Approach to the pharmacological management of chronic pain in patients with an alcohol use disorder

Publication type
Journal article
Authors
Murphy L, Ng KW, Su VC, Woodworth-Giroux S, Levy TS, Sproule BA, Furlan AD
Date published
2015 Jan 25
Journal
Journal of Pain Research
Volume
8
Pages
851-857
Open Access?
Yes
Abstract

This paper provides an overview of research, guidelines, and clinical considerations for the use of medications for chronic pain in the management of patients with an alcohol use disorder. A review of the literature identified randomized controlled trials, epidemiological cohort studies, consensus guidelines, and one systematic review and meta-analysis. Where gaps in the literature existed, clinical experience of the authors is included. Use of nonopioid medications should be given priority and may offer a more favorable risk profile as well as benefits beyond pain management, such as improvement in anxiety, depression, or insomnia. Pregabalin and gabapentin have additional benefits to decrease alcohol cravings or time to relapse after a period of abstinence from alcohol. Drug interactions between selected analgesics and alcohol, disulfiram, or naltrexone require careful consideration