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Chronic Pain and Addiction

Roughly 1.5 billion people suffer with chronic pain globally. Out of these findings, 50 million Americans suffer from chronic pain.

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What Is Chronic Pain?

Chronic pain is persistent pain lasting 12 weeks or more, often times occurring after an injury or procedure. Chronic pain can cause decreased mobility, changes in appetite, stress sensitivity, mood swings, and other psychological impairments. Chronic pain can occur anywhere in the body. An injury in one area of the body may cause several additional issues in other areas of the body. For example, someone with post-trauma pain (pain resulting from a car accident, surgical procedure, or other physical trauma to the body) may also experience:

  • Headaches
  • Back pain
  • Tingling
  • Nerve pain (Fibromyalgia)
  • Joint pain
  • Arthritis
  • Insomnia
  • Depression/anxiety
  • Breathing difficulties
  • Post-trauma pain

Chronic Pain And Health Conditions

The causes of chronic pain can be complex and very difficult to treat. Chronic pain often calls for several medications, some with side effects that can be disruptive to daily activities. For example, conditions like fibromyalgia that causes chronic fatigue, tenderness, and bone pain not only cause chronic pain, but can be emotionally frustrating to deal with. Additionally, chronic pain can be caused by health conditions like:

  • Endometriosis or Uterine Fibroids
  • Cancer
  • Chronic Fatigue Syndrome
  • Obesity
  • Multiple Sclerosis
  • AIDS
  • Inflammatory Bowel Disease
  • Intestinal Cystitis

Chronic pain may also have lifestyle causes like:

  • Long-term poor posture or bending
  • Sleeping on a poor mattress
  • Years of improper lifting or carrying heavy objects
  • Wearing high heels
  • Ordinary degenerative changes due to aging

Other traits of chronic pain include an inability to move around, muscle tension, changes in appetite and emotional frustrations due to ongoing pain. Lastly, women, tobacco smokers, obese people, and individuals who have had an injury are most at-risk for battling chronic pain.

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Chronic Pain Treatment And Medications

Typically, chronic pain is treated with physical therapy, medications and occupational therapy. In the case of physical therapy, patients that need help with walking, or help with completing daily tasks get hands-on help. In other cases, patients may use medications and be urged to practice healthy lifestyle changes that improve posture, stress levels, and energy. The management of chronic pain may require the use of several medications at one time, some with side effects that can be disruptive to the lifestyle changes.

Medications that are mostly commonly associated with chronic pain relief include:

  • Anti-inflammatory medications
  • Opioids
  • Steroids (Prednisone)
  • Muscle relaxers
  • Antidepressants
  • Anticonvulsant and anti-seizure medication

If Advil is not strong enough to combat chronic pain, some patients may need a prescribed anti-inflammatory or muscle relaxers. Muscle relaxers have a potential to be addictive. Antidepressants are effective in the treatment of symptoms related to depression. Note, it is important to not abruptly discontinue depressants without medical advice.

2014 saw 245 million prescriptions for opioid pain relievers. In that same year, there was a reported 2.5 million opioid-related addictions impacting adults.

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Chronic Pain And Opioid Abuse

Opioids are highly addictive and can be used as a last resort and can produce both dependences and withdrawal symptoms. Similar to antidepressants, withdrawing from prescription or synthetic opioids can create uncomfortable side effects that can push someone back into a cycle of dependence. Due to the addictive nature of specific substances, patients are required to discuss the meds they take with a doctor.

While opioids are very effective in pain management, they also have the potential to be addictive resulting in physical dependence. Discontinuing opioid medications can create uncomfortable side effects and symptoms of withdrawal that can fuel the cycle of dependence. Due to the addictive nature of specific substances, patients are required to discuss the medications they take with their prescribing doctor.

The opioid epidemic often stems from patients who have chronic pain and other injuries transitioning from prescription medication to illegal “street” drugs when their need and tolerance for the medication surpasses what their medical providers are able to therapeutically and legally prescribe. This has resulted in opioid abuse and chronic pain having a complicated relationship. A study noted, “chronic pain not caused by cancer is among the most prevalent and debilitating medical conditions.”

Chronic Pain Management And Opioid Abuse

Opioids are prescribed for chronic pain as opioids bind to the opioid receptors in the brain, creating euphoria and pleasure throughout the body. This reaction significantly reduces pain, however, it can also enable a person to develop a tolerance, or worse, a dependence. Due to the risk of a chronic pain patient developing an opioid use disorder, it is important to know how to manage pain medication and be alert for possible signs of abuse.

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Opioid Tolerance, Dependence, And Abuse

When a person takes a prescription opioid like hydrocodone or oxycodone for pain, he or she not only feels pain relief, but also feels extreme relaxation and even euphoria. Once the patient begins to heal and no longer physically requires the opioids, he or she may crave those psychological feelings. If the patient has taken prescription opioids for months or years, the brain chemistry responsible for emotion and mood regulation becomes altered.

Tolerance builds when an individual has taken a substance for some time and needs a higher dose to feel its desired effects. Dependence occurs when the individual needs a particular substance to feel “normal” and experiences a physical consequence if they attempt to decrease their use. Dependent individuals often have unusual behaviors or act unlike themselves if they do not have the drug leading to irritability, depression, guilt, secrecy, shame, fatal and non-fatal overdoses amongst other symptoms.

Opioid Withdrawal

Once a physically dependent individual discontinues stops taking opioids, they may experience withdrawal symptoms. Withdrawal and tolerance are signs of dependence and include the following symptoms:

  • Intense cravings
  • Nausea and vomiting
  • Anxiety
  • Fever
  • Flu-like symptoms
  • Increased heartbeat
  • Sweating
  • Goosebumps
  • Diarrhea
  • Excessive yawning
  • Watery eyes

In some cases, patients can benefit from holistic care like acupuncture and yoga with other medications to manage the cravings and the symptoms of withdrawal.

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Get The Quality Care You’re Entitled To

Chronic pain and long-term use opioids may worsen pain as time progresses. Being proactive about an opioid use disorder can reduce complications in the future. If you or your loved one are experiencing challenges with chronic pain and have become physically dependent to opioids, please don’t hesitate to get the help you’re entitled to. Contact a dedicated treatment provider and explore treatment options today.