Pain and anxiety linked to heavy episodic drinking in emerging adults

Reviewed by Danielle Ellis, B.Sc.Jul 4 2023

Emerging adults – those aged 18 to 24 years –who experience pain are more likely to engage in high-risk patterns of alcohol use such as binge drinking. Anxiety caused by pain may be what motivates unhealthy coping strategies such as excessive drinking as a form of escape/avoidance. These results and others will be shared at the 46^th annual scientific meeting of the Research Society on Alcohol (RSA) in Bellevue, Washington.

Emerging adulthood is an exciting developmental period to focus on for several reasons. It is a period marked by transition – emerging adults are no longer children, but in many ways they have not yet fully undertaken all of the roles and responsibilities that our culture uses to define adulthood. It is when we explore our identities, develop responsibility for our independent decision-making, move towards self-sufficiency, and consider future possibilities for the future."

Emily L. Zale, Assistant Professor of Psychology, Binghamton University

"Emerging adulthood is also a period of experimentation with alcohol or other substances, and can represent a developmental period in which substance-use patterns develop and become entrenched," said Zale. "With regard to pain, it's tempting for us to think that pain is a problem of aging, but recent data have consistently shown us that the rates of some pain conditions – like chronic musculoskeletal pain or chronic low-back pain – look very similar among emerging adults as they do in adulthood. When we put these things together, we see that emerging adulthood is a period in which we might expect to see relationships among heavy episodic drinking, pain, and reactions to pain-like anxiety."

Zale will discuss these findings at the RSA meeting on Sunday, 25 June 2023.

For this study, 695 emerging adults at a large Northeastern public university completed an online survey. "We found that even in this 'healthy' college sample, more than 70 percent said that at some point during the previous three months they had experienced a bout of significant pain," said Zale. "Eight percent of our sample said that they had experienced pain every day for the previous 90 days. We found that even a one-point increase in pain, on a scale of 10, that was experienced at any point during the previous three months was associated with a greater likelihood of at least one instance of heavy episodic drinking, up to 12 drinks in a single day."

Zale recommended that researchers and clinicians who work with emerging adults consider the role of pain as a motivation in drinking among emerging adults. "I also think it is important for people in general to be aware that pain is extremely common, and that the ways that we tend to cope with and manage our pain, even when pain is just short term, might be risk factors for substance use. People who find themselves turning to substances like alcohol to cope with physical pain or the emotional distress that comes with being in pain may be at risk for escalating their drinking or contributing to worsening pain outcomes over time."

Zale will present these findings, "Associations between pain, anxiety, and heavy episodic drinking among emerging adults," during the RSA 2023 meeting in Bellevue, Washington on Sunday, 25 June 2023. More information can be found at RSoA on Twitter @RSAposts. The author can also be reached on Twitter @ZalePhD.