Alcohol and Drug Overdose and the Influence of Pain Conditions in an Addiction Treatment Sample

Abstract

Pain conditions may play an under-recognized role in the overdose epidemic, particularly alcohol-related overdose. Addiction treatment and overdose prevention interventions should incorporate appropriate assessment and treatment of pain including education about the risks of polysubstance use, particularly combining alcohol with sedatives and prescription pain relievers.

A comprehensive multivariate model of biopsychosocial factors associated with opioid misuse and use disorder in a 2017-2018 United States national survey

“…Other substance dependence or abuse has been associated with opioid misuse based on varying risk factors. [13,28,33,47,50] In this study, we speci cally found that nicotine, [28,29] alcohol, [28,30] cocaine, [50] methamphetamine, [32] tranquilizers, [34,35,51] other illicit stimulants [20], and marijuana [28] have a positive relationship with opioid misuse and use disorder. The stimulant effect from nicotine, cocaine, methamphetamine, and other illicit stimulants have been stipulated to mitigate the depressive effects of opioids and may increase the "high" effect.…”

“…Alcohol has been another substance with mixed associations for opioid misuse and use disorder. For instance, Fernandez et al [30] reported that alcohol dependence or abuse was not associated with opioid misuse. We found, however, in our comprehensive adjusted model that alcohol dependence or abuse was associated with a higher probability for opioid misuse, in line with the ndings of Witkiewitz et al [53] Overall, prevention strategies and prevention programs must focus on both the combined use of legal and illicit substances.…”

“…The role of other substance dependence, abuse, and/or misuse, whether legal, illicit, or prescribed, has also been linked to opioid misuse and/or use disorder. Concurrent substance use such as nicotine and tobacco dependence [28,29], alcohol [30], sedatives [31], methamphetamines [32], tranquilizers [33][34][35], other analgesics [36], and marijuana [37] have been positively associated with opioid misuse and use disorder [37,38]. Marijuana may be context dependent as it has a mixed relationship with opioid use, misuse, and use disorder.…”

Biopsychosocial factors associated with opioid misuse in a 2017-2018 United States national survey: A comprehensive multivariate model

“…Alcohol has been another substance with mixed associations for opioid misuse. For instance, Fernandez et al 36 reported that alcohol dependence or abuse was not associated with opioid misuse. We found, however, in our comprehensive adjusted model that alcohol dependence or abuse was associated with a higher probability for opioid misuse, in line with the findings of Witkiewitz et al 37 Overall, prevention strategies and prevention programs must focus on both the combined use of legal and illicit substances.…”

A comprehensive multivariate model of biopsychosocial factors associated with opioid misuse and use disorder in a 2017-2018 United States national survey

“…Concurrent substance use such as nicotine and tobacco dependence [25,26], alcohol [27], sedatives [28], methamphetamines [29], tranquilizers [30][31][32], other analgesics [33], and marijuana [34] have been positively associated with opioid misuse and use disorder [34,35]. Marijuana's association may be context dependent, as it has a mixed relationship with opioid use, misuse, and use disorder.…”