Opiates and Chronic Pain Management
According to researched published in Pain Physician Journal (2006), 90 percent of people in the US receiving treatment for pain management are prescribed opiate medication. Of that number 9 percent to 41 percent had opiate abuse/addiction problems. It is important to remember that for people with a genetic or personal history of an addictive disorder, any psychoactive medication could be problematic. Unfortunately, there may be times when opiate (or opioid) medication management is needed, but there are risks. Please see the information below.
Risks of Opioid Medication Management
- Opioids have been shown to effectively reduce cancer and acute pain conditions and they can also share a role in the management of chronic pain.
- Opioids may be inappropriate for patients with substance use disorders or a history of those problems. If any psychoactive medications are used, providers must take special precautions.
- Concerns about side effects, such as functional impairment and physical inactivity, as well as concerns about physical or psychological dependence, must be taken into consideration when using Opioids for chronic pain management.
- Physical dependence is a physiological adaptation to a substance, defined by a growing tolerance for its effects and/or withdrawal symptoms when use is reduced or ends.
- Psychological dependence (often called addiction) is a primary, chronic, neurobiological disease with genetic, psychosocial, and environmental factors influencing its development and manifestations.
- Psychological dependence may occur with or without physical dependence and is conceptually characterized by impaired control over drug use, compulsive use, continued use despite harm, and craving for the psychic effects of the drug.
- What appears to be psychological dependence may be due to pain that is under treated. This is also known as Pseudoaddiction.
If you want to learn more about potential medication problems with chronic pain management please check out our website at www.addiction-free.com and go to our Publications page to check out my APM Module Two: Examining Your Potential Medication Management Problems that includes a Red Flags checklist for prescription medication problems. You can also check out our Ariticles page to download my free articles including Managing Pain Medication in Recovery.
October 30th, 2008 at 12:42 am
Most chronic pain is neuropathic. The opioids against many forms of chronic pain—like back pain, osteoarthritis, and recurring muscle pain. Opioids are the current standard of care for the treatment of moderate or severe nociceptive pain.Successful pain treatment and symptom management is an attainable goal for the majority of patients with chronic pain. Further controlled clinical trials are needed to define the role of opioid therapy in chronic non-cancer pain, and to establish criteria for patient selection and specific treatment algorithms.
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Sally
Drug Rehabilitation Programs
October 30th, 2008 at 3:40 am
Sally,
Thank you for your comments.
I agree that further research is needed to establish effective criteria to determine the role and safety of using opiates for chronic conditions. I also know that if people have family history or personal history of addiction or have any unresolved trauma or other psychological conditions that chronic opiate use can be very problematic. I have had many patients over the years on low amounts of opiates for long periods of time without any problems.
Dr. Stephen F. Grinstead