VA Primary Care Patients with Chronic Pain: A Comparison of Healthcare Utilization and Patient Characteristics Across Alcohol Risk Categories.

Chronic pain is common in primary care and can be influenced by alcohol use. Co-occurring pain and at-risk alcohol use is associated with poor outcomes, but the prevalence of this co-occurrence is less well understood. This study aims to establish the prevalence of at-risk alcohol use in a sample of VA primary care patients with chronic pain, and determine health characteristics and care utilization of these patients. Eligible VA primary care patients with a musculoskeletal condition (n = 47,091) were classified as at risk, low risk, or abstainers based on responses to annual alcohol screening. Differences across groups in demographics, comorbid health conditions, health factors, and healthcare encounters were assessed. 45.7% of participants were abstainers, 38.5% were low risk, and 15.8% were at risk. Comparisons revealed abstainers to have higher frequencies of health conditions, as well as higher rates of emergency department and primary care utilization. At-risk patients had the highest rate of overall healthcare utilization and, when compared directly to low-risk patients, were more likely to be diagnosed with many physical and mental health conditions. Primary care teams will benefit from considering the impact of alcohol when treating patients with chronic pain. Further prioritization of integrated primary care is recommended.