Associations between daily pain severity and concurrent alcohol craving among women in early recovery following alcohol treatment.

Abstract

Rates of alcohol use disorder (AUD) for women are rising, and women remain more likely to experience serious alcohol-related harms and consequences compared to men. Pain may complicate AUD, as it often co-occurs with alcohol use. However, relations between pain and alcohol craving, an important predictor of return to alcohol use, are underexplored, particularly among women with AUD. The present study investigated the relationship between daily pain severity and concurrent alcohol craving among women with AUD who were engaged in alcohol treatment and reported co-occurring depressive symptoms (N = 72, M_age=44.1, 90.3% White). Additionally, we sought to understand any differences in pain-alcohol craving associations by type of pain (joint/muscle vs. headache pain). Data were drawn from a randomized controlled trial testing the efficacy of a lifestyle physical activity intervention for improving alcohol abstinence. Participants completed three, 10-day periods of ecological momentary assessment (EMA) during the first 90 days post-treatment to report pain severity (headache and joint/muscle pain) and alcohol craving. Results indicated that greater average headache pain (γ₀₁=.21, p = .013) and joint/muscle pain (γ₀₁=.27, p < .001) were associated with greater alcohol craving. On days with higher headache pain than their average, participants also reported increased alcohol craving (γ₁=.03, p = .036). Findings highlight pain as a relevant factor in AUD recovery for women and suggest that pain management may be an important consideration for AUD treatment programs.