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Alcohol, Opioids, and Pain - From the Editors

Opioids and alcohol are both effective analgesics under certain pain conditions. However, although the analgesic or pain-relieving properties of opioids are well known, information about the use of alcohol and its potential for misuse in the context of pain management has begun to emerge more recently. Alcohol doses required to alleviate pain are commensurate with binge drinking,1 defined as...

The Convergent Neuroscience of Affective Pain and Substance Use Disorder

Introduction

A central feature of substance use disorder (SUD) is the emergence of negative affective or emotional states that influence the motivational properties of misused substances.1 Individual propensity to experience pain-related negative affect, for example, is hypothesized to be associated with the maintenance of both opioid use disorder (OUD) and alcohol use disorder (AUD). Chronic...

Cognitive-Affective Transdiagnostic Factors Associated With Vulnerability to Alcohol and Prescription Opioid Use in the Context of Pain

Introduction

Pain is a complex, near-universal phenomenon, which can be conceptualized as a motivational state that engenders goal-directed action.1 Motivational models of substance use highlight the role of expected effects and suggest that individuals become motivated to use substances when such use is perceived as holding greater value than other available objects or events.2,3 A rapidly...

Forebrain-Midbrain Circuits and Peptides Involved in Hyperalgesia After Chronic Alcohol Exposure

Introduction

Chronic pain increases the risk for development of alcohol use disorder (AUD). Given that acute alcohol consumption can reduce pain, humans sometimes drink alcohol for relief of pain. Chronic alcohol consumption, however, can increase pain sensitivity during withdrawal and facilitate pain sensitization related to comorbid pain conditions.1 Ascending and descending nociceptive...

Alcohol's Unique Effects on Cognition in Women: A 2020 (Re)view to Envision Future Research and Treatment

Alcohol use and misuse is increasing among women. Although the prevalence of drinking remains higher in men than women, the gender gap is narrowing. This narrative review focuses on the cognitive sequelae of alcohol consumption in women. Studies of acute alcohol effects on cognition indicate that women typically perform worse than men on tasks requiring divided attention, memory, and decision...

Nature and Treatment of Comorbid Alcohol Problems and Post-Traumatic Stress Disorder Among American Military Personnel and Veterans

Many service members and veterans seeking treatment for alcohol problems have experienced the life-threatening stress of combat, many have post-traumatic stress disorder (PTSD), and many service members and veterans seeking treatment for PTSD have alcohol or other substance problems. Sensitivity to these issues can influence how a therapist relates to the patient and also has possible...

Alcoholic Myopathy: Pathophysiologic Mechanisms and Clinical Implications

Skeletal muscle dysfunction (i.e., myopathy) is common in patients with alcohol use disorder. However, few clinical studies have elucidated the significance, mechanisms, and therapeutic options of alcohol-related myopathy. Preclinical studies indicate that alcohol adversely affects both anabolic and catabolic pathways of muscle-mass maintenance and that an increased proinflammatory and oxidative...

Alcohol Use As a Risk Factor in Infections and Healing: A Clinician's Perspective

Alcohol use and misuse have been part of human society for centuries. Early physicians recognized since the 1800s that alcohol produced not only impairment of the senses but also higher predisposition for tuberculosis. William Osler, the father of scientific medicine, reported in 1905 that patients who misused alcohol had higher predisposition to pneumonia (Osler 2001).

Between 2006 and 2010...

Suicidal Behavior: Links Between Alcohol Use Disorder and Acute Use of Alcohol

Research on associations of suicidal behavior, including suicide and suicide attempt, with alcohol use disorder (AUD) and acute use of alcohol (AUA) are discussed, with an emphasis on data from meta-analyses. Based on psychological autopsy investigations, results indicate that AUD is prevalent among individuals who die by suicide. Results also indicate that AUD is a potent risk factor for suicidal...

Alcohol-Endocannabinoid Interactions: Implications for Addiction-Related Behavioral Processes

Introduction

Endogenous cannabinoids, or endocannabinoids (eCBs), are bioactive lipid molecules that modulate signaling activity of several physiological processes involved in pain, appetite, energy balance, stress/anxiety, immune signaling, and learning and memory. Although understanding of the eCB system has grown in complexity since its discovery by Raphael Mechoulam, it is now widely known...