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Cancer pain and alcohol self-medication

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Abstract

Background

Cancer survivors are at increased risk of pain due to their either cancer and/or treatments. Substances like alcohol may be used to self-medicate cancer pain; however, these substances pose their own health risks that may be more pronounced for cancer survivors.

Methods

We used cross-sectional data from the Behavioral Risk Factor Surveillance System (BRFSS) 2012–2019 to quantify the association between cancer pain and alcohol use. We used negative binomial regression, with interaction terms added to examine variations across age, sex, and race. We also examined whether alcohol use relates to cancer pain control status.

Results

Cancer survivors with cancer pain were more likely to be younger, female, Black, and to have been diagnosed with breast cancer. Cancer pain was associated with lower alcohol consumption (incidence rate ratio (IRR): 0.88, confidence interval (CI): 0.77, 0.99). This association was primarily among people 65 and older, women, and white and Hispanic people. Cancer pain control status was not related to alcohol use.

Conclusions

Lower alcohol use among cancer survivors with pain has many possible explanations, including several alternative pain management strategies or a decrease in social engagement. Our findings of racial and gender disparities in cancer pain are consistent with the broader evidence on disparities in pain.

Implications for Cancer Survivors

Cancer pain management for marginalized groups should be improved. Healthcare providers should screen cancer survivors for both pain and substance use, to prevent unhealthy self-medication behaviors.

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Data availability

The dataset analyzed during the current study is available in on the CDC website, https://www.cdc.gov/brfss/index.html.

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Authors and Affiliations

  1. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN, 55454-1015, USA

    Collin M. Calvert, Darin Erickson, Rachel Widome & Rhonda Jones-Webb

  2. Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, Mail code: 152, Bldg. 9, One Veterans Drive, Minneapolis, MN, 55417, USA

    Diana Burgess

Authors
  1. Collin M. Calvert
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  2. Diana Burgess
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  3. Darin Erickson
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  4. Rachel Widome
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Contributions

All authors contributed to the study conception and design. Conceptualization, data cleaning, analyses, and writing were performed by Collin Calvert. Supervision, resources, and review and editing of writing were performed by Diana Burgess, Darin Erickson, Rachel Widome, and Rhonda Jones-Webb. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Collin M. Calvert.

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Ethics approval

This is an observational study of secondary data. The University of Minnesota Institutional Review Board has confirmed that no ethical approval is required.

Competing interests

The authors declare no competing interests.

Disclosures

Work for this research was supported by the University of Minnesota Doctoral Dissertation Fellowship.

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Calvert, C.M., Burgess, D., Erickson, D. et al. Cancer pain and alcohol self-medication. J Cancer Surviv 17, 1561–1570 (2023). https://doi.org/10.1007/s11764-022-01215-x

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