Pain and Alcohol Consumption in Virtual Reality

Public Health Significance This study provides evidence that pain has significant effects on drinking topography, or the microstructure of drinking patterns. We found novel evidence that acute pain has sex-contingent effects on drinking topography, such that men drank more rapidly while experiencing a painful stimulus. Results are relevant to understanding patterns of drinking while experiencing pain, which is an important aspect to consider when working with a chronic pain population. Research suggests situational pain may motivate alcohol consumption, suggesting that pain may be an antecedent for problematic drinking behavior. In this pilot project, we assessed the effect of a painful thermal stimulus on drinking topography in a virtual reality bar environment using real alcohol-containing beverages. We also examined psychosocial factors that may account for individual differences in pain as an antecedent for alcohol use. Participants (N = 20, M-age = 25.65 years, 55% female, 15% Hispanic/Latino/a/x) completed a psychosocial screening battery before completing two counterbalanced alcohol self-administration sessions. In each, participants experienced either painful heat (44 degrees C) or nonnoxious warmth (38 degrees C). Sip interval (s) and sip volume (g) were measured. Effects of pain on drinking topography were assessed using multilevel models. Multilevel models assessed associations of pain-related changes in topography with hypothesized vulnerability factors. Analyses indicated a significant interaction of pain condition and sex on sip interval (b = -.16.96, p = .015, 95% CI [-30.75, -2.97]), such that painful heat significantly decreased sip interval in men (b = 16.38) but not women (b = -.45). No effect of pain on sip volume was detected (p > .49). Exploratory analyses indicated significant interactions such that the effect of the painful heat condition was stronger in individuals with higher levels of greater negative urgency but the opposite effect for pain catastrophizing. Results suggest acute pain has sex-contingent effects on drinking topography, such that men drank more rapidly while experiencing painful heat. Furthermore, analyses indicated that individuals with greater negative urgency, regardless of sex, may be at elevated risk for hazardous alcohol use when experiencing pain.