Pain as a predictor of heavy drinking and any drinking lapses in the COMBINE study and the UK Alcohol Treatment Trial

Katie Witkiewitz*, Kevin E. Vowles, Elizabeth McCallion, Tessa Frohe, Megan Kirouac, Stephen A. Maisto

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

75 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1262-1271
Number of pages10
JournalAddiction
Volume110
Issue number8
DOIs
Publication statusPublished - 01 Jan 2015

Keywords

  • Alcohol relapse
  • Alcohol treatment outcomes
  • COMBINE study
  • Latent transition analyses
  • Pain
  • United Kingdom Alcohol Treatment Trial

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health

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