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Dealing with Chronic Pain in Recovery

Dealing with Chronic Pain in Recovery

Pain management can be a complex issue for those in recovery from addiction to drugs or alcohol. Opioid pain medications are not recommended for those who have a history of substance abuse or addiction, and doctors are justifiably reluctant to prescribe opioids to anyone with a history of addiction.

Pain Killers and Recovering Opioid Addicts

Opioid pain medications are the standard method of treating pain. Obviously this can be a problem for anyone who is in recovery from addiction to opiates or opioids. For recovering opioid addicts, taking a pain medication will most likely constitute a relapse and can lead to falling back into old habits of drug abuse. There is a good chance that, even after an extended period of sobriety, a recovering opioid addict still experiences cravings for drugs. Fighting off these cravings and maintaining abstinence typically requires constant vigilance and regular attendance at support groups. In the face of this constant challenge to remain sober the presence in the home of opioid pain medications can be too much temptation to resist. The patient may start taking pain killers with every intention of following the doctor’s directions to the letter. However, it is simply too easy to start taking a little extra now and then. The person is then likely to start taking larger doses more frequently. Before he knows it he may become psychologically addicted again, resume addictive behavior, and become preoccupied with obtaining and using opioids.

Another problem is that a recovering opioid addict may have a residual tolerance to the drug, so that it will very quickly lose its efficacy and require the patient to take larger than recommended doses just for pain management.

Cross-Tolerance with Other CNS Depressants

People in recovery for addiction to substances other than opioid pain killers may also face a dilemma in terms of pain management. Even if the person’s drug of choice was not an opiate or opioid, the fact that he has a history of addiction means that he is at much greater risk of becoming addicted following medical treatment. It is likely that he has a genetic predisposition to addiction as well as other emotional and psychological issues that contributed to the addiction in the first place. He is likely to find that opioids are a good substitute for his drug of choice and will begin self-medicating or seeking a high, taking larger doses more frequently until he has become addicted.

There is also the fact that opioid pain killers, being central nervous system (CNS) depressants, are cross-tolerant with other CNS depressants. This means that developing a tolerance for one will result in a tolerance for others. In other words, a person with a well-developed tolerance for alcohol or other sedatives will find that opioids are less effective. Again, this is likely to cause the person to take increasing doses in order to achieve relief from pain.

Alternative Pain Management Strategies

There are no easy answers to the dilemma of pain management for recovering addicts. Pain management is essential to well-being, yet use of opioids may constitute relapse and may lead back into addiction. In such cases doctors will usually try to find alternatives for pain management. These alternatives may not be as effective, but they will help the patient to avoid the possibility of relapse.

If you have any further questions about pain management in recovery, please call our toll-free 24 hour helpline today.