Chronic pain is often defined as any pain lasting more than 12 weeks. Whereas acute pain is a normal sensation that alerts us to possible injury, chronic pain is very different. Chronic pain persists—often for months or even longer.
Chronic pain may arise from an initial injury, such as a back sprain, or there may be an ongoing cause, such as illness. However, there may also be no clear cause. Othe health problems, such as fatigue, sleep disturbance, decreased appetite, and mood changes, often accompany chronic pain. Chronic pain may limit a person’s movements, which can reduce flexibility, strength, and stamina. This difficulty in carrying out important and enjoyable activities can lead to disability and despair.
With chronic pain, the goal of treatment is to reduce pain and improve function, so you can resume day-to-day activities. There are a number of options. However, it is important to remember that chronic pain usually cannot be cured, but it can be managed.
Opioids are commonly prescribed because they are effective in relieving many types of pain. These medications are classified as narcotics and can be dangerous when abused. They also produce significant side effects, including constipation, nausea, mental clouding, and respiratory depression, which can sometimes lead to death.
Long-term opioid use can also result in physical dependence, making it difficult to discontinue use even when the original cause of pain is no longer present. Furthermore, there is mounting evidence that long-term opioid use for pain can actually produce a chronic pain state, whereby patients find themselves in a vicious cycle, where opioids are used to treat pain caused by previous opioid use.
Taken as directed, opioids can manage pain effectively when used for a short amount of time. With long-term use, people need to be screened and monitored because a fraction of those treated will develop an addiction disorder, abuse the drugs, or give them to others. Long-term daily use of opioids leads to physical dependence, which is not to be confused with an addiction disorder. An addiction disorder occurs in about 5 percent of people who take these pain relievers as directed over the period of a year. An addiction disorder can be treated, but like those who misuse or illegally distribute prescription drugs, the prescriber needs to be vigilant to identify and address these problems. That is why everyone who uses prescription opioids needs to be screened and closely monitored.
When people have physical dependence and the opioid use is stopped, withdrawal symptoms include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (“cold turkey”), and involuntary leg movements. Taken in large doses, or in combination with tranquilizers or alcohol, opioids can cause a deadly overdose that causes breathing to stop. To prevent an overdose, it is important to take opioids only as prescribed and to not combine them with other medications unless directed to do so by the prescriber. As clinicians and monitoring systems become more sophisticated, and opioids are better designed to be tamper-resistant or abuse-deterrent, healthcare providers believe that those who suffer because of a fear of addiction will receive the treatment they so desperately need.
Help and Hope
If your chronic pain is unmanageable or you have developed an addiction from pain management medication, you can get help. Call us today.
The word chronic means constant, lasting a long time, or coming back again and again. When you have pain that has bothered you for more than 3 months and doesn’t seem to get better with time, you may be experiencing chronic pain.
Major causes of chronic pain include:
- lower back problems
- nerve damage
- migraine headaches
- sickle-cell anemia
- There are many other causes of pain, and sometimes the cause is unknown.
Chronic pain can be difficult to bear. It can lead you to lose sleep, to become anxious and depressed, to have a hard time keeping up on the job, and to stop doing things you did before. These changes can add stress, produce more pain, and trigger new health problems. If unmanaged, pain can become the center of your life.
Ignoring the pain
If you have a history with drugs or alcohol, you may hesitate to seek medical care for your pain. If you have a history of mental illness, you may be equally reluctant. You may be afraid that care providers will judge you or think you are being dishonest (not sober). Or, you may be afraid that you will be persuaded to take medications that could trigger your addiction. If you don’t know what’s causing the pain, you might be afraid that others will think it’s all in your head.
Disclose your past!
It’s very important that your care providers know your history of drug and alcohol use and about your progress in recovery. If they don’t ask about this, you should volunteer the information, so that they can develop a pain management plan that fits with your recovery plan. Be sure to mention if you are in recovery. Disclose if you are being treated for withdrawal with the help of medications, such as methadone, buprenorphine, or naltrexone. These medications can affect how pain medications work for you. Your doctor is required by law to keep this information confidential and not share it with others (such as employers) who are not involved in your health care.
Lower-risk medications are your first choice.
Since you are in recovery from mental illness or addiction, your best first choice for pain medication will be a kind that does not have addictive properties. Several such kinds of medications are available. Each has been found to be most helpful for particular types of pain. Some types are prescribed, and other types can be purchased at a pharmacy over the counter.
Your care doctor might have you take acetaminophen medication, which is typically used to treat headaches and aches and pains. Topical creams and ointments may offer some relief for pain in one particular part of the body, such as on the knee or elbow. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be helpful for several types of pain, including bone pain or pain caused by swelling and inflammation.
Other medications that were originally developed to serve other purposes have been found to have pain-relieving properties for certain conditions. These include medications for depression, anxiety, and seizures.
Narcotic Medication sometimes might be appropriate
If your pain continues to persist at unmanageable levels,
the doctor may work with you to try an opioid (“narcotic”) medication. Opioids are strong medications that provide relief for some types of pain. However, even when they work well, they have limitations, and they can lead to abuse and addiction. Opioid medications will be recommended to you only if the potential benefits outweigh the risks. They will be prescribed with carefully set limits and boundaries, and only for as long as they are clearly helping.
A history of drug addiction or abuse does not necessarily rule out opioid medication for pain. However, before you go this route, you and your care providers should carefully consider your recovery status, support network, and other factors that can help you avoid relapse. Let the medical professionals consider your recovery status to determine the kind and form of opioid that will be safest for you to take.
Other options to consider
- Herbs and vitamins—Nutritional supplements that may improve overall health and the body’s ability to resist pain signals
- Massage or vibration—The use of hands, rollers, or electronic devices to relieve muscles and reduce sensations of pain
- Acupuncture—The insertion of very fine needles into the skin at specific points.
- Exercise or Physical Therapy
Some medications for pain are not recommended for use with people in recovery. These include benzodiazepines (for anxiety) and cannabinoids (which are derived from marijuana).
Maintain your addiction recovery.
Relapse prevention is very important to pain management, and vice versa. Fortunately, many of the things that help with pain— such as having a positive attitude, keeping busy, and learning coping skills—help control cravings and prevent relapse. Taking an active part in your pain management has a double reward because it can strengthen your recovery from addiction while helping you manage your pain.
Take action immediately if you have a lapse in recovery.
If you find yourself abusing your medication, noticing new or worsened psychiatric symptoms, or having cravings for alcohol or drugs, talk to your care providers or counselor immediately.
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I did not know where to go when I needed help for my drug and alcohol problems. I had medical insurance but it was too confusing to figure out if addiction treatment was covered. Feeling all alone, I decided to quit on my own, and I almost died. I don’t want anyone to go through what I did. That is why I created 800 Recovery Hub.