Expectancies for Alcohol Analgesia and Alcohol Use among Veterans with Chronic Pain: The Moderating role of Discrimination in Medical Settings

Abstract

Introduction. 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 an individual believes that consuming alcohol can help reduce or manage their pain) may contribute to alcohol consumption, dependence, and related harms. Discrimination in medical settings (i.e., degree to which one experiences inequitable treatment while receiving healthcare due to a stigmatized identity) has been linked to a variety of deleterious health outcomes and may amplify associations between expectancies for alcohol analgesia and drinking behavior. Methods. Participants included 430 U.S. military veterans with chronic pain who endorsed past month alcohol consumption (24% female; 73% White; Mage = 57) and completed an online survey via Qualtrics Panels. Results. Hierarchical linear regression analyses revealed that expectancies for alcohol analgesia were positively associated with indices of alcohol consumption, dependence, and related harms. Experiences of discrimination in medical settings were found to moderate associations between expectancies for alcohol analgesia and indices of alcohol consumption and dependence (p’s \u3c .05). Discussion. Expectancies for alcohol analgesia were associated with greater alcohol consumption, dependence, and alcohol-related harms. Discrimination in medical settings moderated two of these associations, suggesting that healthcare-related stigma may amplify associations between expectations for alcohol analgesia and drinking trajectories. Future research is needed to establish temporal precedence and to examine the utility of alcohol interventions that address analgesia expectancies and medical discrimination among veterans with chronic pain