Over 100 million Americans are living with chronic pain. For a lucky few, managing the pain is a relatively straightforward process that simply requires finding the right medication and sticking to it. But for people with addiction, chronic pain can be a more difficult and frightening condition, as traditional avenues to pain management may be inaccessible due to your history of substance abuse. Compounding the problem is the fact that doctors are often suspicious of addicts who report chronic pain issues, assuming that you are exaggerating or inventing symptoms to access narcotics, resulting in inadequate treatment. This can in turn increase your risk of relapse as you seek to alleviate pain via self-medication. Far too often, people living with addiction and chronic pain experience unnecessary frustration and prolonged suffering that severely damage your quality of life.
But there is hope. By working with clinicians with an advanced understanding of chronic pain and addiction, you can develop an interdisciplinary approach to pain management that draws from the most cutting-edge research to provide meaningful, effective relief from physical and psychological distress. By thoughtfully layering therapies that address your symptoms in a way that is appropriate for your unique situation, you can restore function and gain the ability to live the life you want. The following are some of the most common components of comprehensive pain management strategies that can be profoundly beneficial for people with histories of addiction.
There is a broad range of pain medications available for the treatment of various degrees of suffering, and your physician should select a medication that is appropriate for both the nature of your pain and your history of addiction. For some people with addiction issues, opioids are no longer an option due to the high risk of addiction, and alternatives such as NSAIDs, acetaminophen, and COX-2 inhibitors may be adequate to alleviate some chronic pain. However, opioids should not be automatically discounted; when pain cannot be successfully controlled by these interventions, it may be possible to successfully integrate opioid use in the management of chronic pain even for people with addiction issues, regardless of whether or not your substance use included opiates. If you are a recovering opiate addict, certain opioids like methadone and buprenorphine may present the best solution for providing relief while minimizing risk of relapse. If opioid pain medications are the best solution for you, it is critical that you are closely monitored by a physician who is experienced in treating chronic pain in people with addiction issues and can select the best medication for your particular circumstances. It is also vital that you remain in some form of addiction treatment such as counselling or 12-step meetings to prevent relapse. Your physician and your substance abuse treatment team can work together to create the framework for appropriate opiate use and closely monitor your progress to ensure safety and efficacy.[1. https://www.painedu.org/roundtable.asp?roundtableNumber=15]
Antidepressants and Anticonvulsants
Antidepressants such as tricyclics, SSRIs, and SNRIs can offer significant pain relief for some types of chronic pain, including arthritis, nerve pain, fibromyalgia, and lower back pain. Although their exact mechanism of action is unknown, experts believe that they may work by fortifying the spinal cord neurotransmitters serotonin and norepinephrine that reduce pain. Due to the “reciprocal nature of depression and pain,” these medications may also reduce the psychological burden of chronic pain and in turn decrease experiences of physical pain, significantly improving quality of life for patients.[2. http://www.medscape.com/viewarticle/704975] Antidepressants may be used to manage pain even in patients without depression, and research indicates that “analgesic efficacy is not dependent on mood elevation.”[3. http://www.hopkinsarthritis.org/patient-corner/disease-management/managing-chronic-pain-and-depression-in-arthritis/] In other words, these medications can provide physical relief even if the absence of psychological relief. Anticonvulsants such as Topamax, Neurotonin, and Tegretol have similarly been found to reduce some types of chronic pain and offer another option for non-addictive pharmaceutical intervention.
A variety of holistic therapies have been found to offer relief for many people living with chronic pain. A 2012 metareview published in the Archives of Internal Medicine examined 29 studies on 17,922 participants and found that acupuncture reduced pain by 50% in those suffering from chronic back and neck pain, osteoarthritis, chronic headache, and shoulder pain.[4. http://archinte.jamanetwork.com/article.aspx?articleid=1357513] While the precise source of its therapeutic nature remains unknown, the findings definitively confirm the efficacy of acupuncture and support its integration in ongoing pain management. Additional studies indicate that yoga, meditation, and massage can be vital holistic strategies to help you relieve and cope with some types of pain while reducing stress, encouraging relaxation, and improving mental well-being.[5. http://healthland.time.com/2011/07/06/aching-back-try-massage-for-chronic-pain/] These modalities have the added benefit of improving the often-conflicted mind-body connection in people who suffer from chronic pain, and help you reestablish a positive relationship with your physical self.
Psychotherapy can be an integral part of pain management for both those whose pain has an underlying psychological basis as well as those whose pain is caused by defined physical phenomena. For some, chronic pain is caused or aggravated by somatization, or the unconscious manifestation of “unexpressed emotions, needs, or desires” as physically painful phenomena such as muscle aches, tension, and nerve pain.[6. http://www.goodtherapy.org/therapy-for-chronic-pain.html] Psychotherapy offers avenues to explore and express the unconscious mind to relieve physical symptoms in a safe and supportive environment. However, psychotherapy can also provide you with ways of understanding, relating to, and responding to purely physical pain that change pain perception, improve functioning, and enhance your sense of agency. At the same time, cognitive behavioral techniques can be used to modulate the brain’s response to pain, increase pain tolerance, and activate your natural ability to relieve pain through the release of brain chemicals like norepinephrine and serotonin.[7. http://health.usnews.com/health-news/articles/2009/02/10/in-chronic-pain-you-might-need-psychotherapy]
Chronic Pain Management At Alta Mira
At Alta Mira, we are committed to providing comprehensive care for people living with addiction issues who also suffer from chronic pain, that combines clinical and holistic components to create a strong foundation for lasting sobriety. We can work closely with your physician to ensure that your pain management strategy is safely integrated throughout your time with us and tailor your treatment plan to suit your unique needs. We also provide extensive aftercare planning and ongoing outpatient support to prevent relapse while finding relief from pain after residential care. Together, we can create a brighter, more stable future and help you realize your potential, mind, body, and spirit.
Alta Mira provides the highest level of addiction treatment within a serene residential setting. Contact us for more information about how our program can help you or your loved one on the road to recovery.
Image Source: Unsplash user Patrick Fore