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Cited by 248Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesPain Management and Opioid Use

Alcohol and Opioid Use, Co‐Use, and Chronic Pain in the Context of the Opioid Epidemic: A Critical Review

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Witkiewitz, Katie, Vowles, Kevin E.·2018·Alcoholism: Clinical and Experimental Research
DOI 10.1111/acer.13594PMC PMC5832605
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Abstract

The dramatic increase in opioid misuse, opioid use disorder (OUD), and opioid‐related overdose deaths in the United States has led to public outcry, policy statements, and funding initiatives. Meanwhile, alcohol misuse and alcohol use disorder (AUD) are a highly prevalent public health problem associated with considerable individual and societal costs. This study provides a critical review of alcohol and opioid misuse, including issues of prevalence, morbidity, and societal costs. We also review research on interactions between alcohol and opioid use, the influence of opioids and alcohol on AUD and OUD treatment outcomes, respectively, the role of pain in the co‐use of alcohol and opioids, and treatment of comorbid OUD and AUD. Heavy drinking, opioid misuse, and chronic pain individually represent significant public health problems. Few studies have examined co‐use of alcohol and opioids, but available data suggest that co‐use is common and likely contributes to opioid overdose‐related morbidity and mortality. Co‐use of opioids and alcohol is related to worse outcomes in treatment for either substance. Finally, chronic pain frequently co‐occurs with use (and co‐use) of alcohol and opioids. Opioid use and alcohol use are also likely to complicate the treatment of chronic pain. Research on the interactions between alcohol and opioids, as well as treatment of the comorbid disorders is lacking. Currently, most alcohol research excludes patients with OUD and there is lack of measurement in both AUD and OUD research in relation to pain‐related functioning. Research in those with chronic pain often assesses opioid use, but rarely assesses alcohol use or AUD. New research to examine the nexus of alcohol, opioids, and pain, as well as their treatment, is critically needed.

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  • Lower levels of pain acceptance have been linked to opioid-related problems and opioid misuse.

    “lower levels of pain acceptance have been linked to opioid-related problems (Lin et al., 2015) and misuse (Witkiewitz & Vowles, 2018)”

    From To be aware, or to accept, that is the question: Differential roles of awareness of automaticity and pain acceptance in opioid misuse (2023) · cites this paper as Witkiewitz & Vowles, 2018

    The citation to Witkiewitz and Vowles (2018) is attached to the link between lower pain acceptance and opioid misuse, not the preceding claim about opioid-related problems. The section “Chronic Pain as a ‘Third Variable’ in Opioid and Alcohol Co-Use” discusses misuse among people with chronic pain, but does not link misuse to pain acceptance. Searches for “pain acceptance” and acceptance-based treatment found no passage establishing that link; page numbers were unavailable. (LLM, conf=0.74)

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References 143 · Cited by 248

Research works printed but not linked: 97

  1. Anton RF O’Malley SS Ciraulo DA Cisler RA Couper D Donovan DM Gastfriend DR Hosking JD Johnson BA LoCastro JS Longabaugh R Mason BJ Mattson ME Miller WR Pettinati HM Randall CL Swift R Weiss RD Williams LD Zweben A 2006 Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial JAMA 295 2003 17 10.1001/jama.295.17.2003 16670409 · DOI · Paper page
  2. Barrio P Reynolds J García-Altés A Gual A Anderson P 2017 Social costs of illegal drugs, alcohol and tobacco in the European Union: A systematic review Drug Alcohol Rev 10.1111/dar.12504 28334460 · DOI
  3. Baser O Chalk M Rawson R Gastfriend DR 2011 Alcohol dependence treatments: comprehensive healthcare costs, utilization outcomes, and pharmacotherapy persistence Am J Manag Care 17 Suppl 8 S222 34 21761948
  4. Bedson J Belcher J Martino OI Ndlovu M Rathod T Walters K Dunn KM Jordan KP 2013 The effectiveness of national guidance in changing analgesic prescribing in primary care from 2002 to 2009: An observational database study Eur J Pain 17 434 443 10.1002/j.1532-2149.2012.00189.x 22865816 PMC3592995 · DOI
  5. Bickel WK Rizzuto P Zielony RD Klobas J Pangiosonlis P Mernit R Knight WF 1988 Combined behavioral and pharmacological treatment of alcoholic methadone patients J Subst Abuse 1 161 71 2980867
  6. Birke H Kurita GP Sjøgren P Højsted J Simonsen MK Juel K Ekholm O 2016 Chronic non-cancer pain and the epidemic prescription of opioids in the Danish population: trends from 2000 to 2013 Acta Anaesthesiol Scand 60 623 633 10.1111/aas.12700 26861026 · DOI
  7. Bogdanowicz KM Stewart R Broadbent M Hatch SL Hotopf M Strang J Hayes RD 2015 Double trouble: Psychiatric comorbidity and opioid addiction—All-cause and cause-specific mortality Drug Alcohol Depend 148 85 92 10.1016/j.drugalcdep.2014.12.025 25578253 · DOI
  8. Brady KT McCauley JL Back SE 2016 Prescription Opioid Misuse, Abuse, and Treatment in the United States: An Update Am J Psychiatry 173 18 26 10.1176/appi.ajp.2015.15020262 26337039 PMC4782928 · DOI
  9. Brennan PL Schutte KK SooHoo S Moos RH 2011 Painful medical conditions and alcohol use: a prospective study among older adults Pain Med 12 1049 59 10.1111/j.1526-4637.2011.01156.x 21668742 PMC3146463 · DOI
  10. Caputo F Addolorato G Domenicali M Mosti A Viaggi M Trevisani F Gasbarrini G Bernardi M Stefanini GF Services for Addiction Treatment 2002 Short-term methadone administration reduces alcohol consumption in non-alcoholic heroin addicts Alcohol Alcohol 37 164 8 11912072
  11. Castle IJP Dong C Haughwout SP White AM 2016 Emergency Department Visits for Adverse Drug Reactions Involving Alcohol: United States, 2005 to 2011 Alcohol Clin Exp Res 40 1913 1925 10.1111/acer.13167 27488763 PMC5008983 · DOI
  12. Center for Behavioral Health Statistics and Quality 2014 The DAWN Report: Benzodiazepines in Combination with Opioid Pain Relievers or Alcohol: Greater Risk of More Serious ED Visit Outcomes Rockville, MD 27631051
  13. Chapman CR Lipschitz DL Angst MS Chou R Denisco RC Donaldson GW Fine PG Foley KM Gallagher RM Gilson AM Haddox JD Horn SD Inturrisi CE Jick SS Lipman AG Loeser JD Noble M Porter L Rowbotham MC Schoelles KM Turk DC Volinn E Von Korff MR Webster LR Weisner CM Von Korff MR 2010 Opioid pharmacotherapy for chronic non-cancer pain in the United States: S research guideline for developing an evidence-base J Pain 11 807 829 20430701
  14. Chou R Fanciullo GJ Fine PG Adler JA Ballantyne JC Davies P Donovan MI Fishbain DA Foley KM Fudin J Gilson AM Kelter A Mauskop A O’Connor PG Passik SD Pasternak GW Portenoy RK Rich BA Roberts RG Todd KH Miaskowski C 2009 Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain J Pain 10 113 130 10.1016/j.jpain.2008.10.008 19187889 PMC4043401 · DOI · Paper page
  15. Clarke JL Skoufalos A Scranton R 2016 The American Opioid Epidemic: Population Health Implications and Potential Solutions. Report from the National Stakeholder Panel Popul Health Manag 19 S-1 S-10 10.1089/pop.2015.0144 26908092 · DOI
  16. Cleeland CS Ryan KM 1994 Pain assessment: global use of the Brief Pain Inventory Ann Acad Med 23 129 38 8080219
  17. Compton WM Volkow ND 2006 Major increases in opioid analgesic abuse in the United States: concerns and strategies Drug Alcohol Depend 81 103 7 10.1016/j.drugalcdep.2005.05.009 16023304 · DOI
  18. Crits-Christoph P Lundy C Stringer M Gallop R Gastfriend DR 2015 Extended-Release Naltrexone for Alcohol and Opioid Problems in Missouri Parolees and Probationers J Subst Abuse Treat 56 54 60 10.1016/j.jsat.2015.03.003 25841704 · DOI
  19. Cutter HS Jones WC Maloof BA Kurtz NR 1979 Pain as a joint function of alcohol intake and customary reasons for drinking Int J Addict 14 173 82 447427
  20. Cutter HS Maloof B Kurtz NR Jones WC 1976 "Feeling no pain" differential responses to pain by alcoholics and nonalcoholics before and after drinking J Stud Alcohol 37 273 7 4661
  21. Darker CD Sweeney B Keenan E Whiston L Anderson R Barry J 2016 Screening and Brief Interventions for Illicit Drug Use and Alcohol Use in Methadone Maintained Opiate-Dependent Patients: Results of a Pilot Cluster Randomized Controlled Trial Feasibility Study Subst Use Misuse 51 1104 1115 10.3109/10826084.2016.1160118 27158853 · DOI
  22. Dennis BB Bawor M Paul J Plater C Pare G Worster A Varenbut M Daiter J Marsh DC Desai D Thabane L Samaan Z 2016 Pain and Opioid Addiction: A Systematic Review and Evaluation of Pain Measurement in Patients with Opioid Dependence on Methadone Maintenance Treatment Curr Drug Abuse Rev 9 49 60 27021147
  23. el-Bassel N Schilling RF Turnbull JE Su KH 1993 Correlates of alcohol use among methadone patients Alcohol Clin Exp Res 17 681 6 8333601
  24. Fiellin DA Barry DT Sullivan LE Cutter CJ Moore BA O’Connor PG Schottenfeld RS 2013 A Randomized Trial of Cognitive Behavioral Therapy in Primary Care-based Buprenorphine Am J Med 126 74.e11 74.e17 10.1016/j.amjmed.2012.07.005 PMC3621718 23260506 · DOI
  25. Frank D Mateu-Gelabert P Guarino H Bennett A Wendel T Jessell L Teper A 2015 High risk and little knowledge: overdose experiences and knowledge among young adult nonmedical prescription opioid users Int J Drug Policy 26 84 91 10.1016/j.drugpo.2014.07.013 25151334 PMC4277710 · DOI
  26. Friedmann PD Wilson D Nunes EV Hoskinson R Lee JD Gordon M Murphy SM Bonnie RJ Chen DT Boney TY O’Brien CP 2017 Do patient characteristics moderate the effect of extended-release naltrexone (XR-NTX) for opioid use disorder? J Subst Abuse Treat 10.1016/j.jsat.2017.01.018 PMC5565721 28236511 · DOI
  27. Gastfriend DR 2011 Intramuscular extended-release naltrexone: current evidence Ann N Y Acad Sci 1216 144 66 10.1111/j.1749-6632.2010.05900.x 21272018 · DOI · Paper page
  28. Gonzales K Roeber J Kanny D Tran A Saiki C Johnson H Yeoman K Safranek T Creppage K Lepp A Miller T Tarkhashvili N Lynch KE Watson JR Henderson D Christenson M Geiger SD Centers for Disease Control and Prevention (CDC) 2014 Alcohol-attributable deaths and years of potential life lost--11 States, 2006–2010 MMWR Morb Mortal Wkly Rep 63 213 6 24622285 PMC5779340
  29. Griffin ML McDermott KA McHugh RK Fitzmaurice GM Jamison RN Weiss RD 2016 Longitudinal association between pain severity and subsequent opioid use in prescription opioid dependent patients with chronic pain Drug Alcohol Depend 163 216 221 10.1016/j.drugalcdep.2016.04.023 27161860 PMC4880512 · DOI
  30. Gudin JA Mogali S Jones JD Comer SD 2013 Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use Postgrad Med 125 115 130 10.3810/pgm.2013.07.2684 PMC4057040 23933900 · DOI
  31. Häkkinen M Launiainen T Vuori E Ojanperä I 2012 Benzodiazepines and alcohol are associated with cases of fatal buprenorphine poisoning Eur J Clin Pharmacol 68 301 309 10.1007/s00228-011-1122-4 21927835 · DOI
  32. Hall AJ Logan JE Toblin RL Kaplan JA Kraner JC Crosby AE 2008 Patterns of abuse among unintentional pharmaceutical overdose fatalities JAMA 300 2613 2620 19066381
  33. Han B Compton WM Blanco C Crane E Lee J Jones CM 2017 Prescription Opioid Use, Misuse, and Use Disorders in U.S. Adults: 2015 National Survey on Drug Use and Health Ann Intern Med 167 293 10.7326/M17-0865 28761945 · DOI · Paper page
  34. Harris AHS Oliva E Bowe T Humphreys KN Kivlahan DR Trafton JA 2012 Pharmacotherapy of alcohol use disorders by the Veterans Health Administration: patterns of receipt and persistence Psychiatr Serv 63 679 85 10.1176/appi.ps.201000553 22549276 · DOI
  35. Hartung DM McCarty D Fu R Wiest K Chalk M Gastfriend DR 2014 Extended-release naltrexone for alcohol and opioid dependence: A meta-analysis of healthcare utilization studies J Subst Abuse Treat 47 113 121 10.1016/j.jsat.2014.03.007 24854219 PMC4110954 · DOI
  36. Hartzler B Donovan DM Huang Z 2010 Comparison of opiate-primary treatment seekers with and without alcohol use disorder J Subst Abuse Treat 39 114 123 10.1016/j.jsat.2010.05.008 20598831 PMC2910795 · DOI
  37. Helmerhorst GTT Teunis T Janssen SJ Ring D 2017 An epidemic of the use, misuse and overdose of opioids and deaths due to overdose, in the United States and Canada Bone Joint J 99-B 856 864 10.1302/0301-620X.99B7.BJJ-2016-1350.R1 28663389 · DOI
  38. Hickman M Lingford-Hughes A Bailey C Macleod J Nutt D Henderson G 2008 Does alcohol increase the risk of overdose death: the need for a translational approach Addiction 103 1060 1062 10.1111/j.1360-0443.2008.02134.x 18397360 · DOI
  39. Hoffman HG Olofsson O Slaen B Wickston L 1995 Prevalence of abuse and dependency in chronic pain patients Int J Addict 30 919 927 7558484
  40. Howe CQ Sullivan MD 2014 The missing “P” in pain management: how the current opioid epidemic highlights the need for psychiatric services in chronic pain care Gen Hosp Psychiatry 36 99 104 10.1016/j.genhosppsych.2013.10.003 24211157 · DOI
  41. Hser YI Mooney LJ Saxon AJ Miotto K Bell DS Huang D 2017 Chronic pain among patients with opioid use disorder: Results from electronic health records data J Subst Abuse Treat 77 26 30 10.1016/j.jsat.2017.03.006 28476267 PMC5424616 · DOI · Paper page
  42. Humphreys K 2017 Avoiding globalisation of the prescription opioid epidemic Lancet 390 437 439 10.1016/S0140-6736(17)31918-9 28792397 · DOI
  43. Jakubczyk A Ilgen MA Kopera M Krasowska A Klimkiewicz A Bohnert A Blow FC Brower KJ Wojnar M 2016 Reductions in physical pain predict lower risk of relapse following alcohol treatment Drug Alcohol Depend 158 167 171 10.1016/j.drugalcdep.2015.11.020 26653340 PMC4698033 · DOI
  44. Jonas DE Amick HR Feltner C Bobashev G Thomas K Wines R Kim MM Shanahan E Gass CE Rowe CJ Garbutt JC 2014 Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis JAMA 311 1889 900 10.1001/jama.2014.3628 24825644 · DOI · Paper page
  45. Jones CM Christensen A Gladden RM 2017 Increases in prescription opioid injection abuse among treatment admissions in the United States, 2004–2013 Drug Alcohol Depend 176 89 95 10.1016/j.drugalcdep.2017.03.011 28531769 PMC9244861 · DOI
  46. Jones CM Paulozzi LJ Mack KA Centers for Disease Control and Prevention (CDC) 2014 Alcohol involvement in opioid pain reliever and benzodiazepine drug abuse-related emergency department visits and drug-related deaths - United States, 2010 MMWR Morb Mortal Wkly Rep 63 881 5 25299603 PMC4584609
  47. Kenan K Mack K Paulozzi L 2012 Trends in prescriptions for oxycodone and other commonly used opioids in the United States, 2000–2010 Open Med 6 PMC3659213 23696768
  48. Kertesz SG 2017 Turning the tide or riptide? The changing opioid epidemic Subst Abus 38 3 8 10.1080/08897077.2016.1261070 27858590 · DOI
  49. Kim CH Vincent A Clauw DJ Luedtke CA Thompson JM Schneekloth TD Oh TH Sorensen T Trevisan M Yunus M Fam A Farber S Fiechtner J Franklin C Gatter R Hamaty D Lessard J Lichtbroun A Masi A Mccain G Reynolds W Romano T Russell I Sheon R 2013 Associate between alcohol consumption and symptom severity and quality of life in patients with fibromyalgia Arthritis Res Ther 15 R42 10.1093/oxfordjournals.aje.a008684 23497427 PMC3672769 · DOI
  50. Korthuis PT Lum PJ Vergara-Rodriguez P Ahamad K Wood E Kunkel LE Oden NL Lindblad R Sorensen JL Arenas V Ha D Mandler RN McCarty D CTN-0055 CHOICES Investigators 2017 Feasibility and safety of extended-release naltrexone treatment of opioid and alcohol use disorder in HIV clinics: a pilot/feasibility randomized trial Addiction 112 1036 1044 10.1111/add.13753 28061017 PMC5408318 · DOI
  51. Landsman-Blumberg PB Katz N Gajria K Coutinho AD Yeung PP White R 2017 Burden of Alcohol Abuse or Dependence Among Long-Term Opioid Users with Chronic Noncancer Pain J Manag Care Spec Pharm 23 718 724 10.18553/jmcp.2017.23.7.718 28650247 PMC10397637 · DOI
  52. Larance B Campbell G Peacock A Nielsen S Bruno R Hall W Lintzeris N Cohen M Degenhardt L 2016 Pain, alcohol use disorders and risky patterns of drinking among people with chronic non-cancer pain receiving long-term opioid therapy Drug Alcohol Depend 162 79 87 10.1016/j.drugalcdep.2016.02.048 27049582 · DOI
  53. Ling W Weiss DG Charuvastra VC O’Brien CP 1983 Use of disulfiram for alcoholics in methadone maintenance programs. A Veterans Administration Cooperative Study Arch Gen Psychiatry 40 851 4 6347118
  54. Litten RZ Egli M Heilig M Cui C Fertig JB Ryan ML Falk DE Moss H Huebner R Noronha A 2012 Medications development to treat alcohol dependence: a vision for the next decade Addict Biol 17 513 27 10.1111/j.1369-1600.2012.00454.x 22458728 PMC3484365 · DOI
  55. Mann K Lemenager T Hoffmann S Reinhard I Hermann D Batra A Berner M Wodarz N Heinz A Smolka MN Zimmermann US Wellek S Kiefer F Anton RF PREDICT Study Team 2013 Results of a double-blind, placebo-controlled pharmacotherapy trial in alcoholism conducted in Germany and comparison with the US COMBINE study Addict Biol 18 937 46 10.1111/adb.12012 23231446 · DOI
  56. Manuel JK Austin JL Miller WR McCrady BS Tonigan JS Meyers RJ Smith JE Bogenschutz MP 2012 Community Reinforcement and Family Training: a pilot comparison of group and self-directed delivery J Subst Abuse Treat 43 129 36 10.1016/j.jsat.2011.10.020 22154038 PMC3331969 · DOI · Paper page
  57. Mark TL Kassed CA Vandivort-Warren R Levit KR Kranzler HR 2009 Alcohol and opioid dependence medications: prescription trends, overall and by physician specialty Drug Alcohol Depend 99 345 9 10.1016/j.drugalcdep.2008.07.018 18819759 PMC3166770 · DOI
  58. Mark TL Kranzler HR Song X 2003 Understanding US addiction physicians’ low rate of naltrexone prescription Drug Alcohol Depend 71 219 28 12957340
  59. Martell BA O’Connor PG Kerns RD Becker WC Morales KH Kosten TR Fiellin DA 2007 Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction Ann Intern Med 146 116 27 17227935
  60. McCabe SE West BT Veliz P McCabe VV Stoddard SA Boyd CJ 2017 Trends in Medical and Nonmedical Use of Prescription Opioids Among US Adolescents: 1976–2015 Pediatrics 139 e20162387 10.1542/peds.2016-2387 28320868 PMC5369669 · DOI
  61. Moore BA Fiellin DA Cutter CJ Buono FD Barry DT Fiellin LE O’Connor PG Schottenfeld RS 2016 Cognitive Behavioral Therapy Improves Treatment Outcomes for Prescription Opioid Users in Primary Care Buprenorphine Treatment J Subst Abuse Treat 71 54 57 10.1016/j.jsat.2016.08.016 27776678 PMC5119533 · DOI · Paper page
  62. Morasco BJ Gritzner S Lewis L Oldham R Turk DC Dobscha SK 2011 Systematic review of prevalence, correlates, and treatment outcomes for chronic non-cancer pain in patients with comorbid substance use disorder Pain 152 488 497 10.1016/j.pain.2010.10.009 21185119 PMC3053013 · DOI
  63. Morasco BJ Yarborough BJ Smith NX Dobscha SK Deyo RA Perrin NA Green CA 2017 Higher prescription opioid dose is associated with worse patient-reported pain outcomes and more health care utilization J Pain 18 437 445 10.1016/j.jpain.2016.12.004 27993558 PMC5376359 · DOI
  64. Morley KI Ferris JA Winstock AR Lynskey MT 2017 Polysubstance use and misuse or abuse of prescription opioid analgesics Pain 158 1138 1144 10.1097/j.pain.0000000000000892 28267061 · DOI
  65. Murphy L Ng K Su VC Woodworth-Giroux S Levy T Sproule B Furlan AD 2015 Approach to the pharmacological management of chronic pain in patients with an alcohol use disorder J Pain Res 8 851 10.2147/JPR.S88900 26664156 PMC4670016 · DOI
  66. Nielsen S Lintzeris N Bruno R Campbell G Larance B Hall W Hoban B Cohen ML Degenhardt L 2015 Benzodiazepine use among chronic pain patients prescribed opioids: associations with pain, physical and mental health, and health service utilization Pain Med 16 356 66 10.1111/pme.12594 25279706 · DOI · Paper page
  67. Nolan S Klimas J Wood E 2016 Alcohol use in opioid agonist treatment Addict Sci Clin Pract 11 17 10.1186/s13722-016-0065-6 27931253 PMC5146864 · DOI
  68. O’Malley SS Jaffe AJ Chang G Rode S Schottenfeld R 1996 Six-month follow-up of naltrexone and psychotherapy for alcohol dependence Arch Gen Psychiatry 53 217 224 0003-990X 8611058
  69. Okie S 2010 A flood of opioids, a rising tide of deaths N Engl J Med 363 1981 1985 21083382
  70. Portenoy RK 1996 Opioid therapy for chronic nonmalignant pain: A review of the critical issues J Pain Symptom Manage 11 203 217 8869456
  71. Potter JS Marino EN Hillhouse MP Nielsen S Wiest K Canamar CP Martin JA Ang A Baker R Saxon AJ Ling W 2013 Buprenorphine/naloxone and methadone maintenance treatment outcomes for opioid analgesic, heroin, and combined users: findings from starting treatment with agonist replacement therapies (START) J Stud Alcohol Drugs 74 605 13 23739025 PMC3711351
  72. Price AM Ilgen MA Bohnert ASB 2011 Prevalence and correlates of nonmedical use of prescription opioids in patients seen in a residential drug and alcohol treatment program J Subst Abuse Treat 41 208 214 10.1016/j.jsat.2011.02.003 21493031 · DOI
  73. Rehm J Dawson D Frick U Gmel G Roerecke M Shield KD Grant B 2014 Burden of disease associated with alcohol use disorders in the United States Alcohol Clin Exp Res 38 1068 77 10.1111/acer.12331 24428196 PMC4147870 · DOI
  74. Rubinsky AD Chen C Batki SL Williams EC Harris AHS 2015 Comparative utilization of pharmacotherapy for alcohol use disorder and other psychiatric disorders among U.S. Veterans Health Administration patients with dual diagnoses J Psychiatr Res 69 150 157 10.1016/j.jpsychires.2015.07.016 26343607 · DOI
  75. Rustad JK Stern TA Prabhakar M Musselman D 2014 Risk factors for alcohol relapse following orthotopic liver transplantation: a systematic review Psychosomatics 56 21 35 10.1016/j.psym.2014.09.006 25619671 · DOI
  76. Saunders KW Von Korff M Campbell CI Banta-Green CJ Sullivan MD Merrill JO Weisner C 2012 Concurrent use of alcohol and sedatives among persons prescribed chronic opioid therapy: Prevalence and risk factors J Pain 13 266 275 10.1016/j.jpain.2011.11.004 22285611 PMC3294025 · DOI
  77. Saxon AJ Ling W Hillhouse M Thomas C Hasson A Ang A Doraimani G Tasissa G Lokhnygina Y Leimberger J Bruce RD McCarthy J Wiest K McLaughlin P Bilangi R Cohen A Woody G Jacobs P 2013 Buprenorphine/Naloxone and methadone effects on laboratory indices of liver health: a randomized trial Drug Alcohol Depend 128 71 6 10.1016/j.drugalcdep.2012.08.002 22921476 PMC3543467 · DOI
  78. Senbanjo R Wolff K Marshall J 2007 Excessive alcohol consumption is associated with reduced quality of life among methadone patients Addiction 102 257 263 10.1111/j.1360-0443.2006.01683.x 17222280 · DOI
  79. Shaheed CA Maher CG Williams KA Day R Mclachlan AJ 2016 Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain A Systematic Review and Meta-analysis JAMA Intern Med 1 11 10.1001/jamainternmed.2016.1251 27213267 · DOI
  80. Soyka M Müller CA 2017 Pharmacotherapy of alcoholism – an update on approved and off-label medications Expert Opin Pharmacother 18 1187 1199 10.1080/14656566.2017.1349098 28658981 · DOI
  81. Srivastava A Kahan M Ross S 2008 The effect of methadone maintenance treatment on alcohol consumption: A systematic review J Subst Abuse Treat 34 215 223 10.1016/j.jsat.2007.04.001 17596906 · DOI
  82. Staines GL Magura S Foote J Deluca A Kosanke N 2001 Polysubstance use among alcoholics J Addict Dis 20 53 69 11760926
  83. Subramaniam GA Ives ML Stitzer ML Dennis ML 2010 The added risk of opioid problem use among treatment-seeking youth with marijuana and/or alcohol problem use Addiction 105 686 698 10.1111/j.1360-0443.2009.02829.x 20403020 PMC2858346 · DOI
  84. Tonigan JS Beatty GK 2011 Twelve-step program attendance and polysubstance use: interplay of alcohol and illicit drug use J Stud Alcohol Drugs 72 864 71 21906513 PMC3174030
  85. Trafton JA Oliva EM Horst DA Minkel JD Humphreys K 2004 Treatment needs associated with pain in substance use disorder patients: implications for concurrent treatment Drug Alcohol Depend 73 23 31 14687956
  86. Tsui JI Lira MC Cheng DM Winter MR Alford DP Liebschutz JM Edwards RR Samet JH 2016 Chronic pain, craving, and illicit opioid use among patients receiving opioid agonist therapy Drug Alcohol Depend 166 26 31 10.1016/j.drugalcdep.2016.06.024 27422763 PMC4983520 · DOI · Paper page
  87. UKATT Research Team 2005 Effectiveness of treatment for alcohol problems: findings of the randomised UK alcohol treatment trial (UKATT) BMJ 331 541 10.1136/bmj.331.7516.541 16150764 PMC1200586 · DOI
  88. van Amsterdam J van den Brink W 2013 The high harm score of alcohol. Time for drug policy to be revisited? J Psychopharmacol 27 248 55 10.1177/0269881112472559 23325370 · DOI
  89. Vowles KE Ashworth J 2011 Is opioid withdrawal necessary within comprehensive pain rehabilitation programs? Pain 152 1948 50 10.1016/j.pain.2011.03.016 21459513 · DOI
  90. Vowles KE McEntee ML Siyahhan P Frohe T Ney JP van der Goes DN 2015 Rates of opioid misuse, abuse, and addiciton in chronic pain: A systematic review and data synthesis Pain 156 569 576 25785523
  91. Watkins KE Ober AJ Lamp K Lind M Setodji C Osilla KC Hunter SB McCullough CM Becker K Iyiewuare PO Diamant A Heinzerling K Pincus HA 2017 Collaborative Care for Opioid and Alcohol Use Disorders in Primary Care JAMA Intern Med 10.1001/jamainternmed.2017.3947 PMC5710213 28846769 · DOI
  92. Weathermon R Crabb DW 1999 Alcohol and medication interactions Alcohol Res Heal 23 40 54 PMC6761694 10890797
  93. White JM Irvine RJ 1999 Mechanisms of fatal opioid overdose Addiction 94 961 72 10707430
  94. Witkiewitz K Bowen S Harrop EN Douglas H Enkema M Sedgwick C 2014a Mindfulness-based treatment to prevent addictive behavior relapse: Theoretical models and hypothesized mechanisms of change Subst Use Misuse 49 513 524 10.3109/10826084.2014.891845 24611847 PMC5441879 · DOI
  95. Witkiewitz K Votaw V Vowles KE Kranzler HR under review Opioid misuse as a predictor of alcohol treatment outcomes in the COMBINE study: Mediation by medication adherence PMC6063524 29873089
  96. Woodrow KM Eltherington LG 1988 Feeling no pain: alcohol as an analgesic Pain 32 159 63 3362554
  97. Zale EL Maisto SA Ditre JW 2015 Interrelations between pain and alcohol: An integrative review Clin Psychol Rev 37 57 71 10.1016/j.cpr.2015.02.005 25766100 PMC4385458 · DOI · Paper page

Authors
Witkiewitz, K., & Vowles, K. E.
Affiliations
University of New Mexico (US)
Corresponding author
Witkiewitz, Katie
ORCID
Venue
Alcoholism: Clinical and Experimental Research
Publisher
Wiley
Published
2018-02-06
Volume
42
Issue
3
Pages
478-488
ISSN
  • 0145-6008 (ISSN-L)
  • 1530-0277
DOI
10.1111/acer.13594
PMC
PMC5832605
OpenAlex
W2782173468
Cited by
248
References
143
Citations by year
2026: 23 · 2025: 29 · 2024: 30 · 2023: 32 · 2022: 26 · 2021: 32 · 2020: 44 · 2019: 19 · 2018: 12
FWCI
4.86
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Alcoholism Clinical and Experimental Research (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Research Portal (Queen's University Belfast) (submittedVersion)
Funders
  • National Center for Complementary and Integrative Health (R34 AT008398)
  • National Institute on Alcohol Abuse and Alcoholism (R01 AA022328, R01 AA025539)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
alcoholism, opioid use disorder, chronic pain, opioid epidemic, opioid overdose, substance use treatment outcomes, comorbid substance use disorders
MeSH terms
Alcoholism, Costs and Cost Analysis, Humans, Opioid-Related Disorders, United States, Comorbidity, Prevalence, Chronic Pain, Drug Overdose

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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