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Health Services Research & Development

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2005 HSR&D National Meeting Abstract


3014 — Pain and Use of Alcohol to Manage Pain Among Older Adults with Alcohol Problems

Author List:
Brennan PL (VA Palo Alto Hlth Care Sys)
Schutte KK (VA Palo Alto Hlth Care Sys)
Moos RH (VA Palo Alto Hlth Care Sys)

Objectives:
Most older adults report having recently experienced pain, and many older adults have late-life drinking problems. However, the intersection of pain and alcohol misuse by older adults has not been studied. The purpose of this study is to examine the implications of pain for older individuals who have problems with alcohol.

Methods:
Longitudinal design focusing on older adults (n=401) with and without alcohol use problems. At baseline and 3 years later participants provided information about their pain, use of alcohol to manage pain, drinking behavior, chronic health problems, and recent serious injury.

Results:
At baseline, older problem drinkers reported more severe pain, more disruption of daily activities due to pain, and more frequent use of alcohol to manage pain than did older nonproblem drinkers. More pain was associated with more use of alcohol to manage pain; this relationship was stronger among older adults with drinking problems than among those without drinking problems. Among older men, more baseline drinking problems interacted with use of alcohol to manage pain to predict more health problems and serious injury 3 years later. Among older women, more baseline drinking problems interacted with use of alcohol to manage pain to predict more drinking problems 3 years later.

Implications:
The drinking behavior of older patients who present with pain complaints should be more carefully assessed. Patients who have pre-existing problems with alcohol are at elevated risk for self-medication of pain with alcohol and for more subsequent health-related and drinking problems.

Impacts:
The results highlight the importance of integrating alcohol screening with assessment and treatment of pain in older VA patients. Clinicians who are aware of older pain patients’ drinking problems can more closely monitor their alcohol use, alert them to risks of combined alcohol and pain medication use, and advise them of alternative methods of pain management.


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