Association between medically assisted detoxification and neuropathic pain

Nurs Stand. 2021 Jul 19. doi: 10.7748/ns.2021.e11604. Online ahead of print.

Abstract

Background: High-risk alcohol use is correlated with chronic pain. Chronic pain and alcohol dependence are associated with similar neurological, endocrinological and behavioural patterns, and it has been hypothesised that symptoms of neuropathic pain are exacerbated following alcohol withdrawal.

Aim: To investigate the presence of neuropathic pain upon withdrawal from alcohol, in people with high-risk alcohol use with or without a history of medically assisted detoxification.

Method: A small observational cross-sectional study investigated the presence of neuropathic pain in two groups of hospitalised adults exhibiting high-risk alcohol use: one group with a history of medically assisted detoxification, the other group with no history of medically assisted detoxification.

Results: The results provided some evidence that neuropathic pain is more likely to be experienced by people with high-risk alcohol use who have previously undergone medically assisted detoxification.

Conclusion: Understanding that previous medically assisted detoxification may increase the risk of neuropathic pain means that nurses can improve their preparation when assessing, monitoring and managing neuropathic pain in people recovering from high-risk alcohol use. Nurses will be able to direct patients recovering from high-risk alcohol use to available pain management support in a timely manner, for example a local pain clinic, possibly even before detoxification. This is important given the links between pain, relapse into alcohol use and addiction to analgesics.

Keywords: addiction; chronic pain; clinical; mental health; neuropathic pain; pain; pain management; substance misuse.