General Category

The Connection Between Chronic Pain and Addiction

Chronic pain is persistent discomfort lasting at least 12 weeks or more. It can occur after traumatic injuries, various diseases, aging, or surgery, and it impacts daily living. Those who suffer from it are often unable to complete tasks or can experience a range of discomforts. However, without the correct chronic pain management, chronic stress can quickly lead to an addiction.

Sometimes, the pain becomes so severe that medication is provided to the patient to ease their symptoms. Still, many of these medications can cause a chronic pain addiction if not monitored closely. Common medications associated with alleviating pain include:

  • Opioids
  • Anti-inflammatory medication
  • Steroids like Prednisone
  • Antidepressants
  • Muscle relaxers
  • Anticonvulsant/anti-seizure medication

If Advil cannot combat intense pain, then muscle relaxers or anti-inflammatories are prescribed. Unfortunately, muscle relaxers can be addictive and lead to a painkiller addiction if used improperly.

The danger with chronic pain management can be a tolerance to medication, requiring more of it to maintain the same pain management level. It is at this point that an addiction can develop.

The Pain-Brain-Addiction Cycle

When dealing with chronic pain management, it may not just be the underlying cause or pain that physicians may need to contend with. Chronic pain and its associated symptoms on their own can require various medications to deal with pain, in addition to the condition. Furthermore, if coupled with a lack of mobility, chronic pain can cause anxiety, isolation, and depression, thus requiring further treatment.

Opioids

Most medications to treat pain can also be very addictive. Opioids (OxyContin, Percocet, and Vicodin) increase dopamine (feel-good chemicals) in the brain. As time progresses, these medications, which initially provide pain relief, can generate additional pain called opioid-induced hyperalgesia.

Opioid-Induced Hyperalgesia

This condition occurs when your pain receptors are desensitized to medication, while sensitivity to pain increases. The body tolerates the medication, requiring more significant amounts for relief. This cycle can provide a scenario that’s ripe for painkiller addiction.

Furthermore, since opioids are in the same classification as drugs like heroin, those who are unable to obtain a higher dosage through their physician resort to other substances (such as heroin) to ease their discomfort.

In 2018, 3.7 million Canadians over 15 years old stated they used opioid pain relievers over the past year. Among those who reported usage, 351,000 experienced addiction. Studies seem to indicate heroin abuse first began with opioid prescription medication.

The Risks

When individuals are prescribed opioids like oxycodone and hydrocodone for chronic pain management, they may experience pain relief, euphoria, and extreme relaxation.

Once they heal and don’t need the drugs, they can begin to crave the pleasurable sensations they experienced while on them. Their brain chemistry is responsible for mood regulation and emotional changes if consumed for months or years.

Substance tolerance occurs when the medication is taken for a prolonged period, and the person requires a higher dose for the same high. Dependency is when someone needs the substance to feel normal. When not taken, they experience physical consequences.

People who become dependent exhibit unusual behaviour like depression, guilt, irritability, secrecy, and shame. Also, overdoses (non-fatal and fatal) can occur.

Withdrawal Symptoms

Once the person stops taking opioids, they can experience withdrawal. Signs of dependence are:

  • Nausea
  • Intense cravings
  • Vomiting
  • Fever
  • Anxiety
  • Flu-like symptoms
  • Sweating
  • Increase in heartbeat
  • Diarrhea
  • Excessive yawning
  • Goosebumps
  • Watery eyes

Cannabis

Medical cannabis can be used for chronic pain management as well. While some physicians do prescribe it for chronic pain, like opioids, it can lead to addiction. The risk of dependency tends to be minimized by prescribing the appropriate doses with clinical oversight. However, some still self-medicate with illicit cannabis use.

How do you reduce the addiction risks?

While many people can consume prescription opioids without becoming addicted, others who have a substance abuse history or are genetically predisposed to addiction can become vulnerable. Regrettably, it can be challenging to determine who this will affect.

Furthermore, addictions can affect anyone taking opioids. Therefore, doctors are using better implementation when prescribing opioids that minimize their usage. Opioids are no longer the first line of defence for chronic pain treatment. Other treatment options for chronic pain include:

  • Non-steroidal anti-inflammatory medication
  • Antidepressants (for emotional pain)
  • Complementary therapies (supplements, acupuncture, and meditation)
  • Medical management (massage and chiropractic)
  • Physical therapy
  • Cognitive therapy
  • Mindfulness-based chronic stress reduction

Patients are advised to be aware of the side effects of opioid use and to be proactive in reducing addictions. If someone you know is becoming addicted to prescription medication or opioid use, consult an addiction or pain management specialist. 

How can a chronic pain addiction be treated?

Methadone

Methadone is successfully used to combat chronic pain addiction and opioid dependency. Methadone replaces shorter-acting opioids that people may be addicted to, like oxycodone, heroin, hydromorphone, and fentanyl. It is longer lasting and acts slower in the body for longer durations.

In the correct dosage, methadone prevents withdrawal and decreases cravings without euphoria or sleepiness. It lowers the risks of opioid misuse and provides a chance for those who experience addictions to stabilize their lives.

Suboxone

Suboxone treats opioid dependence and can stabilize individuals experiencing withdrawal during detoxification. Additionally, it is used for maintenance treatments to promote a better recovery from an opioid use disorder. It contains buprenorphine and naloxone to reduce withdrawal symptoms.

Suboxone contains buprenorphine, which provides a partial opioid antagonist (it produces weak opioid effects). This facet lessens cravings and withdrawal symptoms without generating the full impact of other opioids, making it easier to stop taking other opioids.

Naloxone works as an opioid receptor antagonist. It can be combined with buprenorphine and other generic combinations to assist with opioid addictions. On its own, it can reverse opioid overdoses. However, when combined with buprenorphine, it discourages buprenorphine’s intentional misuse.

In addition, suboxone is helpful as a comprehensive treatment when paired with help groups, behavioural interventions, and treatment for co-occurring mental health issues.

Naltrexone

Naltrexone blocks and binds opioid receptors, reducing cravings. It blocks the sedative and euphoric effects of drugs like codeine, heroin, and morphine. Also, it has no diversion potential or risk for abuse. If the person relapses and uses the “problem drug,” then naltrexone prevents the high.

New Dawn Medical Can Help

Finding help and support is the first step in your recovery journey for those struggling with chronic pain and addictions. New Dawn Medical’s chronic pain rehab is dedicated to providing all patients with quality care. For added convenience, we have over 20 locations in Ontario. We do not require appointments or referrals; patients can connect with our doctors virtually.

New Dawn Medical offers various treatment options and has a trusted team of staff and doctors to help you every step of the way. Together, we can manage your recovery from chronic pain addiction.


To book an appointment, contact us toll-free at 1-833-456-DAWN (3296), locally at (647) 625-8799, or at info@newdawnmed.com.

New Dawn Medical

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