In recent years, there has been an upheaval of the segment of the medical community that treats chronic pain.
Many experts in the field of pain management and addiction consider the use of opioids for the treatment of chronic pain to be a failed experiment conducted on a large scale over several decades. However, there are many patients with severe chronic pain who would disagree.
The history of opioid and opiate drugs goes back many thousands of years. The concept of using opioids for pain and of an opioid crisis is not new. We have been through this cycle many times. Opium is the original opiate, derived from the beautiful poppy flower. While opium itself has a long history of use as a recreational drug and natural pain reliever, the substances that are present in opium are the sources for many of the opioid medications and street opioids that exist today.
Does alcohol relieve pain?
Another drug that human beings have used for thousands of years, possibly as long as 9,000 years, is alcohol. In addition to social and ceremonial uses, human beings have self-medicated emotional and physical pain with alcohol for millennia. You may be surprised to learn that these two drugs, alcohol, and opium, have a history older than the bible. Yet, we still struggle with trying to understand how to use these drugs safely and in a balanced manner without causing harm.
Opioids and alcohol: The two biggest killers.
Unfortunately, finding a balance is not easy. These two drugs are, today, the biggest killers when it comes to drug use. Alcohol is so entrenched in our society as a legal drug that people don’t even refer to it as a drug. In Narcotics Anonymous meetings, the literature read during every meeting must remind members out loud about this fact. Alcohol is a drug. If all alcohol and opioids were to disappear from the face of the earth overnight, drug-related deaths would drop dramatically. These two drugs, alcohol and opioids, are the most dangerous by far, even compared to other dangerous street drugs, such as cocaine and methamphetamine.
Can ethanol be used as a pain reliever? Does alcohol relieve pain?
With opioids currently under siege as the cause of the worst drug epidemic in history, some people with chronic pain have turned to alcohol as an alternative. Has drinking alcohol ever been used in the medical field as a pain reliever? Have doctors ever prescribed a glass of wine, or something more robust, to relieve pain?
Alcohol has a long history of being prescribed by doctors and dispensed by pharmacists.
Before the government instituted strict controls on drugs in the 20th century, doctors prescribed both alcohol and opioids for pain. Pharmacists often dispensed them in combination. There was a preparation known as laudanum that patients took for a variety of conditions. Laudanum was a mixture of opium and alcohol. From the 18th century through the early 20th century, laudanum was a popular pain reliever and treatment for diarrhea-related illnesses. In the early 20th century, the US government restricted access to laudanum and other opioids. Laudanum use continued through the mid 20th century and eventually stopped along with other opium preparations.
Was alcohol used to control pain for amputations in the Civil War? Does alcohol numb physical pain that is caused by surgery or trauma?
During the Civil War, the amputation of limbs was commonplace to treat soldiers’ injuries. You may imagine a scene where the surgeon gives the patient a bottle of whiskey to drink before cutting. Interestingly, anesthesia did exist during the Civil War. Various anesthesia agents came into use in the 1840s. Still, before that time, alcohol was used for pain in surgical and dental procedures, and when necessary, was also used during the Civil War. While the mid-1800s was long before the age of modern medicine and before the groundbreaking discovery of penicillin, opium-derived drugs and anesthetic agents, such as ether and chloroform, were well known and used regularly. By that time, alcohol was already taking a back seat to more effective drugs for managing pain.
Why would anyone in the 21st century use alcohol for pain control?
Our view of modern medicine may not be entirely accurate. We imagine that scientists and doctors are hard at work in labs around the world, creating new and effective medications to treat illnesses better. When we hear stories about the eradication of a disease, it seems inevitable that science will progress and find ways to end every disease one by one. And, we believe that drug companies will synthesize newer, safer, and more effective drugs to replace older meds. The marketing departments for these companies would love for us to believe that this is what is happening. The truth is that scientists discovered many of the most effective medications by accident.
When it comes to pain management, opioids have continued to be the most effective drugs available. Opiates and opioids are derived or synthesized from various substances found in opium, which people have been using for pain for thousands of years. There have been many attempts by drug companies to push through new medicines to replace the opioids. Generally, they have failed in these attempts with some disastrous results. Because of the devastating effects of opioid addiction, the government has restricted access to opioids more than ever before in history. For patients with ongoing chronic pain, without access to adequate pain medication, many have turned to alcohol as an alternative.
Is it possible to use alcohol safely for chronic pain? Does alcohol numb pain?
Unfortunately, alcohol is not in any way, a safe substitute for opioid pain medication. While opioids are dangerous if abused, they tend to be relatively safe if prescribed and taken as directed. Alcohol is damaging to the human body. There is no way to use alcohol for pain safely. Drinking may be safe in small amounts, such as a glass of wine in the evening on occasion, but as a pain management drug, alcohol use would be highly detrimental to the patient’s health.
Additionally, when combined with other drugs, alcohol is even more dangerous. If you combine alcoholic beverages with sedating drugs, the mix can lead to respiratory depression and death. When combined with medications such as Tylenol, alcohol can damage the liver. Hence, drinking alcohol is not safe to use for pain control.
What can a patient in pain do if their pain management doctor no longer prescribes opioids?
While controls on opioids are stricter than ever, it does not mean that doctors no longer prescribe them for pain. If you are a patient who has been taking opioid medications for chronic pain without any adverse effects, you may be able to continue taking your medications. If your doctor refuses to prescribe your medication, consider looking for a different doctor. Be sure to search for a pain doctor who has credentials in the field of pain management. You may also want to consider seeing a doctor to treat opioid dependence. Most people who take opioids for pain for long periods become physically dependent. Stopping the opioids can lead to an uncomfortable withdrawal syndrome. If your doctor no longer prescribes your opioid medication, you may want to have a consultation with a doctor who prescribes Suboxone to see if buprenorphine may help with opioid dependence. What about the pain? Buprenorphine, the active drug in Suboxone, is also an effective pain medication. So, it can help to treat opioid dependence and treat chronic pain.
What other alternatives are there for chronic pain treatment?
Some patients have found that medical cannabis is useful for treating chronic pain. Medical marijuana is not for everyone, but you may want to consider getting a consultation with a doctor in this field to see if it is right for you. Additionally, there are ways to treat chronic pain that do not involve medication or drugs at all. There is physical therapy, biofeedback, massage, meditation, exercise, and more. If you suffer from chronic pain, you should consider non-medication solutions first before resorting to taking prescribed drugs for the pain.
What can I do if I am already using alcohol for pain?
If you are already drinking hard liquor every night to ease your physical or emotional pain, or even having a few beers when you get home, alcohol may have become a problem in your life. People start drinking for a variety of reasons. Many people do not become dependent on alcohol. When they decide to stop drinking, they stop and put it behind them. Other people find that they have developed a problem concerning alcohol. They may have developed a condition known as alcohol use disorder. Alcohol use disorder may be mild, moderate, or severe. You may find that you don’t feel well without having a few drinks every night before bedtime. Or, you may go on binges on the weekends, ending up in strange places without remembering how you got there. A major problem of using alcohol for pain is that there is no medical management. If you are drinking to ease your pain, you likely keep drinking until the pain goes away. By doing this, you are exposing your body to toxic levels of alcohol, damaging your body, and developing physical and psychological dependence. If you find that you now have a drinking problem, what should you do?
How can I move past using alcohol for my pain?
The first step to dealing with an alcohol problem is to see your doctor. It is essential to have a check-up to see if alcohol has damaged your internal organs, including your liver and heart. And, your doctor will have information about how you can address your dependence on alcohol. There are several options available. For some people, Alcoholics Anonymous meetings provide social and spiritual support to help them stop drinking for good. An inpatient detox program may be appropriate to help you to quit drinking safely. Quitting alcohol cold turkey can be dangerous due to the withdrawal effects of suddenly removing alcohol from your system. After detox, you may choose to go to rehab, either residential or outpatient.
Is it better to slow down drinking alcohol gradually or to stop suddenly?
Is it possible to get your drinking under control and slow down over time? There is medication-assisted treatment for alcohol use disorder that uses the medication, naltrexone. It is commonly known as The Sinclair Method. Patients who follow TSM will take naltrexone an hour before having a drink. Naltrexone is a potent opioid receptor blocker. By blocking the reinforcement of endorphins associated with drinking, you will not get the same pleasurable feelings from drinking. You will find that stopping at one drink for the evening will be possible. Over time, most patients who follow TSM can quit drinking altogether. The effect of blocking endorphins with drinking is known as “pharmacological extinction.” It is similar to the Nobel-prize-winning research performed by Dr. Pavlov at the turn of the 20th century. Proponents of TSM claim that it helps to prevent dangerous alcohol withdrawal and severe cravings that go along with quitting alcohol abruptly. If you choose to go the traditional route and stop all at once, you should consider the safety of an inpatient detox program.
So if I stop drinking for my pain, what do I do about the pain?
As I described above, there are a variety of solutions for treating pain that does not involve medications. Have you looked at all options? What about acupuncture? Osteopathic manipulation? Electrical stimulation treatments? Heat therapy? There are clinics dedicated to providing therapies for pain that do not involve prescribing medications. Some patients have been able to get significant pain relief from topical pain creams. And, there is ongoing research into novel uses of existing drugs to treat pain. For example, ketamine shows promise. Some doctors are already prescribing ketamine for pain in the form of sublingual troches or topical creams. Scientists are once again looking at various psychedelic drugs for treating depression, anxiety, addiction, and chronic pain. As stated above, medical cannabis is already helping patients to tolerate chronic pain with improved functioning. Again, you should first look to treatments that do not involve medications, if at all possible.
What about fibromyalgia-related pain?
You may have heard about low-dose alcohol improving pain levels for patients who have fibromyalgia. Fibromyalgia is a condition where a person has significant pain with a light touch to the skin at specific points on the body. Again, alcohol is not suitable for medical treatment. I would consider this use to be in the category of research for the future, similar to the psychedelic drug research mentioned above. Maybe someday, scientists and clinicians will determine a safe protocol of low-dose alcohol for this specific condition. In the meantime, you should never self-medicate with alcohol. Interestingly, the drug that treats alcohol use disorder, naltrexone, has been shown to reduce fibromyalgia pain when used in minimal dosages.
Are there any benefits to drinking alcohol?
Is there anything good about drinking? You may think that you need alcohol for some reason. Maybe you feel that it makes going to busy nightclubs and parties more tolerable. I recommend reconsidering if you should even be at such events if you need alcohol to feel comfortable. Before resorting to taking a drug to fit into awkward social situations, take a step back, and look at life from a new perspective. If there are situations where you feel the need to drink, do you need to be in those situations? Can you learn to enjoy a fulfilling life without the need for stressful parties and going out to bars and clubs? Of course, you can! You can live a productive and happy life of your dreams without ever feeling the need to drink more alcohol. No one needs to drink alcohol.
What about drinking a glass of wine every night? Isn’t it good for my heart?
Fortunately, any substance that is in wine that may be beneficial is also available as a supplement. You do not need to drink alcohol. Resveratrol is a substance that provides health benefits. You can find Resveratrol in other foods, such as grapes, peanuts, and berries. And, it is available from any health food store that carries a full line of supplements. Resveratrol acts as an antioxidant. There are a variety of other potent antioxidants that you can get from other foods and supplements as well. Now is the time to join the sober-curious crowd and think about how your life could be without alcohol. If you have been thinking about stopping, you can do it. See your doctor today and ask about the best way to quit for you. You can even get started by seeing your doctor in a telehealth visit. If your doctor is not familiar with the medication-assisted treatment of alcohol use disorder with naltrexone, consider looking at the C3 Foundation website. You can learn more about this subject, and there is a locator to find local doctors who can provide in-person and online telemedicine visits. If you have been using alcohol for pain, your doctor will also be able to direct you to resources for addressing your pain.