Pain Management for People With Opioid Addiction
Opioid Pain Management
It is safe to say every person on this earth experiences pain at one point or another. At times that pain can be extreme and overpowering. After a severe injury or surgery, physicians may prescribe a short-term course of opioid painkillers. They can also prescribe long-term opioid painkillers for individuals with chronic pain, such as cancer or other debilitating health issues. However, because of past problems with opioids or out of concern of developing a dependence on them, pain management for people with opioid addiction can be challenging, making alternative pain management very important.
Opioids work by interacting with opioid receptors in the brain to relieve pain. Some of the most commonly prescribed opioid painkillers include oxycodone, codeine, morphine, and hydrocodone, and name brands include OxyContin, Vicodin, and Percocet.
Short-term opioid painkiller prescriptions are usually given to individuals experiencing acute pain, like broken bones or after surgery. Many people can use these painkillers for a short while without any problem. Still, the rewarding properties on the brain can sometimes cause misuse, which can lead to opioid use disorders and increase the chances for certain health risks like an overdose.
There are also long-term opioid prescriptions for those with chronic pain. Chronic pain is classified as pain that lasts longer than three months or has been persistent beyond the time of a normal healing process. About 100 million Americans suffer daily pain, but many studies do not support the long-term benefits of opioid use in managing chronic pain.
Risk of Opioid Addiction from Pain Meds
Even though many people take opioids for more extended periods without developing an addiction, long-term opioid use has a higher tendency to lead to misuse. Current studies show that around 21% to 29% of people who take opioids for chronic pain misuse them, and approximately 8% to 12% will develop an opioid use disorder.
Opioids tend to lead to a substance use disorder because of their chemical structure and impact on the brain. Their molecular structure allows them to bind and activate specialized proteins throughout the body known as opioid receptors, most of which are found in the brain. A person’s perception of pain is altered when these receptors are activated. Besides reducing pain and having an analgesic effect, opioid receptor activation also increases dopamine levels, a brain chemical that reinforces reward and pleasure sensations. For some people, these sensations are more powerful and develop a need to keep experiencing them repeatedly.
Prolonged opioid use can develop an opioid use disorder and increase the likelihood of an opioid overdose. An estimated 47,000 Americans died from an opioid overdose in 2017. The most common medications involved in overdose deaths are methadone, oxycodone, and hydrocodone, although the prescription opioid abuse problems extend beyond these three medications. Anyone can be at risk for an opioid use disorder, but studies show that women are more at risk than men. Women who struggle with chronic pain conditions are more likely to prescribe opioid painkillers and take opioids for more extended periods. Other evidence shows that women may become dependent on opioids quicker than men.
Opioid Alternatives for Pain Management
There are many other options to help control pain, whether acute or chronic. Some of the options include non-opioid drugs, alternative therapies (such as acupuncture, physical therapy, herbal medicine, and yoga), and counseling that can be used to manage pain. Many people choose alternatives to opioids because of a history of a use disorder or fear of developing an opioid addiction.
Non-Opioid Medications for Pain
Non-opioid drugs can be an excellent alternative for pain management for people with opioid addiction or who want to avoid opioids. Some of the common non-opioid medications include:
- Acetaminophen (i.e. Tylenol)
- Glucocorticoid steroids
- Non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Motrin and Advil), ketorolac (Toradol), and naproxen (Aleve and Naprosyn)
- Anticonvulsants, such as gabapentin and pregabalin
- Beta-blockers, such as esmolol and labetalol
Antidepressants, like duloxetine, amitriptyline, and nortriptyline
Some of these alternative options are more effective than others depending on the type of pain. While they carry their own set of risks with use, studies have shown that non-opioid medications can effectively manage a variety of chronic pain syndromes.
Drug-Free Pain Management Options
Researchers are studying more and more how several types of non-pharmaceutical therapies can effectively manage pain. These include:
- Exercise, including physical therapy
- Yoga, a Hindi-based practice that uses gentle stretching and strength training along with deep breathing to help stimulate body, mind, and spirit, can help manage pain.
- Acupuncture, which involves the insertion of needles in specific points around the body, can interrupt pain signals, help self-healing, and increase biochemicals that reduce pain.
- Massage and chiropractic treatment use hand-on manipulation techniques to soothe painful muscles and readjust bones and ligaments out of sync to reduce pain.
- Nutritional therapies are often popular, but more research is needed to understand their role in pain management.
- Mindfulness meditation
Therapies and counseling are also effective for managing pain. A recent study showed that physical therapy is an effective tool in managing chronic lower back pain. Several types of behavioral therapies have also shown great effectiveness in managing chronic pain, which includes
- Mindfulness-based stress reduction
- Cognitive-Behavioral Therapy (CBT)
Both therapy methods have shown excellent results in adjusting psychologically to pain and coping with it.
Treating Pain as an Underlying Cause of Addiction
For some, their addiction to opioids is rooted in physical pain. They may have been prescribed an opioid painkiller for an injury, surgery, or chronic pain, resulting in opioid misuse. Treating pain as an underlying cause of addiction is essential to help someone with long-term recovery. If the person is only treated for their addiction and not the pain is still present, they may go back to using opioids to deal with the pain.
It is essential to know that recovering from opioid addiction does not mean you will have to live your life with physical pain. Some treatment centers may include therapies to manage pain or heal the injury or allow clients to receive these treatments outside the facility while they are recovering so they can leave their program not only with recovery but also pain-free. These alternative therapies may include acupuncture, herbal medicine, massage, physical therapy, and counseling. These alternative therapies help with the physical pain they may have been experiencing before their addiction and help with some of the ongoing withdrawal symptoms of addiction to opioids.
Addiction treatment helps find long-term coping mechanisms for behavioral issues around addiction and physical problems, such as pain. Recovery from opioid use disorders involves treatment and continuous aftercare to maintain recovery. Some of these can include:
- Community support: family, friends, and the people you meet in recovery
- Family therapy, including couple’s therapy
- Other support groups: Alcoholics Anonymous (AA), Narcotics Anonymous (NA), other 12 step groups, or SMART recovery
Finding Treatment for Opioid Addiction
Addiction to opioids can take hold of any person quickly. Professional treatment is necessary for anyone who is no longer in control of their life due to their opioid use. Finding a treatment center as soon as possible will increase your long-term recovery chances. Treatment may start with medical detox to help manage withdrawal symptoms more comfortably and safely under the supervision of medical professionals. Opioid withdrawal can be excruciating and long, including psychologically. Then depending on the severity of the addiction, there may be different levels of care recommended. These can include inpatient programs, outpatient programs, and intensive outpatient programs. Regardless of which level of care you choose, they will consist of different forms of therapy such as individual therapy, group therapy, and family therapy.
Choosing the right treatment center for pain management for people with opioid addiction that fits your needs and goals is one of the most critical parts of long-term recovery. When choosing a place, the location can be substantial. For example, if you choose inpatient care, a distant location could make it more likely for you to commit to treatment and focus on yourself without outside influences. Which places your insurance covers can also be an essential factor in reducing out-of-pocket costs. Many insurance plans do cover out-of-state treatment programs.
At Muse Treatment Center, we offer a comprehensive level of care offering pain management for people with opioid addiction. We offer many treatment programs suited for a range of opioid addiction severities, and each plan is tailored to each client. Our intake team is always available to provide you with information, check your insurance coverage, and answer any questions you may have. There is no better time than now to start your journey to recovery. Please give us a call today at (800) 426-1818.