Alcohol and Cannabis Use for Pain Management: Translational Findings of Relative Risks, Benefits, and Interactions

Location

LSUHSC-NO

Publication Date

April 2026

Start Date

9-4-2026 10:00 AM

End Date

9-4-2026 2:00 PM

Description

Chronic pain affects over 20% of the global population and is tightly coupled with psychiatric illnesses, particularly anxiety and depression, through shared neurobiological pain-affect systems. While effective treatments for chronic pain and pain-related negative affect remain limited, both alcohol and cannabis have been used for centuries to manage pain and pain-associated mood disorders. This review synthesizes neurobiological evidence regarding how alcohol and cannabis modulate pain perception, negative affect, and their interdependence. Acute alcohol administration dose-dependently increases pain thresholds, but chronic use paradoxically produces hyperalgesia and exacerbates negative affect during withdrawal. Similarly, delta-9- tetrahydrocannabinol {THC) demonstrates acute analgesic and anxiolytic effects, yet chronic use leads to tolerance and potential hyperalgesia, in addition to cannabis use disorder (CUD) risk. Critical to pain affect outcomes, the amygdala and associated limbic regions process both nociceptive and emotional information, with alcohol and cannabis producing differential effects on pain-emotion integration. Persistent misuse of alcohol and/or cannabis through negative reinforcement mechanisms significantly increases substance use disorder (SUD} risk and related comorbidities. The co-use of alcohol and cannabis is becoming increasingly common, especially among patients with chronic pain, anxiety, and depression, further complicating treatment outcomes. In addition, sex differences in pain-affect-substance interactions highlight the need for personalized approaches. This review emphasizes the urgent need for integrated, multimodal therapeutic strategies targeting shared pain-affect neurobiological mechanisms.

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Apr 9th, 10:00 AM Apr 9th, 2:00 PM

Alcohol and Cannabis Use for Pain Management: Translational Findings of Relative Risks, Benefits, and Interactions

LSUHSC-NO

Chronic pain affects over 20% of the global population and is tightly coupled with psychiatric illnesses, particularly anxiety and depression, through shared neurobiological pain-affect systems. While effective treatments for chronic pain and pain-related negative affect remain limited, both alcohol and cannabis have been used for centuries to manage pain and pain-associated mood disorders. This review synthesizes neurobiological evidence regarding how alcohol and cannabis modulate pain perception, negative affect, and their interdependence. Acute alcohol administration dose-dependently increases pain thresholds, but chronic use paradoxically produces hyperalgesia and exacerbates negative affect during withdrawal. Similarly, delta-9- tetrahydrocannabinol {THC) demonstrates acute analgesic and anxiolytic effects, yet chronic use leads to tolerance and potential hyperalgesia, in addition to cannabis use disorder (CUD) risk. Critical to pain affect outcomes, the amygdala and associated limbic regions process both nociceptive and emotional information, with alcohol and cannabis producing differential effects on pain-emotion integration. Persistent misuse of alcohol and/or cannabis through negative reinforcement mechanisms significantly increases substance use disorder (SUD} risk and related comorbidities. The co-use of alcohol and cannabis is becoming increasingly common, especially among patients with chronic pain, anxiety, and depression, further complicating treatment outcomes. In addition, sex differences in pain-affect-substance interactions highlight the need for personalized approaches. This review emphasizes the urgent need for integrated, multimodal therapeutic strategies targeting shared pain-affect neurobiological mechanisms.