderate drinkers suffering from fibromyalgia had less pain, less fatigue and missed fewer days of work than non-drinkers.
The study results seem to show that pain and disability were the least in people who were drinking more than what’s considered a “moderate” amounts in the U.S.
What’s nowhere mentioned is the dangerous combination of alcohol and opioids. So the big question is, are any people in their sample taking opioids and, if so, are they insinuating that drinking alcohol with their current pain medications will make the pain and disability less?
Are any people in their sample taking opioids? The only confounding factors listed are: age, gender, cigarette smoking, employment status, self-reported weight and height and level of deprivation.
Nowhere is the dangerous combination of alcohol and opioids mentioned . So, the big question is, are they insinuating that drinking alcohol along with their current pain medications will make their pain and disability less?
Is alcohol being used to enhance the effects of pain medications? If so, this would then show that better pain relief (alcohol & opioids versus either alone) is the key to lower pain and disability. Any pain patient can testify to that.
We have to keep in mind that these studies cannot prove causation, just correlation, though it’s hard to imagine that the amount of drinking is “caused” by the level of pain and disability.
Here’s a view from Medpage Today, which is targeted towards healthcare professionals.
Patients with chronic widespread pain (CWP) who consume moderate amounts of alcohol have lower levels of disability, according to a large new population-based study from the United Kingdom.
A smaller U.S. study previously showed that in patients with fibromyalgia, moderate alcohol consumption was associated with reduced symptom severity and increased quality of life. However, the current study also linked alcohol consumption with the likelihood of reporting CWP.
Using information collected in a survey, researchers identified subjects who reported pain that satisfied the definition of CWP used by the American College of Rheumatology (ACR). From responses to the Chronic Pain Grade scale, they determined the level of disability among subjects – from grade I (low disability; low intensity) to IV (high disability; severely limiting).
Participants reported their average consumption of alcohol per week. One unit of alcohol equals half a pint of beer or lager, a small glass of wine, or a single measure of spirits.
The overall analysis included 13,574 subjects, mean age 55 years. Of these, 16.5% satisfied the ACR definition of CWP. In the sample,
- 28% reported never regularly drinking alcohol,
- 28% reported consuming an average of up to 5 units/week,
- 20% 6-10 units per week;
- 15% 11-20 units per week;
- 7% 21-35 units per week; and
- 2% more than 35 units per week.
In those with CWP, the percentage of subjects with disabling pain decreased with increasing alcohol consumption – from 47.2% among those who didn’t drink regularly to only 18.6% among those who drank 21-35 units/week. The difference, noted the authors, remained highly statistically significant after adjusting for confounders such as age, gender, employment, smoking, and body mass index, with an adjusted odds ratio (OR) of 0.33 (95% CI 0.19-0.58).
In the highest alcohol consumption category — 35 units per week — the proportion with disabling pain was similar to those who didn’t drink regularly. The relationship was similar for both men and women, but the lowest disability was at 11-20 units/week in females and 21-35 units/week in males.
This is considerably more than what is considered “moderate” in the U.S.: 7 units/week in females and 14 units/week in males
Similar patterns for the relationship between alcohol consumption and disability were seen among the 8983 subjects for whom Carstairs Index information was available.
The authors reported, for the first time, that the level of alcohol consumption was also related to the likelihood of reporting CWP — and not just to its severity.
The prevalence of CWP also decreased with increasing alcohol use: from 19.8% in those not drinking alcohol regularly to 13.1% in those consuming 11-20 units/week (adjusted OR 0.75, 95% CI 0.64-0.88) or 21-35 units/week (adjusted OR 0.76; 95% CI 0.61-0.94). The CWP prevalence among the highest consumers of alcohol was similar to non-regular drinkers.
The maximum recommended alcohol consumption in the UK is 21 units/week for men and 14 units/week for women.
These U.K. limits for “moderate” alcohol consumption are 7 units/week (or I drink/day) more than in the U.S. definition.
The authors noted that their study lacks data on some potential confounders that might have shed additional light on the link between alcohol and chronic pain. “Ideally we would have had lifestyle factors (e.g., exercise) and individual characteristics (e.g., depression) known to be markers of CWP onset and which are known to be related to alcohol consumption,” they wrote.
The new analysis adds weight to the previous study. However, the two studies were conducted in different countries, used different sampling frames (fibromyalgia treatment program versus a population study), defined the outcome differently and collected information on alcohol consumption in different ways. Authors of the previous study discussed possible mechanisms linking alcohol consumption with reduced disability. One is that ethanol enhances GABA release in the brain.
In this new paper, researchers noted that alcohol has been reported to improve other areas of health, including mood, quality of life, and physical health.
According to some research, mortality rates from cardiovascular disease are significantly lower among men and women who consume at least one drink daily compared to non-drinkers, although this isn’t the case for heavy drinkers among whom mortality rates increase.
An article from the “Clinical Pain Adviser” goes even farther and points out that the best results came from more than “moderate” drinking:
Moderate to heavy drinking might cut the likelihood of disability for people with chronic widespread pain such as that related to fibromyalgia, according to new research published in Arthritis Care & Research.
They found that disability stemming from pain was strongly linked to alcohol consumption, with moderate to heavy drinkers experiencing less disability.
The researchers found that people drinking 21 to 35 units of alcohol a week were 67% less likely than those who never drink to experience disability. Those amounts translate roughly into 15 to 20 beers or 10 to 15 glasses of wine per week by American standards, constituting moderate to heavy drinking.
they note that a significant number of participants were drinking more than the recommended limit.
This is perhaps the greatest surprise: a behavior considered unhealthy – drinking – is shown to correlate with a healthy outcome – less disability.
Alan Manevitz, MD, a clinical psychiatrist at Lenox Hill Hospital in New York City, told HealthDay that he agreed with the study authors that the findings should not be interpreted to mean that alcohol has a therapeutic benefit for pain. “It’s a poor self-medication and it ultimately causes further deterioration in patients with pain,” he said.
“Not a benefit for pain”? This is just backpedaling because the study clearly points out that drinking even more than a “moderate” amount is associated with less pain and disability.
Here’s the actual study:
Moderate alcohol consumption is associated with lower risk (and severity) of chronic widespread pain: Results from a UK population-based study – Macfarlane – Arthritis Care & Research – Wiley Online Library
Objectives: To determine whether reported level of alcohol consumption is associated with the likelihood of reporting chronic widespread pain (CWP) and, amongst persons with CWP, the associated disability.
Methods: A population-based study in two areas of the United Kingdom. Participants self-completed a postal questionnaire. They were classified according to whether they met the American College of Rheumatology definition of CWP and whether the pain was disabling (Chronic Pain Grade III or IV). They reported their usual level of alcohol consumption. Potential confounding factors on which information was available included age, gender, cigarette smoking, employment status, self-reported weight and height and level of deprivation.
- 13574 persons participated (mean age 55 years; 57% female) of whom
- 2239 (16.5%) had CWP:
- 28% reported never regularly consuming alcohol,
- 28% consuming up to 5 units/wk,
- 20% 6-10 units/wk and
- 24% more than 10 units/wk.
- Amongst persons with CWP, disability was strongly linked to level of alcohol consumption.
- Prevalence of disability decreased with increasing alcohol consumption up to 35 unit/wk (Odds Ratio (OR)21-35 units alcohol/wk v. never drinkers 0.33 95% CI (0.19,0.58)) adjusted for confounders.
- A similar relationship was found between reporting CWP and level of alcohol consumption (adjOR21-35 units alcohol/wk v. regular drinkers 0.76 95% CI (0.61-0.94).
Conclusions: This study has demonstrated strong associations between level of alcohol consumption and CWP . However the available evidence does not allow us to conclude that the association is causal. The strength of the associations means that specific studies to examine this potential relationship are warranted. This article is protected by copyright. All rights reserved.