For most people, pain medication is a temporary solution to a temporary problem. Many types of pain stem from problems that eventually heal and the pain is more or less eliminated once the source of the pain has healed.
But some people aren’t as fortunate and suffer from chronic pain. Chronic pain can be caused by a myriad of health issues and, no matter the cause, the pain is a daily struggle for sufferers. Doctors are often put into a tricky spot when attempting to treat patients who suffer from chronic pain. The most effective pain medications tend to be highly addictive and the NIH has reported a correlation between pain treatment and pain medicine addiction. While doctors don’t want to foster a serious addiction to pain medication in the people that they treat, they also don’t want to leave their patients to contend with unbearable pain – pain that is oftentimes so bad that patients cannot function in their daily lives without medication.
An addiction to pain medication isn’t the only reason why doctors are put into a precarious position when treating chronic pain patients. Long-term use of pain medications can also cause problems like an actual increase in sensitivity to pain (called hyperalgesia), which causes a patient to need a higher dosage of pain medication at more frequent intervals in order to properly manage pain. Pain medications are accompanied by a laundry list of side effects, like most other types of drugs. Chronic pain patients might suffer from any number of these side effects, which include but are not limited to: damage to the liver, rashes, nausea, kidney problems, stomach ulcers, heartburn, an increased risk of stroke and heart attack, cataracts, constipation and anxiety.
Most doctors are trained to recognize the red flags that occur in a pain medicine addict so that he or she can intervene and treat the addiction and find another course of pain treatment for the patient. Since so much of pain is subjective, it can be difficult for doctors to navigate the subtle differences between patients who are truly in debilitating pain and those who are primarily seeking pain medication. Some pain patients start off taking pain medication in an earnest attempt to mitigate their own pain, but they quickly find that they are unable to live without the medication. This reliance alone can cause an addiction to pain medication, but a patient who uses pain medication for real pain in a long-term way might also find that he or she enjoys the medication recreationally, too. This is yet another tricky area of treating chronic pain patients –long-term medication can quickly turn a person who is not an addict into one.
What to Do
Many patients and doctors alike are left wondering what can be done. While researchers are working vigorously to develop pain medications that are both highly effective and not demonstrably addictive, care for chronic pain patients in the meantime must be nuanced, cautious and tailored to the individual patient. Patients with a history of pain medication addiction who suffer from debilitating pain must communicate openly with their respective doctor so that they might develop an approach to managing their pain that allows for daily functioning while still keeping addiction in mind.
One important possibility for both doctors and patients to consider is that pain might be able to be treated without addictive pain medications. Depending on the individual and the specific source and severity of the pain, patients might find reprieve from physical therapy, yoga, meditation, acupuncture or a number of other methods aimed towards lessoning pain without the help of an addictive substance.
If you have a history with addiction and are also in pain, talk to your doctor as well as your therapist, if applicable, and develop a pain treatment plan that will work best for you. Never begin a pain medication without speaking to your health care provider about your relationship with addiction first.