Expectancies for alcohol analgesia and drinking behavior among veterans with chronic pain: The moderating role of discrimination in medical settings.

BACKGROUND AND OBJECTIVES

Chronic pain and alcohol use are highly prevalent and frequently co-occur among U.S. military veterans. Expectancies for alcohol analgesia (i.e., degree to which one believes that drinking can reduce or manage pain) may contribute to alcohol consumption, dependence, and related harms. Discrimination in medical settings (i.e., inequitable treatment in healthcare contexts) has been linked to deleterious health outcomes and may amplify associations between expectancies for alcohol analgesia and indices of hazardous drinking. Our goal was to test discrimination in medical settings as a moderator of associations between expectancies for alcohol analgesia and drinking behavior.

METHODS

Participants included 430 U.S. military veterans with chronic pain and past month alcohol consumption (24% female; 73% White; M = 57) who completed an online survey via Qualtrics Panels.

RESULTS

Expectancies for alcohol analgesia were positively associated with alcohol consumption, dependence, and related harms. Discrimination in medical settings moderated associations between expectancies for alcohol analgesia and alcohol consumption and dependence.

DISCUSSION AND CONCLUSIONS

Among veterans with pain, expectancies for alcohol analgesia were positively associated with indices of hazardous drinking, and discrimination in medical settings moderated associations between expectancies for alcohol analgesia and alcohol consumption and dependence. Future research should explore the potential utility of interventions addressing expectancies for alcohol analgesia and discrimination in medical settings in the context of pain and drinking.

SCIENTIFIC SIGNIFICANCE

These findings are the first to demonstrate that experiences of discrimination in healthcare contexts amplify relations between expectancies for alcohol analgesia and drinking behavior among veterans with pain.