chronic pain and opiate addiction

Treating Chronic Pain and Opiate Addiction

Back in the late 1990s OxyContin (oxycodone) burst on the pharma scene as a wonder pain reliever for treating chronic pain.  Over the next few years, dosages incrementally went from 10 mg pills to the 160 mg dose pill introduced in 2000.  An aggressive marketing campaign commenced that same year, targeting the doctors who prescribe medication to patients with chronic pain issues, as well as post-surgery pain.  Notably, the manufacturer of OxyContin, Purdue Pharma, assured the medical community that the drug was not addicting.

A nationwide epidemic of opioid addiction has resulted from the highly addictive properties of this class of medications, directly cited in 23% of overdose deaths in 2016 alone, according to the Centers for Disease Control.  However, the total category of opioid-related deaths include heroin and fentanyl—drugs that a prescription drug addict may ultimately resort to when they can no longer obtain the prescription opioids.

There are now over 100 lawsuits filed by cities and states against the makers of these highly addictive drugs.  The CDC estimates that 91 Americans die each day from overdose related to opioids, a national tragedy.  Individuals with chronic pain and opioid addiction resulting are now seeking treatment for the devastating chemical dependency that they now suffer with.  Doctors who have been accused of over-prescribing the drugs are also being sued across the country.

The Connection Between Chronic Pain and Opiate Addiction

Controlling chronic pain presents a challenge to physicians, especially in light of the new awareness of the dangers of becoming chemically dependent on prescription pain medications.  Trying to find the best treatment strategy to both alleviate chronic pain while protecting the patient from developing an opioid use disorder (addiction) or dependency requires constant patient assessment.  Long-term use of opioid medications for chronic pain can actually cause changes in brain chemistry that can result in a drug dependency.

Addiction to the pain medications differs from dependency, as addiction refers to the maladaptive behaviors associated with drug use.  These include:

  • Compulsive use or preoccupation with obtaining the opioids instead of considering switching to a different treatment for pain relief
  • Escalating the dosage beyond what has been prescribed, leading to seeking more of the drug through requesting early refills, from doctor shopping, or showing up at an emergency room
  • Obsessing about taking the opioids and craving the next dose
  • Continued use despite the adverse effects, even if the medication is not effectively helping the pain

Treatment for Chronic Pain and Opiate Addiction

Long-term use of opioid therapy will result in a biological change in the brain’s reward system and dopamine production.  This means that when the individual attempts to discontinue the opioid therapy for chronic pain they will experience highly unpleasant withdrawal symptoms.  The first step in treating the opioid addiction or dependency is the detox and withdrawal phase.  With chronic pain patients, the best way to do that is with Suboxone, which is a combination of naloxone and buprehorphine.  Suboxone can ease the withdrawal symptoms, treat the chronic pain to some extent, and reduce cravings for the drug.  Methadone is also useful in early recovery and beyond.

The patient with chronic pain being treated for an opioid dependency will need to use other non-opioid pain medications in addition to the psychotherapy, specifically cognitive behavioral therapy (CBT).  CBT is a short-term therapy that helps the individual identify the triggers that lead to behaviors associated with an opioid use disorder, and to develop new, healthy responses by adopting new techniques and skills to change the problematic behaviors.

Capo by the Sea Provides Treatment for Individuals with Chronic Pain and Opiate Addiction

Capo by the Sea is a premier residential and outpatient drug and alcohol treatment program located in a beautiful coastal community in Southern California.  Treatment for an opioid dependency that has resulted from pain management is a specialty program at Capo by the Sea.  The highly trained expert clinical staff at Capo by the Sea knows how to balance the delicate relationship between treating chronic pain and opiate addiction or dependency.  For more information about the program, please contact Capo by the Sea today at (888) 529-2114.