How Can Someone With Chronic Pain Stay Sober?
When it comes to the crisis of opioid addiction, not everyone becomes addicted through recreational use. Many people can fall into a long-term opioid habit which originally might have grown further and further out of control due to the medication they have been prescribed in order to deal with chronic pain.
Chronic pain is a widespread problem, defined as any persisting pain that can last more than 12 weeks. For some, the pain may be dull but neverending, while for others, it may be recurring severe pains as a result of a physical injury or illness. Not only can the pain itself get in the way of daily life, but it’s also associated with sleep disorders, difficulty concentrating, and mental health issues like depression and stress.
About Chronic Pain
Chronic pain is incredibly common, affecting more than 100 million Americans. The most common cause of all is lower back pain, which is also the leading cause of disability. This accounts for an estimated 1-in-5 of all people. Since the root of chronic pain can sometimes be difficult to diagnose, many doctors start by targeting the pain first with medication while investigating the problem more closely.
Some of the common causes of chronic pain include acute injuries, like a sprained wrist; acute illnesses, such as infections and abscesses; and chronic illnesses like arthritis. Other causes that may lead to chronic pain include back and spine deformities and issues with the nervous system that cause the brain to transmit pain signals even without a physical cause. There are also many cases where chronic pain has no diagnosable cause, which is known as idiopathic chronic pain.
Headaches, joint pain, back pain, neck pain, sinus pain, muscle pain and nerve pain are common properties of chronic pain that can have a range of different causes. Finding and treating the source of chronic pain, if that can be done, can take a lot more time than you may think. Many doctors begin their treatment by addressing the pain first and foremost, which can include medication.
Signs of Chronic Pain
Since the potential causes of chronic pain can be so widespread, the symptoms that define it can be extremely diverse as well. For some people, the pain is intermittent, for others, it is always present to some degree. It can range from mild and dull to acute and debilitating pains. It can even move from one end of the scale to the other. Some experience it as a burning sensation, a shooting pain, a throbbing ache, a tightness that results in pain, or something else entirely.
As chronic pain consists over a long time period or even grows worse, it can have a knock-on effect on other parts of the sufferer’s life, as well. It can lead to sleep disorders, mental health problems like anxiety and depression, increased blood pressure, and even a weakened immune system, making the sufferer more likely to catch other illnesses.
Besides the physical pain, here are a few examples of the symptoms and other health issues commonly attributed to those with chronic pain:
- Mental health issues like depression, stress, and anxiety
- Sleep disorders, such as insomnia and reduced quality of sleep
- Fatigue and regular drowsiness
- Lack of appetite and nausea
- More regular illness due to a weakened immune system
For many chronic pain sufferers, finding relief from the pain can have a positive effect on the rest of these symptoms. As such, many doctors will prescribe medication in order to control the pain as soon as possible. However, this does not always result in the perfect treatment plan than you may hope it would be.
Opioid Addiction and Physical Pain
Over half of the individuals living with chronic pain are treated for it by way of prescribed pharmaceutical medications. Doctors will sometimes recommend over-the-counter drugs, like NSAIDs, ibuprofen or naproxen. Many doctors may recommend meds at an increased or specific dosage to make it more effective. However, in the majority of cases, prescription medications only available through the doctor are a more commonly recommended path of treatment. These can include:
- Oxycodone and hydrocodone-based medication like codeine, morphine, Vicodin, OxyContin and Percocet. These medications are opioids, meaning they often come with a high risk of an addiction developing over time.
- Anticonvulsants are most often used for issues like epilepsy but have also been shown to lessen chronic pain. Why medications like pregabalin and gabapentin work is not well known, but it’s believed they may affect how we process pain signals. These medications also come with a risk of addiction, with pregabalin becoming a more prevalent risk.
- Antidepressants like amitriptyline, doxepin and clomipramine are sometimes used for their perceived ability to decrease pain. Studies have shown they can help by increasing the efficacy of neurotransmitters in the body.
Opioid prescriptions are common. They do not always lead to addiction. However, there is a significant risk. According to the National Institute on Drug Abuse, 21-29% of patients prescribed opioids abuse them, and 8-12% develop an opioid addiction as a result. Furthermore, over 80% of all heroin users’ addictions are in some part attributable to starting with prescription opioids!
Chronic pain can lead to opioid addiction, and other forms of substance abuse, without prescription medication. Some people may turn to opioids as a form of self-medication or use other drugs to mitigate the other symptoms of chronic pain like sleep disorders and mental health issues.
How to Stay Sober with Persistent Pain
Our body’s response to opioids changes over time. We can acclimate to them, meaning they become less effective over time, which means we take more than the recommended amount in order to receive the desired result. Opioids are naturally addictive, too. As such, it’s not difficult for someone who needs to use prescription opioids to develop a dependency over time, even fully unintentionally.
However, there are ways of combating this outcome. You can stay sober with chronic pain by looking to alternative treatment options. If you are using opioids, then reviewing your use of them is essential. Being honest about the effectiveness of your medication and any changes you have made to your own dosage and usage habits can highlight a developing opioid addiction, offering you and your doctor the opportunity to change your treatment plan.
Signs of Opioid Addiction in Response to Pain Medication
Not all opioid use in the treatment of chronic pain is necessarily irresponsible, though there is always a risk. Many of the symptoms may not be immediately noticeable to the user, but clear to those around them. In other cases, the opioid user may begin to feel them themselves. These include the following symptoms:
- Avoiding family and friends
- Spending more time alone
- Less interest in past hobbies and interests
- Decreased self-care and grooming
- Mood shifts, such as stress, sadness, and hopelessness
- Sudden changes in appetite
- Appearing “hyper”, such as talking faster and losing train of thought mid-conversation
- Drastic changes to sleeping patterns
- Missing appointments and developing and erratic schedule
It can difficult to recognize, admit to, and to seek help for an opioid abuse problem. Prescription opioids can quickly become of vital importance to the user, who may be very reluctant to give them up. However, without addressing the problem, it may grow to become even more destructive and risk.
Getting Help for Pain Management Without Drugs
A good chronic pain management program will often provide well-rounded care that helps an individual cope with chronic pain, not just the reliance on opioids. However, those who have developed an opioid dependency or fear the potential that they might do so will want to look for treatments and techniques that avoid addictive medication altogether.
There is a range of different ways you can manage chronic pain without having to rely on opioids.
Alternative treatments include the following:
- Non-opioid medication: Some of the medications mentioned above do not fall under the category of opioids, which bring the greatest risk of addiction. NSAIDs, antidepressants, acetaminophen can all be used as general replacements. Muscle relaxants (like diazepam) and low doses of naltrexone can be helpful in cases of acute musculoskeletal pain (like back pain or neck pain) and issues like Fibromyalgia and complex regional pain syndrome, respectively.
- Topical pain relief: Applied directly to the location where the pain is most present, creams and gel forms of capsaicin, lidocaine, trolamine salicylate, and counterirritants (with ingredients like menthol and eucalyptus) may provide some relief.
- Acupuncture & Massage: Acupuncture and massage therapy have been helpful to people with physical ailments and pains for thousands of years. There are pressure points throughout the body that can be worked with to release sensations of pain. Acupuncture has been scientifically proven to “release” excruciating pain through the needle-pinning of such pressure points by a licensed acupuncturist.
- Electrotherapy: A range of techniques involve using mild electric currents directly through the skin, which are believed by some to block pain signals from reaching the brain
- Meditation: Mindful meditation, often done with the help of biofeedback machines, can help relieve some physical pains by reducing stress on the body. Overall, however, it’s not known to lessen chronic pain, but to help manage the other symptoms that can arise as a result of it and to improve the overall quality of life.
- Cognitive behavioral therapy: Different forms of counseling can be used to mitigate the effects of chronic pain. CBT is designed to help you recognize and redirect negative thoughts towards better coping mechanisms.
- Healthy lifestyle changes: Diet and increased physical activity can reduce weight, help to reduce inflammation, reduce stress, and improve sleep.
- CBD (Cannabidiol): The non-psychoactive component of marijuana, this cannabinoid is believed by some to offer chronic pain relief, as well as reducing stress and improving quality of sleep. However, clinical trials on CBT are still in its infancy, though it has many advocates.
- Pain management strategies: Other forms of therapy and mental techniques can help chronic pain sufferers habituate to the pain, growing used to it and developing techniques of distraction and mental avoidance that can reduce the impact it has on your life. One growing strategy is the use of video games, which has been shown in some studies to have great potential as a coping strategy.
Getting the Help You Need
Inpatient and outpatient facilities can help treat opioid addiction and chronic pain at the same time with access to a wide range of pain management strategies. As many heavy opioid users, like heroin dependents, started with prescription opioids, we are used to chronic pain is a common concern, and provide a range of services like medication management, cognitive behavioral therapy, and the controlled use of medications like methadone that can help treat chronic pain while also weaning an individual off of opioid use.
If you believe that you’re at risk of an opioid abuse issue related to prescription medication, or you are dealing with opioid addiction but need help with chronic pain, get in touch with us at Opus Treatment for a consultation and we can develop a treatment plan to help tackle both issues at once.
If you or a loved one needs help, call us at 949-625-4019.