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Sobriety with Chronic Pain

Published On: 02 December 2020

Recovering from addiction while experiencing chronic pain is one of the toughest, most aggravating challenges a human being can face. Opioids are commonly prescribed to treat chronic pain, which can make pain management difficult while working through the journey of recovery. How we manage chronic pain in the United States has been both a culprit and a source of tension for treatment providers who understand the complexities of this issue for those in recovery. On a day to day basis, sobriety with chronic pain is an uphill battle. The slide back into addiction is a slippery slope, so many people in recovery choose to avoid prescription medications like opioids. However, dealing with chronic pain daily can make sobriety difficult and relapse more likely.

Sobriety With Chronic Pain: Is it possible to maintain sobriety with chronic pain?

What is Chronic Pain? 

We all feel pain as it’s a part of human nature, but what defines chronic pain? Pain occurs when something hurts, causing an uncomfortable or unpleasant feeling. The presence of pain often means that something is wrong. Each individual is the best judge of his or her own pain.

Acute pain lets you know that your body is injured. It usually doesn’t last long. It should go away as your body heals. Chronic pain lasts much longer, and it may last months or even years, interfering with your daily activities. And sobriety with chronic pain is a difficult battle.

The term “chronic pain” is a kind of catchall term for as many as seven categories of persistent pain:

  • Chronic primary pain: Pain lasting three months or longer that cannot be attributed to any other condition
  • Chronic posttraumatic pain: Pain lasting three months or longer following trauma or surgery
  • Chronic neuropathic pain: Pain resulting from damage to the somatosensory nervous system
  • Chronic headache and orofacial pain: Pain experienced in the head or face which occurs on fifty percent of days over a three month or longer period
  • Chronic visceral pain: Pain experienced in an internal organ
  • Chronic musculoskeletal pain: Pain experienced in muscles, bones, joints, or connective tissue
  • Chronic cancer pain: Pain related directly to cancer or to the treatment of cancer

What is the difference between addiction and substance abuse? 

Several levels of addiction can occur, depending on the substance someone has been exposed to. Individuals can experience occasional substance abuse and not technically become addicted until they’ve continued to use the substance for a specific amount of time. When someone initially starts to take drugs or alcohol in excess, it is typically considered substance abuse. With continued use, they then develop a substance use disorder, otherwise known as addiction. 

Is it possible to maintain sobriety with chronic pain? 

If you are recovering from opioid addiction, pain management in recovery can be a complex challenge. This is especially true if you are enrolled in a sober living program, as most sober living homes do not allow residents to use any narcotics or medications that could potentially be abused. Often when we go to the doctor, the first option for pain relief is medication. However, this may not be the best option for people who are recovering from severe addiction and the benefits of using opioids for pain relief may not outweigh the risks. 

If you and your physician choose to use other methods of chronic pain management, it is ultimately up to you to hold yourself accountable. Being honest about the effectiveness of your medication and any changes you have made to your own dosage and usage habits can highlight a developing opioid addiction, offering you and your doctor the opportunity to change your treatment plan.

Here are few ways to help maintain your sobriety:

  1. Yoga: According to Harvard Health, yoga practice can improve both physical and mental well-being. There are countless variations of yoga that can be used in addiction recovery to manage chronic pain conditions such as migraines, fibromyalgia, and low back pain, among many others.
  1. Meditation: What can mindfulness meditation do for pain relief? A study found people who practiced meditation experienced more pain relief, lower levels of anxiety and depression, and improved mental health than those who didn’t. Also, meditation is something that is commonly practiced in drug and alcohol rehab programs. So continuing the practice while entering recovery and sober living may also be an easy way to relieve pain while maintaining a consistent and healthy routine in recovery.
  1. Get serious about sleep: Improving your sleep hygiene—which means sticking with a sleep schedule, making sure you have a comfortable place for rest and avoiding caffeine, stimulating activities, and screen time before bed—can ensure you get the rest you need.
  1. Compassionate Care: If you are seeking help in recovery and seeking help for chronic pain, try first talking with your sponsor or other treatment professional about the best options for physicians who understand how to manage pain for a person in recovery. A good doctor should show compassion and offer a non-judgmental approach to helping you get free from pain. In some cases, opioid medications may be the only viable option for pain relief.
  1. Fall in Love with the Right Kind of Food: A change to a diet like the Mediterranean diet—which includes leafy vegetables, fresh fruits, whole grains, fish, and olive oil—may reduce pain by improving overall health and reducing inflammation.
  1. Keep a pain journal: For those experiencing chronic pain, keeping some form of a pain journal can be very therapeutic and can help the addict give a voice to what they are feeling. The purpose of this journal is to provide the addict with an avenue to vent their frustrations, as well as providing some sort of measurement or index of their discomfort.
  1. Get up, Get Moving, and Exercise: If you suffer from chronic pain, exercise is probably the last thing on your mind, but research has shown that individuals in sobriety with chronic pain who exercise regularly report less pain and increased activity. This is because exercise keeps you in shape and keeps your muscles strong. Speak with your doctor, and if approved, try slowly incorporating exercises such as walking, stretching, light strength training, and yoga into your daily life.

Alternative Treatments:

  • Non-opioid medication: Some of the medications mentioned above do not fall under the category of opioids, which bring the greatest risk of addiction. NSAIDs, antidepressants, acetaminophen can all be used as general replacements. Muscle relaxants (like diazepam) and low doses of naltrexone can be helpful in cases of acute musculoskeletal pain (like back pain or neck pain) and issues like Fibromyalgia and complex regional pain syndrome, respectively.
  • Topical pain relief: Applied directly to the location where the pain is most present, creams and gel forms of capsaicin, lidocaine, trolamine salicylate, and counterirritants (with ingredients like menthol and eucalyptus) may provide some relief.
  • Acupuncture & Massage: Acupuncture and massage therapy have been helpful to people with physical ailments and pains for thousands of years. There are pressure points throughout the body that can be worked with to release sensations of pain. Acupuncture has been scientifically proven to “release” excruciating pain through the needle-pinning of such pressure points by a licensed acupuncturist.

Signs of a substance abuse problem with chronic pain?

Because chronic pain is such a risk factor for misuse of drugs or alcohol, it is essential to recognize the signs that may indicate a person has a problem. Whatever the reason a person starts taking drugs, whether recreationally or as prescribed, tolerance, patterns of increased use, physical dependence and, ultimately, addiction may develop—sometimes before the user even realizes it. 

Typically, abused substances act as brain depressants that suppress the production of neurotransmitters. When the patient ceases using the substance of choice, the brain rebounds by producing a surge of adrenaline that may lead to withdrawal symptoms. As a result, the patient may continue to crave the substance and develop an addiction.

The use of most substances will produce noticeable signs and symptoms. When dealing with sobriety with chronic pain, these may include physical or behavioral symptoms—most likely both.

  • Cravings 
  • Tolerance
  • Withdrawal Symptoms
  • Physical Dependence 
  • Drug-seeking behaviors 
  • Financial trouble related to substance use
  • Increased risky behavior and neglecting responsibilities

If someone you care about is using drugs or alcohol in a way that’s threatening their health, relationships, finances, career, and perhaps even their life, you no doubt feel overwhelmed and desperate to help them come to their senses. We know there’s nothing more painful than seeing someone you love hurt themselves and those around them. 

Whether it is you, or someone you love who has found themself battling sobriety and chronic pain, speak with an addiction professional.Their guidance can reduce your pain and strengthen your resolve. Don’t give up hope. A recent Surgeon General’s report on alcohol, drugs, and health noted that there are approximately 25 million people in active remission from addiction in the U.S. Addiction can be terrifying, but it can also be overcome. 

Our goal is for every patient to enjoy a life free from the shackles of drug or alcohol addiction. Learn more about our commitment to helping you live your best life online, or give us a call today! 

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