Pain control in recovering alcoholics: effects of local anesthesia

Abstract

Objective: The medical literature suggests that alcoholics may present greater challenges to achieving clinical pain control than nonalcoholics. This study was undertaken to test the hypotheses that: (1) significant differences exist between alcoholics and nonalcoholics on detection and pain thresholds during electric tooth stimulation; (2) group differences exist in the depth and time course of pulpal anesthesia; and (3) responses to tooth stimulation are associated with severity of alcoholism and/or other psychological factors.

Method: Male alcoholics (n = 22) in aftercare treatment (mean length of sobriety = 113 days) and age-matched nonalcoholics (n = 22) received 1.0 ml of 3% mepivicaine at the apex of a maxillary lateral incisor and saline placebo at the apex of the contralateral incisor.

Results: At baseline no group differences were found on sensory thresholds. During drug intervention significant drug and time effects for both detection threshold (p < .0001) and pain threshold (p < .0001) were found, but group differences and interactive effects were not significant. By exploratory regression analysis of alcoholic subjects, history of depression/unhappiness was significantly associated with shallower pulpal anesthesia, whereas high need for control/low actual control and frequency of treatment for detoxification were associated with deeper anesthesia.

Conclusions: Our findings suggest alcoholics in recovery are not at increased risk for inadequate pain control with local anesthesia.