When pain management turns into addiction

From professional athletes dealing with aftereffects of concussions and injuries to grandparents recovering from surgery, anyone who watches the news today knows opioid addiction is not limited to celebrities and the homeless. It’s a national epidemic affecting every age and socioeconomic group.

In June of 2017, Governor Ducey declared a state of emergency in Arizona regarding the opioid addiction problem. In the article, the Governor states, “Most of us know someone impacted by substance abuse — our family, our friends, our neighbors. Our hearts ache for them, but that isn’t enough. We must do more.”

In 2016, 790 Arizonans died from opioid overdoses, according to data from the Arizona Department of Health Services. The trend shows an increase of 74 percent over the past four years, reminding all of us that the opioid crisis is still a real threat to our community.

From pain to addiction

Many people begin by using prescribed narcotics to manage pain. Eventually, they develop a dependency that can take over and destroy normal life functions.

Some patients are afraid to discuss their problems with a doctor because they worry the doctor will tell someone or they fear being cut off from the medication they depend on. But people should know, patients with addiction problems are still protected by doctor/patient privilege and many pain management doctors are experts in tapering medications to keep patients safe.

Some of the things you should ask when working with your pain management Doctor include:

• Am I taking any medications other than my opiate pain killer, that when combined with the opiate may increase my risk of an adverse reaction or death?
  • You should not combine any drug in the benzodiazepine class with an opiate – it dramatically increased the chance of death. That class of drugs includes most antidepressants, anti-anxiety, and sleeping pills. 
• Am I taking the best medication in the best form to minimize my opiate dosage?
  
• Is it possible that I do not respond to certain medications like most other people?
  • Some people cannot properly metabolize the pain killers into the form of the drug that actually provides the pain relief. The only way to find out is to have a genetic screen performed that will help the doctor determine the right drug to prescribe.
• How can I safely wean down or completely off my opiate medications?

Signs to watch for

For many, addiction sneaks up slowly and remains unnoticed until it’s too late. Some addiction symptoms to watch for include drowsiness, lack of motivation, inability to concentrate, loss of friendships and healthy lifestyle habits and secrecy from trying to live a double life.

There can also be appearance changes such as pupils staying constricted even with dim lighting; itching of the arms, stomach or legs; drooping eyes; flushing of the face and neck; head nodding; intense calm; and slurred speech.

Many patients fear withdrawal symptoms such as vomiting and diarrhea, joint pain, flu-like feelings and severe insomnia. The thought of dealing with pain and withdrawal symptoms at the same time can be overwhelming for many patients and should only be done under the care of a medical professional.

Overcoming addiction

Opioid addiction is a chronic medical condition that results from changes in the brain in susceptible people. Once narcotic addiction develops, escaping the cycle of detox and relapse is typically a long-term process. Certain medications, counseling, and support from friends and family can greatly improve the chances of success.

A popular misconception is that by taking drugs used to treat narcotic addiction like methadone, buprenorphine or naloxone, addicts simply replace one addiction with another, reports the National Institute on Drug Abuse. That is inaccurate. Brain imbalances that occur with addiction alter reward, decision-making, impulse control, learning and other functions. The medications restore balance to these brain circuits, preventing withdrawal symptoms and restoring the patient to a normal condition that allows effective psychosocial treatment and social functioning.

Support system necessary

In addition to medication and counseling, recovery works best for people who have a support system like narcotics anonymous, family help and a medical team that is truly invested in helping patients get (and stay) healthy.

If you think you might have a dependence on pain medication or spot some of these signs in a loved one, a good first step is to talk with your doctor or a medical professional with expertise in pain medication addiction about getting help. Unfortunately, trying to overcome addiction on your own can be dangerous and unsuccessful. By working with a credible pain management doctor from the beginning, you can avoid the risk of addiction altogether.

Dr. Alex Bigham is the owner and CEO of Novocur Pain Management Clinics and has over 18 years of healthcare experience in private practice and Ambulatory Surgical Center settings. Novocur offers advanced treatment options in a concierge type practice without the concierge price tag. Dr. Bigham appears frequently on local TV and radio programs to discuss the latest in Pain Management or related health topics.