Opioid Abuse and Chronic Pain: An Ongoing Discussion

After decades of work at a physically demanding job, a constant, nearly unbearable ache in your lower back makes it difficult for you to complete even the simplest tasks.

Returning home from a tour of duty overseas, the incessant pain from the leg injury you received while on patrol makes it difficult to concentrate, much less move.

The crippling arthritis in your hands means you can no longer look after yourself without help, and to compound the problem, the pain has a way of keeping you up at night.

If these stories describe a situation that seems familiar to you, you may be suffering from chronic pain.

According to the Centers for Disease Control and Prevention (CDC), chronic pain affects “more than one-third of people in the United States, and about 20 to 30% of the world’s population.” That means that more than 106.3 million Americans have suffered from chronic pain. And with an aging population, that number is only expected to rise, due to increased instances of diabetes, heart disease, obesity, arthritis and cancer. According to the National Institutes for Health (NIH), more Americans will go on long-term disability due to chronic pain than from any other cause, and that in fact chronic pain should in and of itself be considered a disease, regardless of its cause.

With so many Americans suffering from chronic pain, it should be no surprise that the use of medications made specifically to ease that pain is on the rise. In many cases, the drugs prescribed are called “opioid analgesics.” The specific drugs classified as opioid analgesics, or “opioids” for short, include well-known prescription painkillers such as morphine, hydrocodone and oxycodone.

Since their adoption as a treatment for chronic pain by the medical community in the 19th century, opioids have become more powerful and more prevalent. And of course, with an increase in potency and availability come a rise in cases of opioid abuse. The CDC notes that the number of opioid prescriptions handed out by doctors has increased dramatically in the last 20 years, pointing out that a 300-fold increase in opioid prescriptions has contributed to their increased abuse. In fact, “the number of people who die from prescription opioids exceeds the number of those who die from heroin and cocaine combined.”

Nevertheless, when managed correctly and monitored carefully, opioids remain one of the few viable options for many people suffering from chronic pain. But what can be done for those with chronic pain who have developed an addiction to opioids, or for those with prior histories of or predispositions toward addiction, who suffer from chronic pain? Must they continue to struggle with that pain, or are other options available?

For those with prior histories of addiction, research suggests much care should be taken by both patient and physician when prescribing opioid analgesics. Statistics vary with regards to how prevalent prolonged, prescribed opioid use for the treatment of chronic pain turns into addiction. Some studies put the number at as low as 2%; others suggest that number is significantly higher. However, it is generally accepted that those with a prior history of addiction are much more likely to abuse opioids than those with no prior history.

Can those who currently abuse opioids address that addiction while still dealing with their chronic pain? The question seems to lack a definitive answer; the NIH has pointed out that, as the population ages, and as we continue to see increases in other populations with chronic pain issues, such as injured military personnel, “the development of effective, non-addicting pain medications is a public health priority.” Research suggests there are positive advancements in non-addicting pain treatment on the horizon; however, for the time being opioid analgesics remain the primary option for treating individuals with chronic pain.

For chronic pain sufferers who have developed addictions to opioids, treatment facilities like the Addictions Treatment Center at Prairie View also provide alternative options. “It’s a really difficult situation for those who suffer from chronic pain and also struggle with addiction,” said Cody Beaton, LMSW, T-LAC, of the Addictions Treatment Center at Prairie View. “The pain is real and timely relief is highly desirable. However, research has shown that long-term opioid use can actually increase one’s sensitivity to pain. Thankfully, new opioid formulations are gaining steam in the medical field, which could certainly impact this issue.”

These new opioid formulations are designed to significantly reduce the risk of abuse. In fact, new legislation supported by a policy brief that was developed in part by Beaton while at Wichita State University would allow Kansans greater access to and insurance coverage for opioid analgesics with abuse-deterrent properties. The bill, SB 102, will come up for consideration when the new Kansas state legislative session begins in January 2016.

Further, prescription medication isn’t the only effective treatment for chronic pain. “There are alternative ways to manage pain, many of which are incorporated here at the Addictions Treatment Center,” said Beaton. “Yoga, meditation, and other relaxation techniques, or coping skills, are an example. Massage, physical therapy, and hot/cold packs are also helpful in managing chronic pain. Addiction can certainly complicate a situation involving chronic pain, but people need to know that there are effective ways to manage the pain and to live an enjoyable life.”

If you, or someone you love, are struggling with opioid addiction, there are treatments available that can help. To inquire about the services the Addictions Treatment Center at Prairie View provides for those struggling with prescription drug addiction, please contact us here: https://prairieview.org/contact/.

About Prairie View

Prairie View has a passion for helping people live well and relate to one another in a positive, healthy manner. By offering a complete range of mental and behavioral health services for children, adolescents, adults, older adults and families, Prairie View treats depression, anxiety disorders, marital and family conflicts, aging issues, addictions and more.

Founded in 1954, Prairie View is the state’s only faith-based non-profit behavioral and mental health center with locations in Newton, east and west Wichita, Hillsboro and McPherson. Prairie View serves as the Community Mental Health Center for Harvey, Marion and McPherson counties.