Pain Management Information

Pain Management

People who have become dependent on alcohol or drugs may present with a range of acute and chronic pain conditions, which can include: backache, headaches, toothache or acute abdominal pain. Analgesic medications, prescribed for pain relief can play an important role in the treatment of pain especially acute pain although it is important to bear in mind that the management of pain and in particular the management of chronic pain, involves more than the prescribing of medication. 

It is important that you make your doctor aware of your addiction history and become willing to try treatments for chronic pain that are not opiate analgesics.

One group of analgesics, the opioid compounds are natural or synthetic derivatives of opium. These medications include: codeine, various combinations of codeine and paracetamol, dihydrocodeine, oxycontin (more often prescribed for severe chronic pain) and tramadol. Dependence has been described with all these drugs. People who are chemically dependent are particularly at risk of becoming addicted to opiate based analgesics.  

Indeed some patients admitted to Smarmore Castle Private Clinic have already become physically dependent on pain killers and /or addicted to these drugs. Addiction is characterised by compulsive drug seeking behaviour, a core symptom of dependence and this can sometimes lead to the inappropriate seeking of pain relieving medications.

In more general terms however those with a diagnosis of drug dependence must be aware of the inherent addictive potential of all these drugs. Opioids are strongly reinforcing drugs and must be prescribed with care to someone who is chemically dependent. Even people who are not already chemically dependent but are emotionally vulnerable are at risk of becoming addicted to pain killers.

Certain conditions which are organic, remitting and often terminal cause prolonged suffering. Here it is reasonable to try non-opiate drugs first although ultimately these patients may require opiate medications.

Most people who are suffering from alcohol and drug dependence and also experiencing chronic pain should be considered for other medications for the treatment of pain, such as paracetamol, aspirin and non steroidal anti inflammatory drugs (NSAIDs) such as ibuprofen. Some of the more recent NSAIDs have fewer effects on the gastro-intestinal tract and are often prescribed for those who are at risk of bleeding from the stomach or other parts of the gastro-intestinal tract.

All people who are striving for abstinent based recovery need to be most careful about the taking of pain killers other than simple analgesics. 

There are also medications which may be used to treat certain types of pain and which are not opiate drugs. These include anticonvulsants and very small amounts of amitriptyline, an anti depressant. 

Complementary Therapies

These may also be considered and are strongly encouraged as alternatives to opiate based medications. Such techniques include:

  • acupuncture,
  • massage therapy, 
  • physiotherapy,
  • aromatherapy,
  • yoga,
  • meditation,
  • cognitive behavioural therapy.

The application of relaxation techniques also plays an important role in the management of chronic pain.

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