Ambulatory assessment of physical pain, emotional distress and alcohol use

 描述(申请人提供)：这个项目的目标是测试一个理论框架，为什么慢性疼痛的个人消费酒精来管理他们的疼痛，以便更好地了解酒精与阿片类止痛剂相比，对日常生活中身体疼痛的影响。具体目的本项目将结合实验和动态评估方法，调查使用酒精控制疼痛的三个可能且相互关联的原因：(1)酒精的止痛效果与处方阿片类药物的止痛效果相似，(2)饮酒止痛的人是否也会饮酒以缓解其他形式的压力，尤其是情绪困扰，以及(3)慢性疼痛与饮酒后预期的张力降低之间的关联，这些预期与疼痛和情绪困扰有关。该项目还将确定在受控条件下获得的基线疼痛反应在多大程度上改善了对日常生活事件的预测，如疼痛和情绪困扰的体验。方法定期饮酒、开处方、服用阿片类镇痛剂或同时服用阿片类镇痛剂的慢性腰背痛患者，完成实验室疼痛诱导任务，以获得对标准化刺激的基线疼痛反应。然后，参与者将提供有关酒精和阿片类药物使用、身体疼痛、[酒精和阿片类药物使用预期]以及在两周内使用智能手机的日常生活中的情绪困扰的信息。意义这个翻译研究项目将把从酒精使用基础研究中获得的知识应用到日常生活中慢性疼痛患者的酒精使用中。有证据表明，这些人患酒精使用问题的风险更高。当前项目的调查结果可能有助于制定针对这一人群的干预措施。

 DESCRIPTION (provided by applicant): The goal of this project is to test a theoretical framework for why individuals with chronic pain consume alcohol to manage their pain, in order to better understand the effects of alcohol, as compared to opioid analgesics, on physical pain in daily life. Specific Aims This project will combine experimental and ambulatory assessment methods to investigate three possible and interrelated reasons for using alcohol to manage pain: (1) the similarity of alcohol's analgesic effects to those of prescription opioids, (2) whethr individuals who drink to reduce pain also drink to reduce other forms of stress, specifically emotional distress, and, (3) the association of chronic pain and tension reduction expectancies for alcohol use related to pain and emotional distress. The project will also determine to what degree a baseline pain response obtained under controlled conditions improves prediction of daily life events, such as experience of pain and emotional distress. Method Chronic back pain outpatients who regularly use alcohol, are prescribed and take opioid analgesics, both, or neither, will complete a laboratory pain-induction task to obtain a baseline pain response to a standardized stimulus. Participants will then provide information on alcohol and opioid use, physical pain, [alcohol and opioid use expectancies], and emotional distress in daily life using smartphones over the course of two weeks. Significance This translational research project will apply knowledge gained from basic research on alcohol use to the use of alcohol among chronic pain individuals in daily life. Evidence suggests that these individuals are at increased risk for the development of alcohol use problems. The findings from the current project may aid in the development of interventions that target this population.