Chronic Pain and Addiction

Chronic pain is a debilitating health condition with many different causes. Some people experience chronic pain due to a particularly bad injury and lack of total physical recovery. In other cases, it may be nerve damage from years of exposure to a certain pollutant or environmental hazard, or the pain may simply be part of a genetic disorder or general defect in the body. 

No matter what the cause, however, chronic pain can be a terrible condition to live with. About 100 million Americans – 1 in 3 – struggles with chronic pain, a condition of major to severe discomfort and pain lasting for more than 12 weeks. Chronic pain is different from acute pain and its consequences – while it’s normal for a broken arm or a scarring wound to hurt for more than a few days, any pain beyond 12 weeks is typically diagnosed as being reoccurring and not of an acute, immediate nature. 

Pain is normal, temporary, and necessary. But chronic pain is a malfunction of this system, due to an ongoing progressive condition, or due to nerve malfunction through damage or defect. 

Because of the intense amount of pain that many patients are under, most doctors prescribe anti-inflammatories, analgesics and other forms of medication that help the body reduce pain and inflammation, either to help lessen the symptoms of an incurable condition, or in preparation/combination with a more comprehensive, specialized treatment designed to diagnose, target and eliminate the cause of the pain. 

The main issue here is that, too often, the patients are prescribed very powerful opiates with an elevated risk for dependency through prolonged use. Given that chronic pain medication must be taken to deal with the reoccurring pain, prolonged use is inevitable. And such, the dots are connected between growing opiate addictions and chronic pain. 

Only a fraction of those struggling with chronic pain get addicted. Many manage just fine on their medication, taking less than is prescribed and only utilizing the minimum of their medication to get themselves through. In fact, while around 86 percent of those struggling with heroin started on prescription medication, a vast majority of them got hooked on medication that wasn’t theirs

Yet for those struggling with both chronic pain and sobriety, understanding that getting off the drugs means going back into a life of chronic pain is important. It also means understanding that there are non-opiate solutions to pain waiting for you in the recovery process. Opiates aren’t the only viable kind of pain management, and there is research to suggest that they may not even be the best kind. But before we get into how to deal with chronic pain while going through recovery for an addiction, let’s examine the relationship between pain and addiction – and why pain, in any of its forms, is the most common cause for drug dependency. 

The Link Between Pain and Addiction

Pain and addiction go together, even if the pain isn’t always physical. Emotional pain, loss, lack of connection, depression and injury – these are all reasons to feel demoralized, and in some cases, even worthless. Drugs like alcohol, painkillers and even heroin offer people a chemical replacement for their negativity, and they’re known as destructive or maladaptive coping mechanisms. 

An effective or adaptive coping mechanism is a task or process utilized by someone in emotional duress to deal, or cope, with their situation in a way that solves a problem. For example, engaging in moderate exercise, eating a healthy diet, and visiting a group therapy or professional therapist several times a month is an adaptive coping mechanism for many mental illnesses. Getting involved in cooking healthier food can be a creative outlet while improving your body’s hormone balance and overall mood. Exercise is great for the brain, floods your system with endorphins and boosts your self-esteem and self-image. Therapy can help you curb negative thinking and change the way you approach crises in life, by helping you nip overthinking in the bud. 

On the other hand, there are maladaptive coping mechanisms that lead to negative long-term consequences. One example is stress eating, which can lead to obesity and an eating disorder. Addiction is another example of a short-term solution with long-term consequences. People using opiates as pain medication are especially at risk versus many others struggling in their life because opiates are an addictive substance to begin with – and many doctors may be prescribing opiates with too much power, without much cause.

Alternatives for Chronic Pain

Chronic pain typically doesn’t just go away without comprehensive treatment – and if that isn’t an option due to the nature of your pain, or some other circumstance, then pain management is essential instead. While in recovery, any form of addictive substance is a no-go – but there are alternative methods of dealing with pain. There are plenty of non-addictive analgesics, and medication that specializes in pain relief without addiction. 

Physical therapy, acupuncture, meditation and animal-assisted therapy are all forms of effective pain management that utilize no medication whatsoever. On the side of medication, aside from over-the-counter painkillers, there are countless experimental treatments being worked on to replace opiates in a safe and affordable manner, and there is even a case for regulated medical marijuana (not the marijuana with excessive THC content).  

Your Meds Might Not Even Work

Opiates are known to be powerful analgesics, but for fatigue syndromes such as fibromyalgia and other common causes of chronic pain, a systematic review shows that long-term, prolonged usage of opiates as pain management is ineffective – to be more specific, the evidence towards the efficacy of opiates in long-term pain management is weak at bestOpiates are extremely potent analgesics, yet what is being argued here is their long-term efficacy. Chronic pain is not acute pain, a single dose of morphine won’t do the trick for long-term relief. Instead, patients need a steady source of pain relief, and as opiates tend to develop a rapid tolerance, there is enough logic (and sufficient research) to suggest that opiates aren’t effective for chronic pain patients, even if they’re extremely useful in a case of acute pain, such as a broken bone or a gunshot wound.