Alcohol consumption and opioid craving among chronic pain patients prescribed long-term opioid therapy

Background: Concurrent use of alcohol with opioids is common among chronic pain patients, heightening the risk for disordered opioid use and overdose, yet the relationship between alcohol consumption and opioid craving among chronic pain patients remains largely unexplored. Here we examined the relationship between alcohol consumption and opioid craving among chronic pain patients on long-term opioid therapy.Methods: A cross-sectional study was conducted with 335 chronic pain patients on long-term opioid therapy. Participants completed the Timeline Followback to assess alcohol consumption, as well as measures of opioid craving, pain severity, and pain interference. Linear regression analyses examined the relationship between alcohol consumption and opioid craving, controlling for pain severity, pain interference, and opioid misuse severity.Results: Alcohol consumption (total number of drinks and amount consumed in one sitting) was positively associated with opioid craving (p < 0.001 and p = 0.005, respectively). Pain severity did not predict opioid craving. The relationship between alcohol consumption and opioid craving remained significant after controlling for pain severity, pain interference, and opioid misuse severity.Conclusion: Alcohol consumption is linked with more severe opioid craving among chronic pain patients pre-scribed long-term opioid therapy. Patients receiving opioid analgesics should be carefully screened for co-use of alcohol.