Addiction and Pain Management: Managing Pain Without Opioid Painkillers?

Addiction and Pain Management: Managing Pain Without Opioid Painkillers?

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Many men and women suffer from some sort of pain stemming from an injury or an illness. However, couple coping with pain with addiction treatment and it creates a new set of difficult circumstances.  For example, a recovering heroin addict prescribed opioid painkillers for pain management would be detrimental to their long-term recovery.  Ongoing, excruciating pain however, is not acceptable and tolerable.  So what’s a recovering addict supposed to do to effectively cope with and manage pain?

Types of Pain and Pain Management Treatment Options

addiction and mental illnessThere are two types of pain; acute and chronic. Acute pain results from trauma or an acute illness (an illness that has a quick onset and is not long lasting, a heart attack for example.) Acute pain typically goes away in days or weeks as the injury heals. Chronic pain is long lasting and can be treated but not cured.

It is important to set realistic goals for yourself when you are considering treatments that provide relief and improve function. Completely alleviating pain may not be a realistic goal, such as after major surgery. Acute use of opioids turns into chronic use in 50% of patients, which is a major factor in the opioid crisis in America.

There are different medications and services which include massage, acupuncture, physical therapy, exercise, meditation etc. that can be beneficial, especially when paired.  If you feel like the non-medicinal route an option for you, discuss it with your doctor and learn which options may be most advantageous and constructive to your specific injury / illness.

Medical Treatment for Pain Management – NSAID

If you are a recovering drug addict considering medicine as a part of pain management, a pharmacist we spoke with advised a NSAID such as ibuprofen 200-400 mg every 6 hours as needed or acetaminophen 500-1000 mg every 6 hours as needed. They can also be used together if the individual response is not sufficient.

Higher doses of ibuprofen (like 800 mg) are not much more effective than ibuprofen 400 mg.  But NSAIDs are not without side effects and cautions.  Patients with heart failure and diabetes should avoid prescription NSAIDs.  However, short-term use should be safe for stable patients.  Use in patients at a high GI bleeding risk should not take NSAIDs.

There are also a number of drug interactions that must be considered.  Acetaminophen must be used with caution in patients with liver failure, limiting total daily dose to 2-3 grams.  Using these medications is often adequate in controlling acute pain especially if self limiting.

Opioid Treatment for Pain Management

Note that the information provided in this section came from a pharmacist.  We understand the controversy surrounding this next section and while we don’t want anyone in ongoing pain, please note that the NAATC (National Alliance of Addiction Treatment Centers), Kill The Heroin Epidemic Nationwide and Heroin News do NOT endorse the use of opioids for suffering and recovering drug addicts or alcoholics. 

Physicians often prescribe opioids such as hydrocodone or oxycodone, often in combination with acetaminophen.  This is where caution must be exercised in prescribing opioids for patients in recovery from chemical dependency.  There are screening tools that can be used to determine the potential for misuse/abuse of the medications.  There is a tool called an opioid agreement that is signed by the patient and provider that lays out the expectations for opioid use, such as using a single pharmacy and provider to prescribe opioids, use of drug screens for compliance and avoidance of use of illicit drugs, among others.  Some believe that these may be options if non-opioid medications are ineffective.  However, even those who support their use agree that opioids should be prescribed at the lowest dose and for the shortest period of time to treat acute pain.

Publishers of the NAATC Are Not Medication Professionals

Please note that the publishers and writers of the NAATC are are not doctors and the author is not encouraging the use of opioids. However, the information provided in this article may represent exceptions and extreme situations (such as late stage cancer, a traumatic accident involving loss of limbs or 3rd degree burns).   In cases that are not extreme going the non-medicinal route may be the most appropriate option followed by non-opioid medication. If you are experiencing pain and see a doctor, let them know your history of drug abuse.

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Written by William Charles and Megan Sarah, Owner/Publisher and Blogger of Kill the Heroin Epidemic Nationwide, Heroin News and the National Alliance of Addiction Treatment Centers (NAATC)

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