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

Research output: Contribution to journalArticle

37 Scopus citations

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 (US)
Pages (from-to)1262-1271
Number of pages10
JournalAddiction
Volume110
Issue number8
DOIs
StatePublished - Aug 1 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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