Microaggressions and Hazardous Drinking among non-Latinx Black Individuals with Chronic Pain

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PROJECT SUMMARY/ABSTRACT Hazardous drinking and chronic pain are both highly prevalent and frequently comorbid public health conditions that exact a significant burden on patients, providers, and health care systems.1,2 Indeed, non-Latinx Black adults with chronic pain are more likely to report greater pain intensity, increased avoidance of activities due to pain, greater fearful thinking related to pain, and greater physical and psychological disability in the context of their chronic pain experience when compared their non-Latinx White counterparts.3-6 Despite there being lower rates of drinking among non-Latinx Black adults, they experience greater negative consequences (e.g., alcohol dependence symptoms and social consequences) for drinking than non-Latinx White adults.7 Additionally, compared to their non-Latinx White counterparts, alcohol-dependent non-Latinx Black adults have an increased likelihood of experiencing recurrent and persistent alcohol dependence.8 Minority stress-based models of substance use and mental health outcomes posit that marginalized groups, such as non-Latinx Black adults, are vulnerable to problematic substance use via common racial/ethnic microaggressions (MAs), defined as verbal or non-verbal indignities that insult or put down people because of their race/ethnicity.9 Extant work among non-Latinx Black individuals has only initially documented the negative impact of MAs on alcohol use.10 There is a need to understand the longitudinal nature of MAs and alcohol use motivation (i.e., greater alcohol craving, intention to drink, and coping-oriented motives for alcohol use) and drinking (i.e., greater alcohol consumption, greater frequency of drinking, and more negative consequences from drinking) among non-Latinx Black adults who are hazardous drinkers with chronic pain. The proposed research project supports the 2017-2021 strategic plan of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) by advancing research in two of the key areas. First, the current proposal has the goal of improving strategies to prevent alcohol misuse, alcohol use disorder, and alcohol-related consequences among an ‘at-risk’ population for these conditions (goal 3). Second, it enhances the public health impact of NIAAA-supported research, by focusing on one of the largest demographics in the US who demonstrate disparities in hazardous drinking (goal 5). Further, the proposal contributes to research on health disparities and comorbidities, which represent two of the cross-cutting research themes of NIAAA. 2