ORCID
Dezarie Moskal: 0000-0002-4209-8881
Jacob L. Scharer: 0000-0001-6311-5022
Jennifer S. Funderburk: 0000-0002-9003-2326
Joseph W. Ditre: 0000-0002-8914-6908
Gregory P. Beehler: 0000-0002-4520-2947
Document Type
Poster
Date
4-9-2026
Keywords
Alcohol use, Chronic pain, Veteran, Comorbidity, Veterans affairs
Campus Community
D'Aniello Institute for Veterans and Military Families
Language
English
Funder(s)
VA Center for Integrated Healthcare, Syracuse University Center for Health Behavior Research & Innovation, IVMF Veteran & Military Behavioral Health Collaborative
Funding ID
n/a
Disciplines
Military and Veterans Studies | Public Affairs, Public Policy and Public Administration | Social and Behavioral Sciences
Description/Abstract
Hazardous alcohol use (HAU) and chronic pain are each common among U.S. veterans and are associated with poorer health outcomes when they co-occur. Primary care plays a central role in the identification and management of both conditions. However, national estimates of their co-occurrence and related comorbidity burden are limited. Accordingly, this study aimed to estimate the prevalence of HAU and chronic pain and compared comorbidity patterns in a national Veterans Affairs (VA) primary care sample.
This national retrospective VA electronic health record study included 3,900,633 veterans aged 18+ seen in primary care between July 2022 and December 2023. HAU was defined by Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) scores (4 for males <65 years; 3 for males >65 years and all females). Chronic pain was defined by qualifying pain diagnoses (e.g., neuropathic, musculoskeletal) documented at two or more encounters during the 18-month observation period. Veterans were grouped into four categories: neither condition, HAU only, chronic pain only, and both conditions. Prevalence estimates and odds ratios from logistic regression were calculated (reference group: neither-condition).
Results showed that 50.9% had neither condition, 14.0% had HAU only, 28.0% had chronic pain only, and 7.1% had both conditions. Overall, 21.0% had HAU and 35.1% had chronic pain. Veterans with co-occurring HAU and chronic pain demonstrated the most clinically complex comorbidity profile with significantly higher odds (p<.001) of all examined comorbidities, including depression (OR=1.65), anxiety (OR=1.74), PTSD (OR=1.83), substance use disorder (OR=3.98), cancer (OR=1.21), cardiovascular disease (OR=1.34), and sleep disorders (OR=2.16).
Findings indicate that co-occurring HAU and chronic pain affect a meaningful subset of veteran primary care patients who experience elevated clinical complexity and risk for adverse health outcomes. Primary care settings routinely encounter these patients, underscoring the need for comprehensive assessment and coordinated care planning that extends beyond single-condition frameworks.
Recommended Citation
Moskal, Dezarie; Scharer, Jacob L.; Funderburk, Jennifer S.; Ditre, Joseph W.; and Beehler, Gregory P., "Hazardous alcohol use and chronic pain co-occurrence and comorbidity rates: A national study of Veterans Affairs primary care patients" (2026). Voices of Service Symposium. 34.
https://surface.syr.edu/vos/34
Creative Commons License
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