Treating Chronic Pain in Opioid Dependent People

Chronic Pain

Chronic pain is the severe, debilitating and persisting pain that can affect any part of the body. It can be caused by any number of factors such as environmental influences, injury, surgery, muscle tension or other diseases. Some medical conditions such as endometriosis or bowel disease are characterized by chronic pain. Chronic pain varies in strength and can be resistive to medical treatments but it is known to cause severe, all encompassing problems for those who are suffering. Chronic pain can affect a persons ability to work, socialize or be involved in daily activities. It can affect vision, weight, ability to sleep, movement and digestion.

Chronic pain is one of the most difficult and challenging conditions to treat. Some pain is able to be managed through localized treatment at the site of injury or trauma. Others need to have extensive psychological management to improve a persons quality of life and reduce distress associated with the pain. Medications can improve some people’s quality of life but do need to be managed appropriately to reduce the risk of dependency that can develop.

Pain Medications

There is a vast array of prescription and over-the-counter medications available to treat chronic pain. The most effective and widely used are the opioid analgesics. Drugs in this category include codeine, morphine, fetnanyl, hydrocodone, oxycodone, hydromorphone, meperidine and others. These drugs are effective at treating pain in the body as they attach to specific opioid receptors in the brain, spinal cord or gastrointestinal tract to change the way a person feels pain. Opioid’s are known to alter how the body responds to pleasure and pain which causes a feeling of well being, relaxation and euphoria. However, repeated use or abuse of an opioid can lead to addiction.

Opioid analgesics have a number of common side effects which include constipation, nausea, dizziness, increased sweating and drowsiness. These drugs can have adverse reactions with other medications and drugs, including alcohol.

Long term & repeated use of opiod drugs can lead to dependence and tolerance. Opiod pain medication should only ever be used under strict guidance from a medical professional who can manage the risks of addiction and tolerance appropriately. Opioid addiction is a serious drug dependence problem and many people develop this dependency on the substance without realizing. The symptoms of withdrawing from opiates are known to be incredibly painful, difficult and many people relapse. Withdrawal symptoms can include flu-like symptoms, bone and muscle aches, severe headaches, nausea and diarrhea.

It should be noted that the majority of people who are prescribed opiate pain medications do not develop an opioid addiction. Many people safely use oxycodone, vicodin or other medications to treat the symptoms of chronic pain without developing any of the adverse effects.

Opioid Dependence

Opiate pain medications are incredibly popular, with the annual study by the IMS Institute for Healthcare Informatics revealing that in 2010, the most commonly prescribed medication in the United States was Vicodin. Vicodin, or hydrocodone, is a strong synthetic opioid prescribed to treat severe, chronic pain. The drug was prescribed over
130 million times in 2010 revealing that there is a significant problem with opioid dependence and/or chronic pain in our society.

According to the 2007 National Survey on Drug Use and Health, an estimated 5.2 million people over the age of 12 in the United States had used prescription pain medication in the month prior to the survey. A significant number of these used the drugs for non-medical purposes. According to research by the Office of National Drug Policy, prescription pain medication abuse increased 163 percent since 1995.

Doctors who prescribe opiates for chronic pain need to manage the risks associated with these potentially harmful medications. An evaluation of personal or family history of substance abuse, history of mental health issues or existing psychiatric disorders should be conducted prior to prescribing any drug. Patients also should be advised of the risk of addiction associated with the use of the drug and inform them of the seriousness of managing the medication use appropriately. Individuals who may be at risk of developing an addiction such as those in the high risk groups should not necessarily be denied the drug, they should be closely monitored for the potential development of an abuse problem.

Treating Pain in Opioid Addicts

If a person has an existing opioid addiction, there is some risk that medications used to treat chronic pain will not work due to drug tolerance levels. Additionally, for those who are undergoing rehabilitation, opiate medications can trigger a relapse into an addiction. Chronic pain has been found to be relieved in opioid dependent people with methadone and buprenorphine which are prescribed as an opiate-replacement drug. Used appropriately, these drugs can also have strong analgesic properties.

Some non-opioid drugs have been found to be effective at treating pain in people who have tolerance to opiates. These include anti-epileptic drugs, anti-arrthythmic and antidepressant drugs. These types of medications can be safely used in combination with other treatments. Benefits are found when combining pain treatment with psycho-therapeutic options such as group counseling or cognitive behavioral therapy. Exercise therapy may also provide some relief and improve the quality of life.

Doctors and hospitals have been found to be cautious or biased towards treating chronic pain in opiate addicts. Institutions may have concerns concerns about the amount of pain medications being prescribed and believe that this is contributing to an increase in addiction levels. Drug addicts are often the most discriminated group of people who seek treatment from doctors and there are many misconceptions about the disease. Drug addicts experience chronic pain as often as those who do not have a substance abuse and have the right to access appropriate medical care. It is important to understand that these co-occurring conditions need to have the right medical attention and receive the right care.

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