Many times people living with chronic pain hear negative messages from their care givers. Messages like “it’s all in your head,” “you need to try harder,” or maybe “you’re making yourself hurt so you can get drugs.” Another phrase I often hear from doctors and nurses, as well as substance abuse counselors, is “they’re just drug/med seeking.” I also used to think some of my patients were “drug seeking.” However, I have learned that what they were really looking for was relief from their pain—both physical and emotional.
These negative messages, combined with their feelings of hopelessness and helplessness, can cause these people become very confused, guarded, and defensive. Unfortunately, mistaken beliefs about chronic pain and addiction in the healthcare system and recovery community, can discourage recovering people from connecting with appropriate support. In fact, they often lead to life threatening suggestions.
In addition to the counterproductive messages from health care providers, this chronic pain population also receives negative messages in their self-help programs. Some misguided, but well intentioned recovering people in AA (Alcoholics Anonymous) and/or NA (Narcotics Anonymous) tell newcomers to “never take anything—no matter what,” even though AA and NA both have conference approved literature that clearly explains that some members need to be on “appropriate” medication.
Recently I have seen a number of my patients with chronic pain and chemical dependency problems who have received totally inappropriate treatment from their health care providers and bad advice from their recovery program. These situations are very frustrating because they are so unnecessary. I am very concerned because this inappropriate treatment can easily lead to relapse, and in some cases death.
Educating these recovering people about their addictive disorder and their pain condition is critical to their recovery. However, what is often as important is teaching healthcare providers, family members, and sponsors about effective addiction-free pain management. It is also essential for them to become more helpful by being less judgmental, shaming, and blaming. Hint: empathy and compassion, and understanding must come before positive strength-based challenge.
For one patient there was no understanding and compassion. Several years ago she suffered an on the job injury and was put on pain killers. She quickly developed a tolerance (it started taking more and more to get relief) and she started abusing her medication. She ended up with health problems and got arrested for forging a prescription. After getting out of jail she found that smoking heroin took her pain away better than the pain medication.
She eventually developed a high tolerance with the heroine and it was no longer relieving her pain. She sought help and was put in a hospital detoxification program. Unfortunately, due to the stigma of being on a street drug, she was accused of drug seeking and being histrionic. In spite of this shaming treatment, she got through the inpatient detoxification and was planning to start an outpatient program the next day.
That night she went home and started experiencing severe pain. The medication she had been given did not work and she had not yet learned new ways to manage her pain. She used. She felt very ashamed and stopped quickly. The next day went in and told the treatment team what happened. They dropped her from their program.
Over the past 25 years I have seen similar scenarios many times. When a patient fails (relapses), the treatment professional “blames the victim.” Treatment professionals need to realize that it is not always the addict’s fault. Often they use again because they have not been given appropriate tools by their treatment providers. In addition, the relapse episode itself can often be a positive turning point for many recovering people if they are aided in examining the relapse episode and learning from it.
Fortunately this story has a happy ending. My patient took it upon herself to reach out and get alternative help and was able to obtain and maintain sobriety. She also learned how to effectively manage her pain without using dangerous chemicals by following an effective medication management plan.
If you want to learn more about the Addiction-Free Pain Management® System for chronic pain management please check out our website at www.addiction-free.com. to learn more about effective chronic pain management please go to our Publications page and check out my book Managing Pain and Coexisting Disorders. To look for my upcoming trainings please go to our Calendar page. If you want to read more about the type of treatment I think people deserve you can find my article The Right to Quality Chronic Pain Management that you can download for free on our Ariticles page.
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