Futures Recovery

Underlying Pain

Persistent pain is one of the leading contributors to opioid addiction among adults in the United States.

A significant number of people addicted to opioids first became exposed to those drugs through pain medication prescriptions. While opioid analgesics are widely seen as front-line treatment for physical pain and are widely prescribed to reduce pain from injuries or medical and dental procedures, evidence suggests that the risks of these medicines may outweigh the perceived benefits for some patients.

Many people began taking opioid pain relievers such as Oxycontin, Vicodin, and Percocet for short-term relief, but quickly became physically and psychologically dependent on those drugs. Addiction to opioids and the resulting misuse may lead people to acquire those drugs illicitly, or switch to heroin, which is also an opioid. Significant efforts by policymakers, insurers, and the medical community at large are underway to stem the prescription of unnecessary opioids and the flow of illegal opioids.

One reason that so many people may become dependent on opioids is that the source of their physical pain was never adequately diagnosed and treated. Patients who did not receive appropriate therapy to treat pain may require additional care and other forms of therapy to help manage pain symptoms. Still others may need to learn long-term coping mechanisms such as exercise or physical therapy to manage chronic pain that may not be otherwise treatable.

One of the most difficult aspects of managing pain conditions with opioid medications is that these medications can eventually intensify the pain they are supposed to control. This condition is known as opioid-induced hyperalgesia. OIH is characterized by a paradoxical response to opioids making the patient more sensitive to certain painful stimuli. The type of pain experienced might be the same as the underlying pain or might be different from the original underlying pain.

Futures helps clients identify and treat underlying pain conditions to reduce the need for habit-forming medications. When pain management with opioids does not result in significant reduction of pain severity and improved level of functioning, the treatment should be changed—especially if it has resulted in an opioid use disorder. Patients often report they are feeling better when alternative treatments are introduced, combined with a gradual reduction and discontinuation of the ineffective narcotics. If an addiction has developed, opioids must be replaced with non-habit forming medications, appropriate physical exercise, stress reduction methods.

Chronic pain is stressful while stress can intensify physical pain. This cycle of pain and stress may lead to attempts by patients to alleviate the physical and emotional pain with drugs and alcohol. To escape this trap, patients need to learn how to cope with stressful situations in healthy ways. Stress reduction tools may include mindfulness techniques and cognitive behavioral therapy. Stress-reducing physical activity should become part of their daily routine, so people need no longer depend upon habit-forming medications and experience a return to a significantly higher quality of life.