Battling addiction is difficult.
Contending with pain is challenging. For those who must confront both at the same time, the stakes are raised that much higher.
Take, for example, an individual who has had chronic back pain for years since a spinal surgery. The pain has lessened, but cannot be ignored. This same person has a history of alcohol abuse. More recently, in order to handle the ambient pain, he has increased his alcohol consumption. His family, deeply concerned, recommends he check himself into a rehab facility.
The individual commits to rehab, but his chronic pain continues. He knows alcohol is no longer an appropriate escape valve. How should he proceed?
When substance use disorder and pain meet, what are healthy options to handle that pain? This article sheds some light on this difficult subject and presents sources for additional information.
Acute vs. Chronic Pain
Medical professionals differentiate between acute and chronic when talking about pain. It is important to understand the distinction between the two, especially when substance misuse and recovery is involved.
According to PubMed.gov, acute pain “is provoked by a specific disease or injury, serves a useful biologic purpose, is associated with skeletal muscle spasm and sympathetic nervous system activation, and is self-limited.”
On the other hand, chronic pain “may be considered a disease state. It is pain that outlasts the normal time of healing, if associated with a disease or injury.”
Both varieties present their challenges. In consultations with a doctor or another practitioner, be sure to confirm which pain type you or your loved one is experiencing.
When Pain Management Is Needed
Being in recovery does not completely discount the possibility of using traditional pain management methods. There are scenarios in which, with proper precautions, it is admissible to enter into a pain relief regimen including opioids. After an injury or surgery, the use of pain medication may be advised. Nonetheless, individuals in this situation should proceed with care. Precautions include:
- Be sure to divulge to your doctor about being in recovery. This will impact the type of care you receive.
- Ask what to expect during the healing process. Sometimes increased pain will surface, but that does not necessarily mean additional medication is the right response.
- Take only medications that have been prescribed by a doctor.
- Avoid adding over-the-counter (OTC) or herbal supplements to the pain medications the doctor has prescribed.
- Find a loved one to be in charge of dispensing prescription medications.
- Stop taking the pain medication as soon as possible—and in consideration of the doctor’s recommendation.
In situations outside of those mentioned above (or in the rare case of a doctor’s recommendation), the risks associated with pain medication and recovery are high. Someone in recovery is already in a vulnerable state. The introduction of medication has an increased chance of triggering an old addiction—or initiating a new one.
The Medication-Free Approach
Any alternative to opioid-based management should be accompanied by behavioral therapy.
The VA Center for Clinical Management Research in Ann Arbor and the University of Michigan Addiction Center collaborated to pilot the ImPAT (Improving Pain during Addiction Treatment) approach. This method of pain management for people in addiction recovery functions completely without medication. A dedicated combination of behavioral therapy and social support have already shown great promise.
Learn more about ImPAT on the University of Michigan Health Lab website and remember that pain relief without painkillers is possible.
- Last year, Great Oaks Recovery Center, published a post on this same subject.
- In 2016,Twin Lakes Recovery Center expanded on the topic to highlight the role that doctors can take in assisting in pain management.
- A 2007 report from the Psychiatric Times delves deeper into pain and substance use, providing real-life case studies as examples.
- A peer-reviewed academic source offers a research-based report entitled “Successful Pain Management for the Recovering Addicted Patient.”