#iPainSummit2019: Chronic Pain and Addiction

At the International Pain Foundation’s iPain Summit, held this year from November 14th-16th, a wide variety of topics related to the challenges faced by patients with chronic pain were discussed. One session, presented by Gayle M. Taylor-Ford, addressed addiction and chronic pain. All too often substance addiction or abuse overlap with chronic pain and can make treatment access even more of a challenge for patients. This presentation elaborated on these issues and how patients struggling with both addiction and pain can be treated effectively and safely. This is a challenging subject as some patients say that they would prefer to be addicted to a drug than to experience their constant chronic pain. This statement alone is a testament to how burdensome and traumatizing constant pain can be.

The Opioid Crisis

Anyone who follows current events has probably heard plenty about the opioid addiction crisis that has had a major impact in the US in recent years. Opioids are a common treatment approach for patients with serious pain that doesn’t resolve with milder drugs. However, their widespread use has led to a growing population of people who are addicted to them; overdose deaths have climbed and overall life expectancy in the US has fallen as a result. 

Difficulties With Access

With this problem now well known, it has become more difficult for patients who really need relief to get access to opioid medications. Many doctors are much more hesitant to prescribe them and patients that do receive them often have to enter into agreements that require close monitoring of use. Statistics suggest that possibly as many as 60 percent of people who are addicted to opioids also report chronic pain.

The Downsides of Opioids

Opioids can be very effective at treating serious, short-term pain, but use of these drugs carries considerably more risk and downsides over a longer period. Use of these drugs for a month or more can actually increase someone’s pain sensitivity. The human body also can develop tolerance to opioids relatively quickly, meaning that patients have to increase their dosage to get the same benefit from before. Higher doses increases the risk of addiction and other undesirable effects. However, the experience of “drug cravings” is not itself an indicator of addiction.

Addiction and Pain

If a patient is addicted, how can they be treated effectively? It is possible for these patients to be treated, but they often require more specialized care. An example of more specialized care would include a pain clinic. A patient that is addicted to another substance, such as alcohol, would not be permitted to use opioids while undergoing rehabilitation for addiction.

If you have chronic pain but are also dealing with addiction to opioids or anything else, it is important to have a trustworthy relationship with your physician so you can be as honest with them as possible. 

Check out the original presentation here.

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