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Wojnar M1,2, Jakubczyk A1, Kopera M1, Ilgen MA2, Brower KJ2

1 Medical University of Warsaw, Department of Psychiatry, Warsaw, Poland
2 University of Michigan, Department of Psychiatry, Ann Arbor, MI, USA

Physical pain has been considered a potential predictor of relapse in alcohol-dependent individuals after treatment. However, it is not clear how presence of pain may interact with other known triggers of return to drinking and whether reduction of pain would decrease risk of post-treatment relapse in alcoholism.
A sample of 366 alcohol-dependent subjects were enrolled at addiction treatment centers in Warsaw, Poland. At baseline, data was collected about pain level, demographics, childhood abuse, impulsivity, depressive symptoms, severity of alcohol dependence and sleep problems. After completing alcohol treatment program patients were followed up for 12 months and alcohol use, including relapse, as well as pain severity were evaluated.
At the follow-up assessment, 29.5% of patients confirmed that they drank alcohol during last four weeks. Comparing to baseline pain levels, 48.6% of subjects reported increased severity of pain, 28.8% – comparable levels, and 22.6% of alcoholics declared decreased severity of pain after treatment. There was a significant association between the decrease in level of pain and the lower risk of relapse. Other factors associated with relapse during four weeks prior to the follow up were: baseline severity of depressive symptoms, low social support at baseline and number of drinking days during 4 weeks prior to entering treatment. In multivariate analysis, a decrease in pain level was associated with a lower likelihood of relapse (OR=0.159; 95%CI:0.04-0.62; p=0.008) even when controlled for other factors associated with relapse.
The study on a treatment sample of alcohol-dependent individuals indicates that decreases in pain level following treatment for alcohol dependence are associated with, and may contribute to, a lower risk of alcohol relapse.

Abstract for Symposium
Alcohol Dependence and Nociception: New Insights Into a Painful Subject
Chair: Andrey Ryabinin (US)