September is Pain Awareness Month

September is Pain Awareness Month. Pain is defined as physical discomfort or suffering caused by illness or injury. The National Institute on Drug Abuse (NIDA) reports that about 100 million Americans have chronic pain. Chronic pain is defined as pain that persists past normal healing time typically considered to be about six months. 

Everyone suffers from some type of pain over the course of their lives. However, there are some individuals, about one-third of the United States population, according to the National Institute of Medicine,  that live with chronic pain. 

Pain Awareness Month began in 2001 and was led by the American Chronic Pain Association (ACPA) with the goal to raise awareness of the issues of pain and pain management. The ACPA, along with a coalition of other groups, developed the umbrella partnership, Partners for Understanding Pain. This group provides pain awareness toolkits, pain management information, communication tips and tools to help patients better communicate with healthcare professionals, and more. 

The aim of Pain Awareness Month is as follows:

• Reduce the stigma associated with chronic pain
• Create a greater understanding of pain and chronic pain amongst healthcare providers, patients, and the community
• Decrease the barriers to effective pain management

According to the National Institutes of Health (NIH), out of the 100 million Americans suffering from chronic pain, they fall into the following categories:

• ½ experience daily pain
• ⅓ have mild pain
• ⅓ + have moderate pain 
• Less than ⅓ have severe pain

No matter what level of pain is being endured, or how frequently, more needs to be done to help these individuals manage their pain and return to the ability to perform in their daily lives.  The most commonly experienced types of pain are as follows:

• Back pain
• Migraine or headache pain
• Neck pain

Many individuals suffer from more than one type of chronic pain. For example, a person who has a neck injury and subsequent pain may experience chronic headaches.

In the past few decades, prescription opiates have been the ‘go-to’ for pain as well as chronic pain treatment. But as we have learned, using opioids to treat pain can lead to dangerous dependence and addiction. So many today with opioid addictions were first prescribed these highly addictive and dangerous drugs to manage acute pain which became chronic. 

Chronic Pain and The Brain 

Chronic pain can lead to changes in the brain. Some of these alterations can lead to other complications. When the brain feels pain, survival mechanisms are activated. This includes the fight or flight response. When these responses are stimulated, there are both physical and chemical changes. These include the following increased heart rate and blood flow to muscles as well as other stress responses. 

Typically, after this initial response, the body calms and returns to normal. However, with chronic pain, this isn’t normally the case. With chronic pain, there can be prolonged changes in both systems and chemicals in the brain. The results of this prolonged brain response can be both physical and psychological. Many of these effects are detrimental to the individual. 

This is one reason why there has been much research into ways to manage chronic pain. Most of the research has been focused on learning how sensory neurons are activated and how these signals are translated in the brain with the aim of blocking the pain at its source. This is how pain medications such as opioids work. However, opioids are not only addictive but haven’t been highly successful in ongoing pain treatment. 

There has been recent research, funded in part by the National Institute on Drug Abuse (NIDA), that suggests there may be other more effective ways to understand and treat pain including chronic pain. This research focused on the part of the brain called the basolateral amygdala (BLA) and a specific group of neurons in this region. Researchers found that deactivating this particular group of neurons in mice resulted in less negative affective responses to pain even though the pain was still perceived. While this research is still in its infancy, it offers hope for new ways to better treat chronic pain. 

How Chronic Pain Affects Emotions

Individuals living with chronic pain are more likely to suffer from certain mental health conditions. The most common are as follows:

• Depression 
• Anxiety
• Anger
• Fear

When someone lives with any of these mental health conditions, they can be more likely to ‘self-medicate’ to help ease not only the physical pain but also the emotional issues they are feeling. This can present as drinking alcohol or using another substance. However, many times it results in the person taking more of the pain medication than they are prescribed or taking it more frequently. 

Either of these practices can lead to addiction as well as other complications. For example, when opioids are mixed with alcohol or medications used to treat anxiety such as benzodiazepines or benzos, there is a great risk of overdose and overdose death. 

Chronic Pain and Addiction

As mentioned, opioids are commonly used to treat pain. Taking opioids for longer than prescribed or for extended periods of time can lead to addiction. Here are some facts associated with opioids used to treat pain from the NIDA:

• About 21% to 29% of individuals prescribed opioids to treat chronic pain misuse them
• Between 8% and 12% of those using prescription opioids will become addicted 
• About 5% of those who misuse prescription opioids will begin using heroin

And while the overprescribing of opioids may have begun by the healthcare community being misled by pharmaceutical companies as to the safety of this drug, awareness of this epidemic has grown and it is the responsibility of our nation as a whole and healthcare professionals to work together to end this deadly practice.

Pain Awareness Month aims, in part, to bring awareness to the number of Americans living with chronic pain as well as support the efforts to find new and better treatments for chronic pain. 

However, for someone living with chronic pain, this can be scary, especially if they have become dependent on or addicted to prescription opioids to help treat the pain. While the treatment may not be entirely working, confronting the possibility of not having that medication to help with pain can be terrifying. 

For those who have become addicted, the fear is only intensified. 

Treatment for Chronic Pain and Addiction 

The individual who is facing both chronic pain and an addiction to opioids need addiction treatment programs a bit different from others. For this group, identifying the cause of pain is paramount. Many times healthcare providers don’t know enough about pain and its specific causes to properly identify its source and thus provide proper treatment alternatives. 

Not only do the underlying cause or causes of pain need to be identified, any co-occurring mental health disorders (such as depression and anxiety), as well as substance use disorders, also need to be identified in the assessment stage of treatment. It’s essential that all of these conditions—pain, mental health disorders, and addiction—be treated simultaneously. This will better strengthen the persons’ foundation for recovery.

The NIDA’s Director Nora Volkow has spoken out about the treatment of chronic pain and the need for alternatives to opioids. In fact, the NIDA is working in collaboration with other groups to discover what other methods are effective and how to get them to those suffering the most. 

In a video, Dr. Volkow talked about the need to incorporate other, alternative methods into the treatment of chronic pain. She said that individuals and healthcare practitioners need to understand that while the pain may not completely disappear, it can be lessened enough so that individuals suffering can get back to functioning in life properly. 

In addition to more effective medications, alternative approaches to manage pain such as meditation, physical therapy, and more are being shown to be effective in long-term pain management. 

Since September is Pain Awareness Month, there’s no better time to address your chronic pain or that of a loved one and get help. If you or a loved one are taking opioids to treat chronic pain and have become dependent or addicted, Futures Recovery Healthcare can help. At Futures, we offer a specialized program for those living with chronic pain who have become dependent on opioids and other substances. 

Our Pain Track offers effective identification and treatment of pain and its underlying causes that exacerbate substance use disorders. From physical therapy and nutritional plans to detox and evidence-based therapies, Futures is well-versed and successful in helping individuals living with chronic pain and addiction heal. 

If you want to learn more about how Futures can help you or a loved one contact us online or call 866-804-2098.