5 Important Facts about Pain Management & Addiction

Bad things do happen; how I respond to them defines my character and the quality of my life.

I can choose to sit in perpetual sadness, immobilized by the gravity of my loss,

Or I can choose to rise from the pain and treasure the most precious gift I have – life itself.”

Walter Anderson, U.S. writer and artist

Let me introduce you to Ray, nickname “Fats” because he likes jazz and he’s the skinniest guy you’ll ever meet. Ray’s a friend I made when I was at my lowest, just 2 weeks into the half a year I would ultimately spend in rehab. I was getting treatment for alcohol addiction, and Ray was there due to his addiction to his pain prescription meds and other drugs (the kind that aren’t exactly what you’d call “prescription”).

Ray was in a motorbike accident when he was just 19; he was 33 when I met him. When we got to know each other better, I learned about the impact his accident had had on him, socially, professionally, and on a deep, personal level too. Ray doesn’t know when he became addicted, only that, at some point during years racked with pain, he did. I, too, would struggle to answer that question, but this isn’t about me. It’s about Ray and others like him.

The accident in which Ray got hurt wasn’t his fault, he wasn’t DUI, he wasn’t being reckless, and he was within the speed limit. He got side-swiped by a van, reddish in color is all he remembers about it. That, and the fact it then sped off and left him on the road. “Screaming and bleeding,” as Ray himself puts it. The police never traced the driver, and Ray never recovered.

This article is about the 5 important facts you need to know about pain management and addiction. Ray knows only too well about both, and his experiences here are supplemented by solid research. When we both finally left rehab (Ray, a few weeks after me), we kept in touch, and I visit him as often as I can. My good friend, “Fats,” is part of my support network, and I’m part of his. As Ray would say, “let’s get moving.”


  1. The Pain-Addiction Connection

The kind of pain that Ray experiences day in, day out is, sadly, not unusual. Around 50 million other Americans are also trying to deal with the physical and mental effects of such chronic pain. Just like Ray, many of these pain sufferers are unable to work, unable to exercise, unable to sleep decently, and many of those have fallen into depression, whether it’s been recognized and treated by their doctor or not. If ever there was one demographic in our nation that was truly susceptible to the dangers of addiction, chronic pain sufferers are it.

Therefore, it really can be no surprise to anyone that many of these people resort to other substances, aside from their medication, in which to make their lives somewhat more bearable. Getting drunk or getting high, just to make the pain more tolerable for a while, must be a sure-fire temptation. Add the fact that many of these people might be at risk of addiction anyway, and the connection is made, willingly on the part of the sufferer too.

If that wasn’t enough in terms of addiction predictability, then just throw in the fact that many of today’s painkilling drugs around carry the potential for dependence. Take opioids, for example, providing morphine-like effects. As Ray would say, “about as nailed on as it gets.” When it comes to killing severe and chronic pain, the sufferer will happily increase their dose in an attempt to control it.


  1. The Dependence Potential of Prescription Painkillers

Prescription medicines, be they painkilling or not, are still drugs, still the result of laboratory production, and, yes, brimming with huge profits for those who produce and sell. In fact, the U.S. pharmaceutical industry was worth a colossal $446 billion in 2016 alone, 45{ee2969969a16e02279579c5e0b4ac9015219e99d363c310bf75d46c189d8acdf} of the total global market share.

Not all of these prescription drugs are addictive. However, many of today’s new wave of painkillers do possess a high dependency potential, and the reason for their self-administration, the alleviation of chronic pain, only increases the possibility of addiction within those taking them

A brief word about today’s current doctors’ drugs of choice for pain sufferers. All painkillers are designed to interfere with the body’s nervous system, targeting the signals it transmits as pain. However, many also target the “pleasure” zones in the brain, resulting in an additional “high.” Of these, and they’re all powerful, the most powerful are opioids, designed to act in exactly the same way as heroin. Yes, heroin. The most abused of these are oxycodone, meperidine, and hydrocodone.

Back to Ray, who was prescribed oxycodone. He once told me he’d bypass the slow-release nature of the drug by simply crushing the tablets up, which eventually led to snorting the resulting powder, and even injecting, just like heroin itself. Ask a heroin junkie what it’s like to withdraw from the drug, and you can plainly see why people such as Ray, already in severe pain, needed more of the same to stay the same.


  1. The Dual-Treatment of Pain Management & Addiction

When treating addiction  with any other prevalent condition, like depression, they each have to be dealt with together, at the same time. If not, the untreated one will always lead you back to the other. This is even more of the case when it is addiction coupled with inescapable chronic pain. Managing the necessary pain relief while preventing possible relapse is, as Ray says, “a job for the professionals.”

The main element of successful treatment is psychotherapy, where patients such as Ray are taught to understand the various factors of their abuse of their medication, how they actually contribute to their level of pain, and different ways of coping with both.


  1. Pain Management as an Addict

If pain management was difficult before, it’s more than doubly so now. However, there are various medications now available that will reduce pain in a different way, such as certain antidepressants, among others. Big flashing warning light, you may think, but these types are non-addictive.

There is also the field of non-drug management of pain for the patient to experience, such as mind-body therapies like meditation, mindfulness to treat addiction (one of Ray’s personal favorites), and biofeedback. Additionally, you have chiropractic treatments and the use of acupuncture. Strangely enough, when Ray got clean from the opioid drugs in his system, he discovered that he had a distinct fear of needles (yes, he did inject during his actively addicted years), and duly fainted during his first, and definitely his last, acupuncture session.


  1. The Possible Solution

U.S. pharmaceutical companies, aware of the dangers of prescription drug/opioid addiction, continue to rake in the profits of high dependence products like oxycodone, seemingly viewing the resulting addicts as collateral damage.

However, an Australian company, in conjunction with colleagues in Colorado, is currently looking at a new drug called (+)-naloxone, which can actually heighten the pain-relieving level of opioids, but, an important but, reduces the addictive effect. At least some elements of the scientific /pharmaceutical community are working for the entire good.


Let’s Get Moving…

Are you suffering from chronic pain? Do you use opioids to control it? Are you worried about their addictive effect? If you would like to comment, share your experience, or make any observations on the detail of this article, please free totally free to do so in the comments section below. All are gratefully received.

So, to finish, those are the 5 important facts about pain management and addiction you need to know:

  •        The Pain-Addiction Connection
  •        The Dependence Potential of Prescription Painkillers
  •        The Dual-Treatment of Pain Management & Addiction
  •        Pain Management as an Addict
  •        The Possible Solution

Having listened to the experiences of my friend Ray on many a night spent talking together, I am reminded constantly of the frailty and unpredictability of our existence. A minute earlier or a minute later reaching that junction, and Ray’s life could have been so much different. I’d gladly surrender our friendship, having probably never met otherwise, for him to have lived in another way, not in pain, not as an addict, and not as someone whose life has the shadow of relapse. Myself? 6 years clean and sober, just like “Fats.” Take care.