Is alcohol an effective pain relief for chronic diseases?
The positive effects can reinforce alcohol use, leading to misuse and resulting harm. Photo / Getty Images
Question: Why is alcohol such an effective physical painkiller in chronic diseases such as arthritis? Lack of mobility associated with such conditions affects not just physical but mental health, which, along with other stressors, adds to the attractiveness of drinking for its relaxing impact. What is it in alcohol that produces these effects?
Answer: People generally drink alcohol to experience two main recreational drug effects: the opioid high and an anti-anxiety effect. But you are correct in noting that alcohol also has a meaningful impact on pain. Indeed, researchers believe some older adults may increase their drinking as they age because it reduces pain.
For example, a Californian study found that 22% of adults aged 75-85 used alcohol to manage pain. But is there a problem with using alcohol for pain reduction?
Alcohol stimulates opioid receptors in the brain, producing an opioid effect in the drinker of pleasure, tranquillity and euphoria – not too dissimilar to heroin or morphine.
Its anti-anxiety or calming effect comes from its stimulating influence on GABA receptors, producing feelings of disinhibition and relaxation, somewhat similar to taking diazepam (Valium). However, although small amounts of alcohol produce relaxation, heavier drinking can deplete GABA, increase tension, and induce panic.
Unfortunately, these positive effects can reinforce alcohol use, leading to misuse and resulting harm.
Medications such as naltrexone, used to help heavy drinkers reduce their intake, reduce the pleasure and relaxation produced by alcohol, thus limiting its reinforcing effects.
Alcohol is also a depressant that acts at the central nervous system level, depressing our body systems in a manner very similar to a range of anaesthetic agents. If alcohol is consumed recklessly, this depression of the central nervous system can stop our breathing, leading to death.
Alcohol also has analgesic effects for short-term pain, a 2017 review in the Journal of Pain noted. It has a small effect on pain threshold, so it slightly increases the point at which you feel pain from a given stimulus. And it has a moderate to large effect on ratings for pain intensity.
The mechanism by which alcohol induces its analgesic effect is not entirely clear. But studies in animal models suggest it may inhibit the transmission of signals from the stimuli or injury to the brain by binding to specific receptors on the spinal cord.