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Pain Management for Individuals in Recovery for Addiction

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

February 26, 2019

When it comes to pain management for a person in recovery, relapse can be prevented if the individual is honest with their healthcare professional about their addiction. Doctors will typically prescribe non-habit-forming drugs for individuals who are in recovery.

Have you ever stubbed your toe and then find that the pain goes away after a few minutes on its own? Or have you broken your arm or leg, and had to deal with the excruciating agony that goes along with it? Pain can make life intolerable, and managing it can be even more of a burden. There are specific pains that absolutely require medical attention–for instance, it is highly advisable to seek medical attention if you’re experiencing a prolonged chest or back pain, or if you fracture a bone and can’t focus on anything but that gut wrenching feeling. Oral pain can also be extremely challenging to deal with.

These sources of pain can be especially problematic for a person in recovery from a drug addiction. Prescription drugs can help with pain and make it less intense, but people suffering from an addiction use them to cope with everyday life. Sorting out how to manage pain is not easy for someone in recovery, but fortunately there are ways that a person can successfully manage pain and stay clean at the same time.

What Is Addiction?

Addiction is not defined by the simple fact that a person needs a drug, it’s that they want it, or that they might perceive that they need it. Addiction is using a drug even when the rest of your mind, body, and social interactions are in the gutter. Addiction is a disease, wherein the person dealing with it will go to great lengths to get their drug of choice, whether that means theft, further mental consequences and disorders, or putting their life and the lives of others in harms way.

Pain can be pretty frightening and intense for someone in recovery–because they probably expelled a lot of resources and energy to get to where they are. The problem with addiction is that even when a person stops using a drug, their craving for that drug doesn’t go away with ease–and if they happen to relapse and start using again, their craving for the drug is no different from the day they stopped using it. In fact, according the American Society of Addiction Medicine, “addiction is progressive” and therefore drug use can be even more extreme after a person relapses.

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Drugs That Can Trigger A Relapse

Pain medications that evoke a feeling of euphoria can be consequential for a person in recovery, because their brain might want more, or want something more potent. Drugs that can cause a person to relapse depend on what a person is recovering from–a person recovering from an opiate addiction might have a relapse from using tramadol. According to the National Institute of Drug Abuse, this is because, “tramadol is a pain reliever with a relatively low addiction potential for the general public, it has greater potential harm for the recovering addict because the mild “high” it produces can trigger the need for an even stronger “high” and subsequent relapse.”

Most people in recovery know not to use drugs that can cause a relapse, and often ignore an urge to take something stronger than what has been prescribed. The question is, what drugs are okay, and what drugs are not? Not knowing what drugs can cause a “trigger” can be the ultimate factor for relapse. Even a person suffering from alcoholism can have a trigger from using prescribed pain killers, because in their mind–they yearn for something stronger to achieve that feeling of ease and comfort. So the real question is when do you need a prescription pain killer, and when don’t you?

When Is A Prescription Necessary For Pain Management?

People in the medical fraternity are trained to spot potential drug abuse. For example, if a patient enters into the doctor’s office spouting off specific drug names and quantities needed, this would seem like a pretty good indication of drug abuse (at least from a medical standpoint). Some people suffering from addiction may be aware of this, and therefore they might be more cautious when pursuing a drug. The pain scale charts (with the smiley faces) on the wall in a doctor’s office are a pretty good example to use–the first feeling of pain is usually “little to no pain,” whereas the final pain, and most intense pain, is usually “unmanageable” or “worst pain ever.”

Typically, with the first example, the pain comes and goes and may only require a little medicine–this is referred to as an acute pain. A chronic pain, on the other hand, can be more likely to require medical intervention and medication.

Treatment Of Acute Pain And Chronic Pain

Simply put, chronic pain is a pain that never goes away, and acute pain is when the pain comes and goes. If a person is suffering mild to moderate pain or a slight discomfort, they might be able to get by with an ice pack, elevation, and taking an over the counter drug like acetaminophen (Tylenol or something of equal value), but someone suffering from a chronic pain is more likely to need something more potent. Sometimes taking a more potent drug is unavoidable to treat chronic pain, because even though chronic pain is usually incurable, medication can help. Unfortunately, if a chronic pain is not properly treated the pain can actually worsen and lead to worsened conditions.

What To Do If You’re In Recovery–But Need To Manage Pain

For a person in recovery, who is more susceptible to relapse from pain killers, it is crucial to be open with the doctor about a substance addiction. The doctor will most likely suggest a minimal pain management option, and wait to see how effective it is. If a drug is not potent enough to treat the pain, a physician may suggest a higher dosage or even a stronger drug. It is alway best to continue on with a recovery program and, if applicable, keep a behavioral psychologist in the loop as well. This way you have an accountability buddy, so to speak, and someone else will know about your current situation.

How To Spot Drug Seeking Behavior

As previously mentioned, doctors are trained to spot drug seeking behaviors. Here is a list of classic drug seeking behaviors from the National Center for Biotechnology Information:

  • Complaint of 10/10 Pain
  • Complaint of Headache
  • Complaint of Back Pain
  • Medication by Name
  • Complaint of Out of Medication
  • Chief Complaint of Refill
  • Request for Parenteral Administration
  • Complaint of Dental Pain
  • Complaint of 10+ Pain
  • Complaint of Lost Medication

Seeking Help For An Addiction

According to a statistic from the National Institute on Drug Abuse, 40 to 60% of people with a drug addiction relapse–much like people suffering from diabetes, hypertension, and asthma. “Thus drug addiction should be treated like any other chronic illness; relapse serves as a trigger for renewed intervention.” Though it can be difficult to determine when to use medication and when not to use medication for pain management, if you’re suffering from an addiction, your best bet is to be completely honest about past addictions and recovery. Sometimes medical standpoints can be hard to understand and there can be a lot of jargon–so always ask questions if you aren’t sure!

One thing that’s certain, if you are in recovery, you don’t want to relapse. Contact us today if you have questions about proper treatment for addiction. Relapse may be a possibility, but you don’t want to find out the hard way

American Society of Addiction Medicine - Definition of Addiction

National Institute on Drug Abuse - Successful Pain Management for the Recovering Addicted Patient

National Center for Biotechnology Information - How Frequently are “Classic” Drug-Seeking Behaviors Used by Drug-Seeking Patients in the Emergency Department?

National Institute on Drug Abuse - Drugs, Brains, and Behavior: The Science of Addiction

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