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Updated September 3, 2026
Some people turn to alcohol or tobacco as a way to cope with chronic pain. These substances can temporarily change how you feel, reduce distress, or provide a short-term sense of relief. Both alcohol and tobacco carry significant health risks and can become difficult to stop using. Smoking has also been associated with a greater risk of chronic musculoskeletal pain. A meta-analysis of 32 studies involving nearly 296,000 people found that current smoking was associated with increased risk of chronic musculoskeletal pain, although the researchers noted that the relationship doesn't establish that smoking directly causes the pain. The relationship between alcohol and pain is more complicated. Alcohol can temporarily reduce pain, which may make it appealing as a coping strategy. But repeated or heavy alcohol use can contribute to tolerance, withdrawal-related increases in pain sensitivity, and a cycle in which pain and alcohol use reinforce one another. Don't let a substance become the coping strategy When alcohol or tobacco becomes a primary way of coping with pain or escaping distress, the short-term relief can reinforce the habit. Over time, this can make it harder to develop other ways of responding to pain, stress, and difficult emotions. This doesn't mean that everyone who drinks alcohol or uses tobacco has a problem. It means it's worth paying attention to why you're using it and what role it plays in your life. Ask yourself: Am I using this because I enjoy it, or because I feel like I need it to cope? That's an important distinction. What I learned at Mayo Clinic During my three-week stay at the Mayo Clinic Pain Rehabilitation Center, alcohol consumption was prohibited. The program also included chemical health education and support related to substance use. Mayo's current pain rehabilitation programs continue to incorporate chemical health education as part of an interdisciplinary approach to chronic pain self-management. The goal wasn't simply to tell people what they couldn't do. It was to help people develop healthier ways to manage pain, stress, emotions, and daily life. That distinction is important. Find healthier ways to cope Chronic pain can be exhausting and frustrating. It's understandable to look for something that provides relief. But the goal of self-management is to develop skills that don't depend on alcohol, tobacco, or another substance to get through the day. Physical activity, relaxation, stress management, cognitive strategies, social connection, meaningful activities, and other self-management skills can offer healthier ways to respond to the challenges of chronic pain. And if alcohol or tobacco use has become difficult to control, getting professional help is a sign of strength, not failure. If alcohol dependence is present, stopping suddenly can be medically dangerous. Professional guidance may be needed to stop safely. The bottom line Alcohol and tobacco may seem like ways to cope in the short term, but they can create problems that make life more difficult in the long run. Don't let a substance become the strategy you depend on to manage pain. The goal isn't simply to find another way to escape pain . The goal is to develop the skills and confidence to live a meaningful life while managing the challenges that chronic pain can bring. Learn more
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