Dr. Jeff Boissoneault - Chronic Pain and Substance Use
Dec 13, 2023
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Dr. Jeff Boissoneault discusses the intersection between chronic pain and substance use disorder, highlighting the need to prioritize measuring and treating pain. The podcast covers the impact of chronic pain on recovery goals, addiction stigma, and the effect of alcohol on pain. It also emphasizes the need for further research in the field and provides advice for trainees to have a successful career.
Chronic pain is prevalent among individuals with substance use disorder, highlighting the need for integrated treatment approaches.
Alcohol can initially provide temporary relief from pain, but chronic heavy alcohol use can worsen pain over time.
Further research is needed to understand pain and substance use in different populations, explore the impact of pain on recovery outcomes, and develop targeted interventions.
Deep dives
Prevalence of Chronic Pain and Substance Use
Chronic pain is a widespread condition, affecting up to 30% of individuals in the US. Among individuals with substance use disorder, the prevalence of chronic pain is even higher, with over 50% of treatment seekers experiencing chronic pain. Chronic pain can have a significant impact on daily life and functioning, leading individuals to seek various self-management strategies, including substance use.
Effects of Alcohol on Pain
Acute consumption of alcohol has been found to have analgesic effects, increasing pain thresholds, decreasing pain intensity, and providing temporary relief. However, chronic heavy alcohol use can lead to peripheral neuropathy, a painful condition, and can increase pain sensitivity over time. It is important to understand the complex relationship between alcohol and pain, as individuals with chronic pain may turn to alcohol as a means of self-medication, but in the long term, it can worsen their pain.
Areas for Future Research
There are several areas that require further research in the field of pain and substance use. First, there is a need to study pain and substance use in various populations, including older adults and underserved/minoritized populations. Additionally, research should focus on the impact of pain on recovery outcomes and the potential benefits of intentionally incorporating pain management strategies in the recovery process. Understanding how individuals perceive the effects of substances on pain relief can also inform targeted interventions and treatment approaches.
Understanding the Physiology of Pain
Pain exists in the brain and is distinguished from nociception, which is the peripheral signals interpreted by the brain. The nociceptive process involves signals traveling through the peripheral nervous system to the spinal cord and then ascending to the brain. Different brain regions are involved in the sensory, emotional, and cognitive aspects of pain.
The Impact of Alcohol on Pain
Alcohol can act on various neurotransmitter systems in the brain, including those related to pain. It can modulate pain experience and affective and cognitive processing of pain. Alcohol may have an analgesic effect by modulating neurotransmitter systems involved in pain. However, the specific mechanisms and effects of alcohol on pain are still being studied.
Chronic pain commonly co-occurs with substance use disorder and may get in the way of recovery goals and valued living. Despite this, chronic pain can go untreated and unmanaged in treatment settings, and many people with substance use disorders struggle to get treatment for pain due to addiction stigma. Dr. Jeff Boissoneault provides an overview of the intersection between pain and substance use and makes the case for why scientists and clinicians should prioritize measuring and treating chronic pain. Dr. Boissoneault is an associate professor in the department of anesthesiology at the University of Minnesota Medical School.
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