How is chronic pain and addiction treated?

An estimated 50 million adults in the U.S. have chronic pain. That’s 20.4 percent of the population, according to a recent report from the CDC. “Pain is a component of many chronic conditions, and chronic pain is emerging as a health concern on its own, with negative consequences to individual persons, their families, and society as a whole,” the report states. One particularly negative consequence? Addiction. Here’s a closer look at the issue, along with a roundup of tips to help alleviate chronic pain without medication.

Chronic pain meds aren’t safe just because they’ve been prescribed by a doctor.

Understanding Chronic Pain

Acute pain is sudden or severe pain that resolves over a period of time. It may be caused by injury, illness, or surgery. Chronic pain, on the other hand, is persistent pain that lasts for months or longer. The Mayo Clinic classifies chronic pain as health condition on its own. It can interfere with a person’s abilities to participate in daily activities, reduce energy levels, and detrimentally impact relationships, all while making the person suffering feel less healthy overall.

“Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority,” proclaims a report from the Institute of Medicine (IOM).

But should opioids be used as the first line of defense when it comes to treating chronic pain? The country’s current addiction crisis speaks for itself. While opioids may ease the pain, they can also lead to an equally dangerous addiction.

Chronic Pain and Addiction

Alongside restrictions on mobility, poor perceived health, and reduced quality of life, dependence on opioids and anxiety or depression are the primary issues caused by chronic pain. Unfortunately, both drug dependence and mental health issues are linked with an increased risk for addiction.

Opioids such as Percocet, OxyContin, and Vicodin affect the parts of the brain that perceive pain. They flood the brain with high levels of a “feel-good” neurotransmitter, dopamine. Unfortunately, as the medication is taken, patients often develop a tolerance to it, meaning they need larger amounts of it to get the same effect. Over time, this can lead to a full-blown addiction.

While many people can take opioids without becoming addicted under the guidance of their physicians, others are more vulnerable. Because addiction is so complex and multi-factored, scientists can’t say exactly why one person with chronic pain develops an addiction and another person does not. They have identified some factors that make people more vulnerable to painkiller addiction, including everything from genetics to previous substance abuse.

Opioids belong to the same class of drugs as heroin and morphine. Because heroin is less expensive and easier to obtain than prescription drugs, some people with chronic pain progress to heroin use. In fact, a staggering 80 percent of Americans who use heroin started by misusing prescription opioids first. On the bright side, only a small portion (four percent) of people who’ve misused prescription pain meds have progressed to using heroin. “This suggests that prescription opioid misuse is just one factor leading to heroin use,” according to the NIH.

For many addicts, prescription pain meds for chronic pain are a precursor to heroin use.

The overall takeaway? Managing chronic pain is a careful balance. ”Chronic pain not caused by cancer is among the most prevalent and debilitating medical conditions but also among the most controversial and complex to manage. The urgency of patients’ needs, the demonstrated effectiveness of opioid analgesics for the management of acute pain, and the limited therapeutic alternatives for chronic pain have combined to produce an overreliance on opioid medications in the United States, with associated alarming increases in diversion, overdose, and addiction,” conclude researchers in a paper published in the New England Journal of Medicine. 

Beyond Prescription Pain Meds

There are many different potential treatments for chronic pain which don’t include opioids. These include complementary and alternative medical treatments, such as massage, acupuncture, meditation, and herbal supplements; interventional pain management, which may include facet rhizotomy, spinal cord stimulation, and intrathecal pumps (pain pumps); physical therapy and yoga; and therapy to address stress management, depression, and anxiety.

In addition to these treatments, doctors may also prescribe medications — starting with the lowest dose. They may include non-steroidal anti-inflammatory drugs (NSAIDs), antidepressants, and muscle relaxants.

Patients who are prescribed opioids may be asked to sign a voluntary opioid agreement to reduce their risk of addiction. This defines expectations and responsibilities of patients and providers alike and may include drug testing, using a designated pharmacy, and having a third party administer the drugs.

Unfortunately, despite best practices and efforts, addiction can occur when opioids are used to treat chronic pain. Choosing a substance abuse treatment program with expertise in this area can help guide the path to recovery, relapse prevention, and the return to an addiction-free life.   Call us to learn about admissions to Harris House today.

What is the most common treatment for chronic pain?

What is the most common form of treatment for addictions?

Does chronic pain lead to addiction?

How do people deal with chronic pain?