Intersection of alcohol use, pain symptoms, and negative affect in total knee arthroplasty patients and people with HIV.
| Title: | Intersection of alcohol use, pain symptoms, and negative affect in total knee arthroplasty patients and people with HIV. |
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| Authors: | Fitzpatrick-Schmidt T; Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.; Dasa V; Department of Orthopedics, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.; Leonardi C; School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.; Ferguson TF; Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.; Welsh DA; Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.; Molina PE; Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.; Ronis MJJ; Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.; Edwards S; Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA. Electronic address: sedwa5@lsuhsc.edu. |
| Source: | The journal of pain [J Pain] 2025 Jul; Vol. 32, pp. 105446. Date of Electronic Publication: 2025 May 20. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Churchill Livingstone Country of Publication: United States NLM ID: 100898657 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-8447 (Electronic) Linking ISSN: 15265900 NLM ISO Abbreviation: J Pain Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, PA : Churchill Livingstone, c2000- |
| MeSH Terms: | HIV Infections*/epidemiology ; HIV Infections*/psychology ; HIV Infections*/complications ; Alcohol Drinking*/epidemiology ; Alcohol Drinking*/psychology ; Chronic Pain*/epidemiology ; Chronic Pain*/psychology ; Osteoarthritis, Knee*/surgery ; Arthroplasty, Replacement, Knee*; Humans ; Male ; Female ; Middle Aged ; Aged ; Cross-Sectional Studies ; Longitudinal Studies ; Retrospective Studies ; Pain Measurement ; Depression |
| Abstract: | Alcohol is a well-known analgesic, although excessive alcohol use can lead to hyperalgesia and heightened negative affect. This cross-sectional study examined associations between alcohol use, self-reported pain, and negative affective symptoms in two distinct cohorts of patients vulnerable to chronic pain: individuals undergoing total knee arthroplasty (TKA) surgery and a cohort of people with HIV (PWH). Participants were enrolled in two clinical studies: a retrospective study of patients undergoing TKA and a longitudinal study of PWH, the New Orleans Alcohol Use in HIV (NOAH) cohort. Based on the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) score, participants in both cohorts were stratified as alcohol drinkers (AUDIT-C ≥ 1) or non-drinkers (AUDIT-C < 1). In the NOAH cohort, pain intensity and interference were assessed using the 36-Item Short Form Survey (SF-36). In the TKA cohort, self-reported pain was quantified using the Pain Intensity and Pain Interference items from the Patient-Reported Outcomes Measurement Information System® (PROMIS-29) and the Knee Osteoarthritis and Outcomes Score (KOOS) Pain scores. Alcohol drinkers reported fewer pain symptoms compared to non-drinkers across both cohorts, and females with HIV reported more pain compared to males with HIV. Furthermore, pain symptoms were associated with increased anxiety and depression symptoms in both cohorts, and in PWH these associations appeared stronger in drinkers compared to non-drinkers. These findings suggest that although alcohol may offer some analgesic benefits, patients should be cautioned about its use for self-medication, as it may increase risk for pain-related negative affective comorbidities. PERSPECTIVE: Alcohol can both relieve and exacerbate pain. The current study discovered that ongoing alcohol use was associated with fewer self-reported pain symptoms but appeared to increase associations between pain and negative affective symptoms in two vulnerable cohorts. Findings support cautioning patients against the recurring use of alcohol for pain management.; (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of Competing Interest No other conflicts of interest to disclose. |
| Grant Information: | F30 AA030941 United States AA NIAAA NIH HHS; P60 AA009803 United States AA NIAAA NIH HHS; T32 AA007577 United States AA NIAAA NIH HHS |
| Contributed Indexing: | Keywords: Alcohol; HIV; Negative affect; Pain; Total knee arthroplasty |
| Entry Date(s): | Date Created: 20250522 Date Completed: 20250703 Latest Revision: 20260512 |
| Update Code: | 20260512 |
| PubMed Central ID: | PMC13159567 |
| DOI: | 10.1016/j.jpain.2025.105446 |
| PMID: | 40403859 |
| Database: | MEDLINE |
Journal Article