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Managing Chronic Pain While in Recovery

 

According to the National Institute On Drug Abuse, doctors treat more than 100 million patients in the U.S. for chronic pain, including some in the recovery phase of addiction treatment. The challenges doctors and recovering addicts face are numerous and complex. There’s always the possibility of developing an entirely new dependence since some drugs can be addictive if used long-term. At the same time, doctors want to recommend treatments most likely to be effective, which often includes prescription pills.

Treating Patients with a Predisposition for Addiction

In addition to having a genetic predisposition for addictive behaviors, environmental influences, such as access to meds legitimately needed to manage discomfort, can also increase the risk of relapse. When treating patients with a predisposition for dependency, the first priority for doctors is still to offer meaningful relief. Abuse potential can be minimized, however, by taking certain precautions, including:

  • Receiving all prescriptions from the same doctor
  • Monitoring patients for signs of abuse
  • Prescribing the lowest dosage possible

Encouraging Doctor Involvement

While doctors are encouraged to help with patient screening and monitoring to minimize the risk of relapse during recovery, it’s not always easy to find the right balance between being cautious and doing what’s best for the patient’s discomfort. Someone in the process of recovery is going to automatically be at an increased risk of developing a new dependency, although this is also has to do with what a patient was previously addicted to before being treated. One way for doctors to become involved is to look for possible signs that a patient is becoming addicted to their medication, including:

  • Making excuses to get an early refill
  • Attempting to get refills at multiple pharmacies, which can be tracked in states linked to a database meant to identify such attempts
  • Showing signs of increased drug tolerance, such as requiring an increased dosage to get the intended benefits of the medication

Alternatives to Medication Worth Considering

NSAIDs and opioids are the drugs most commonly prescribed to help patients manage chronic pain. However, there are alternatives to pills that may also help with the management of ongoing discomfort for recovering addicts. Physical therapy, for instance, is often recommended to help patients regain muscle strength and learn specific exercises they can perform to better manage their discomfort. Additional alternatives to pills to manage persistent conditions include:

  • Counseling to deal with underlying psychological issues that may be aggravating chronic conditions
  • Transcutaneous electrical nerve stimulation (TENS): The application of electricity to nerve endings
  • Herbal drugs and other medications not likely to spur a new addiction problem
  • Acupuncture, aromatherapy, biofeedback, hydrotherapy, and other treatments often considered alternative

The Joint Commission on Accreditation of Healthcare Organizations and the World Health Organization have guidelines physicians are encouraged to follow when prescribing medications. Yet when it comes to treating recovering addicts with chronic pain, many health professionals argue that more education is needed so doctors can better understand the risks associated with such treatment efforts. Since every recovering addict is different, careful observation will always be necessary.

Sources:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC315480/

http://www.drugabuse.gov/publications/research-reports/prescription-drugs/chronic-pain-treatment-addiction

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