Characterizing Alcohol Use and Expectancies for Alcohol Analgesia Among Breast Cancer Survivors With Arthralgia

Expectancies for alcohol analgesia (EAA; beliefs that alcohol use can reduce pain) are linked to heavier drinking in chronic non-cancer pain; however, no studies have examined EAA in those with cancer-related pain.

These secondary analyses examined cross-sectional associations among EAA, alcohol use, and pain among breast cancer survivors with persistent pain due to aromatase inhibitors (AIs; arthralgia).

Data were from 213 female breast cancer survivors with AI-associated arthralgia (M age = 58.9, 77.5% White) who completed baseline assessment in a behavioral pain intervention trial. Alcohol consumption and alcohol use severity were assessed via the Alcohol Use Disorders Identification Test (AUDIT). Linear/logistic regressions were conducted covarying for depression, anxiety, age, race, and pain severity.

EAA scores were related to greater likelihood of current drinking (AOR = 6.02, p = 0.003). Among participants who reported current alcohol use (n = 153), EAA scores were associated with greater alcohol consumption and alcohol use severity (ps < 0.001). Probing of a significant pain severity x EAA interaction (p = 0.015) indicated that EAA scores were more strongly associated with alcohol use severity among participants with less (vs. more) severe pain.

In breast cancer survivors with AI-associated arthralgia, EAA are related to greater likelihood of drinking and heavier/more problematic alcohol use, which may reduce efficacy of AIs while increasing risk for side effects. EAA scores were more strongly associated with drinking in women with less severe pain.