Alcohol use disorder (AUD) and chronic pain disorders are pervasive, multifaceted medical conditions that often co-occur. However, their comorbidity is often overlooked, despite its prevalence and clinical relevance. Individuals with AUD are more likely to experience chronic pain than the general population. Conversely, individuals with chronic pain commonly alleviate their pain with alcohol, which may escalate into AUD. This narrative review discusses the intricate relationship between AUD and chronic pain. Based on the literature available, the authors present a theoretical model explaining the reciprocal relationship between AUD and chronic pain across alcohol intoxication and withdrawal. They propose that the use of alcohol for analgesia rapidly gives way to acute tolerance, triggering the need for higher levels of alcohol consumption. Attempts at abstinence lead to alcohol withdrawal syndrome and hyperalgesia, increasing the risk of relapse. Chronic neurobiological changes lead to preoccupation with pain and cravings for alcohol, further entrenching both conditions. To stimulate research in this area, the authors review methodologies to improve the assessment of pain in AUD studies, including self-report and psychophysical methods. Further, they discuss pharmacotherapies and psychotherapies that may target both conditions, potentially improving both AUD and chronic pain outcomes simultaneously. Finally, the authors emphasize the need to manage both conditions concurrently, and encourage both the scientific community and clinicians to ensure that these intertwined conditions are not overlooked given their clinical significance.

酒精使用障碍 （AUD） 和慢性疼痛障碍是普遍存在的、多方面的医疗状况，经常同时发生。然而，尽管其患病率和临床相关性，但它们的合并症经常被忽视。患有 AUD 的人比一般人群更容易经历慢性疼痛。相反，患有慢性疼痛的人通常会通过酒精来缓解疼痛，这可能会升级为 AUD。这篇叙述性综述讨论了 AUD 与慢性疼痛之间的复杂关系。根据现有文献，作者提出了一个理论模型，解释了 AUD 与酒精中毒和戒断慢性疼痛之间的相互关系。他们提出，使用酒精镇痛很快让位于急性耐受性，从而引发了对更高水平的饮酒的需求。尝试戒酒会导致酒精戒断综合征和痛觉过敏，从而增加复发的风险。慢性神经生物学变化导致对疼痛的关注和对酒精的渴望，进一步加深了这两种情况。为了促进这一领域的研究，作者回顾了改进 AUD 研究中疼痛评估的方法，包括自我报告和心理物理学方法。此外，他们讨论了可能针对这两种情况的药物治疗和心理疗法，有可能同时改善 AUD 和慢性疼痛的结果。最后，作者强调了同时管理这两种疾病的必要性，并鼓励科学界和临床医生确保鉴于这些相互交织的疾病的临床意义不会被忽视。