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Within and Beyond the Binary: Sex and Gender Differences in Pain and Alcohol Use Disorder

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Abstract

Purpose of Review

Alcohol use disorder (AUD) and chronic pain are frequently comorbid conditions. This review aims to communicate recent research describing the bidirectional effects of pain experience and alcohol use, while focusing on sex and gender differences at this intersection with an emphasis on translational research.

Recent Findings

Most pain syndromes affect people assigned female at birth (AFAB). Although people assigned male at birth (AMAB) typically drink more than AFABs, AFABs progress to AUD more quickly and experience more alcohol-related comorbidities. In the preclinical setting, different alcohol models highlight sex differences in the escalation of alcohol drinking, while a state of alcohol dependence appears to produce sex-specific alterations in withdrawal-induced pain- and anxiety-like behaviors.

Summary

Preclinical and clinical studies are accelerating in order to elucidate important sex differences in both chronic pain and AUD. A better understanding of the physiological mechanisms underlying pain and AUD will support the discovery of more effective, potentially sex-specific, therapeutic options for these devastating co-morbid conditions.

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Funding

Preparation of this review was generously supported by the following training and research grants from the National Institute on Alcohol Abuse and Alcoholism (NIAAA): F30AA030941 (TFS), R01AA025996 (SE), P60AA009803, and T32AA007577.

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Authors and Affiliations

  1. Department of Physiology, LSU Health-New Orleans, New Orleans, 2020 Gravier St. Room 734, New Orleans, LA, 70112, USA

    Taylor Fitzpatrick-Schmidt & Scott Edwards

  2. Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans, New Orleans, LA, USA

    Taylor Fitzpatrick-Schmidt & Scott Edwards

  3. Comprehensive Alcohol-HIV/AIDS Research Center, LSU Health-New Orleans, New Orleans, LA, USA

    Taylor Fitzpatrick-Schmidt & Scott Edwards

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T.F.S. and S.E. drafted, reviewed, and edited the manuscript and created and edited Figure 1.

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Fitzpatrick-Schmidt, T., Edwards, S. Within and Beyond the Binary: Sex and Gender Differences in Pain and Alcohol Use Disorder. Curr Addict Rep 11, 68–80 (2024). https://doi.org/10.1007/s40429-023-00534-y

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