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Pain Management and Addiction: Double Trouble

Too many people in this country become addicted to prescription medication not because they are flagrant lawbreakers but because they are trying to deal with an overwhelming pain management issue. The Institute of Medicine tells us that we are spending about $635 million on the costs of pain management annually. An estimated 10 million people suffer from pain management and also become addicted to pain medication.

Multiple Co-Occurring Disorders

The person who goes through this nightmare experiences much more than the pain from a traumatic accident or medical condition. He also experiences stress, anxiety, or post-traumatic stress disorder from the situation that put him into chronic pain. On top of that, if he loses control of his ability to manage his medications, his problems are compounded with an addiction disorder.

Therapists in substance abuse rehab centers have learned to provide modified rehabilitation programs to the man or woman who has co-occurring disorders of chronic pain and addiction. Besides helping the person learn how to recover from his addiction, he also has to resolve his pain issues, or at the least learn how to live with them.

This experience of multiple co-occurring disorders is not limited to poor or uneducated people. In fact, those with higher income levels or better socioeconomic standards may be more likely to succumb. They are the people who lead busy lives; it’s all too easy to go to the doctor’s office and get a pain pill and then keep trudging ahead in order to balance a demanding business with family life even as they’re suffering from discomfort.

Education About Pain

That’s why it’s so important for the addicted person to learn not only about how to handle his addiction but also to understand the mechanisms of pain. The substance abuse counselor must work with the patient’s medical doctor so that his recovery plan includes a way to manage the pain as well as the addiction.

First, it’s important to understand the definitions of tolerance, addiction, physical dependence, pseudo-addiction, and addiction.

  • Tolerance occurs when someone who has been taking a medication discovers over time that he needs a greater dose in order to achieve the same ameliorative effect.
  • Dependence is reached when the person’s sudden discontinuation of the medication will result in physically or emotional distressing withdrawal symptoms, which can even include a lesser amount of the medication measured in the bloodstream on routine labs.
  • Pseudo-addiction generally occurs when someone is not receiving sufficient treatment for the condition that causes him pain. Symptoms mimic addictive behaviors, with the person sneaking extra doses or watching the clock for his next dose. Pseudo-addiction issues disappear when the patient’s pain has been managed effectively.
  • Addiction is a medical diagnosis with neurobiological implications, complicated by genetic and social factors, that results with the patient demonstrating compulsive pill-seeking behaviors, cravings, and his wish to continue medication despite warnings of harm.

What should you do if this sounds like you, or like someone in your family? The first step is to contact a substance abuse rehab center and ask if the therapists there are familiar in the treatment of pain medication or opioid addiction management. It’s important to get him into an environment in which both of his illnesses are diagnosed and managed. It’s important, as we said, for him to recognize that he has two diagnoses, through no fault of his own.

Working on recovery will be an ever-ongoing process. Some therapists liken the recovery process to walking up a down escalator: If you stop walking, you will go down. Watch for another posting in this space that discusses way for the addict to manage his levels of pain. In the meantime, if you need help, contact a licensed, certified substance abuse treatment center now for more information.

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