Background/Purpose: As many as 25% of chronic pain patients use alcohol to manage pain.¹  Preliminary studies in fibromyalgia patients have shown that low to moderate alcohol consumption was associated with lower symptoms compared to no alcohol consumption.² We assessed a large cross-sectional chronic pain sample for associations between severity of symptoms and alcohol consumption.

Methods: 2585 patients (58% female) presenting to a university chronic pain clinic completed a survey battery and reported number of alcoholic drinks consumed per day. Patients were grouped by level of alcohol consumption (drinks per day): none, low (≤1), moderate (>1 and <3) and heavy (≥3). Associations between alcohol consumption and fibromyalgia symptom severity (SS) scale were assessed using analysis of covariance (ANCOVA). Univariate analysis was used to determine significant covariates, using chi-square (X²) tests and one-way analysis of variance (ANOVA) for categorical and continuous variables, respectively. Bonferroni’s post-hoc test was used to assess pairwise differences. Adjusted means ± standard deviation and pairwise differences (x) ± standard error are reported. Analysis performed using IBM SPSS 22.

Results: 1991 (70%) subjects did not consume alcohol; 594 subjects consumed alcohol and were grouped into low (n= 444), moderate (n= 120) and high (n= 30) levels. Univariate analysis revealed significant differences in gender (X²= 41.4), fibromyalgia status (X²= 29.8), smoking status (X²= 26.4), opioid therapy (X²= 47.7) and age (F= 3.4), all p< .001. After controlling for covariates, alcohol level had a significant effect on symptom severity (F= 5.8, p< .001). Adjusted mean SS scores were 6.8 ± 0.1, 6.5 ± 0.1, 5.9 ± 0.3 and 7.0 ± 0.4 for the no alcohol, low, moderate and high levels, respectively. Post hoc tests showed that the moderate alcohol consumers had significantly lower SS scores compared to low alcohol consumers (x= 0.9 ± 0.3, p= .015) and non-drinkers (x= 1.3 ± 0.3, p< .001); no other significant pairwise differences were observed. These data represent a U-shaped curvilinear relationship (Figure 1).

Conclusion: The results suggest that consumption of moderate amounts of alcohol in chronic pain patients is associated with lower symptom severity compared to low or no alcohol consumption. These findings are similar to previous studies examining this relationship in fibromyalgia patients. These results should be further investigated for associations between alcohol consumption levels and other chronic pain symptoms.