A man with face in hands, screaming in a field. Pain management in Addiction recovery.

Managing Pain in Addiction Recovery

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You Do Have Options—Effective Ones, Too!

I was diagnosed with ulcerative colitis in my early 20s. I had no idea that not only would I have to learn how to manage stress, but I was also in for an uncomfortable surprise: the pain. Ulcerative colitis (UC) is a type of inflammatory bowel disease, similar to Crohn’s disease. It can be quite painful.

When a person suffering from UC goes into a flare, the mucosal layer of the colon becomes inflamed. I’ll spare you the gory details (I guarantee, they’re not pretty). But the one facet you need to comprehend is how uncomfortable the abdominal cramping can be.

Unfortunately, at the time I was diagnosed, there weren’t many options for dealing with the pain. UC became my ticket to receiving opioid painkillers. From oxys to hydros to Demerol, all I had to do was to go to the clinic and ask for them. Other than reaffirming my diagnosis, they generally asked few questions. Soon I was faking my symptoms and doctor-shopping for drugs, even when I wasn’t experiencing any pain at all.

“I have had to learn how to deal with the occasional pain of my chronic illness without painkillers.”

After falling hard in addiction, I finally achieved freedom in sobriety with all the gifts this life provides. However, I’ve had to learn to deal with the occasional pain of my chronic illness without painkillers. I need to fess up to something. At first I panicked at the concept of living without my crutch, especially when I knew the pain would inevitably resurface in a flare. But I discovered that I had other alternatives; life was not, in fact, over.

The good news is that—depending on the type of pain and the care needed to be able to function on a day-to-day basis—anyone in recovery now has multiple options.

The kind of pain matters.

Although pain is pain (the receptors are essentially the same in every part of your body) the intensity of pain and how it is perceived do make a difference. Here’s a partial list of the types of pain that exist:

  • Acute pain begins suddenly and is short-term. It’s often referred to as “sharp”, and two examples are a sports injury or a migraine headache.

  • Chronic pain lasts for a longer period of time. It may affect different systems in the body or spread to different regions.

  • Breakthrough pain comes about when the pain management (such as painkillers) is no longer working or wears off.

  • Soft tissue pain happens when soft tissues become damaged or inflamed.

  • Nerve pain happens when a nerve is damaged. One example is sciatica.

  • Ischemic pain is the chest pain a patient feels during a heart attack, and sometimes after.

  • Referred pain is when pain may be perceived in another part of the body, but its origin is actually in another.

  • Phantom pain comes when a part of the body (such as a limb) is removed and the pain breaks through.

  • Total pain is defined as the emotional, physical, and spiritual factors that adversely complicate a full recovery from pain.

The type of pain matters, because different treatments work more or less effectively depending on the type of pain that exists. Pain management is a medical plan to deal with a person’s particular needs, so they can adapt to live a full life as possible. One aspect of pain management can be setting a plan with an online recovery coach to get your life on track.

But there’s more to know! Read on.

Pain management comes in various forms.

Opiate-based painkillers were an enormous improvement over what used to exist, which was well … nothing. Get your leg sliced off in a medieval sword fight? Too bad. Even though opium has been around a long time, it wasn’t distributed widely in Europe in the Middle Ages. By the early 1800s, it had become available in the West and scientists had isolated the alkaloid morphine from the opium poppy plant. This radically changed the way pain was managed in medicine.

Nevertheless, the dangers of morphine also became widely known. The biggest of these was addiction. Nowadays, painkiller usage has exploded to deal with all sorts of pain. In many cases, the potential for habit-forming, life-destructive behavior is inevitable.

“Although opioid painkillers won’t be disappearing any time soon, it’s important to realize that this class of medication is not all there is to dealing with pain!”

Although opioid painkillers won’t be disappearing any time soon, it’s important to realize that this class of medication is not all there is to dealing with pain! In fact, some treatments and non-opioid-based pharmaceuticals are more effective than morphine with certain types of pain, and without all the dangers.

Any person experiencing consistent pain should always consult a physician. Before beginning any pain-management regimen, first go to the professionals. Honestly (and openly) assess what your options are. There are two kinds of pain management under the supervision of professionals. A person has options: Western medicine, and non-traditional or holistic therapies.

Recommending which treatment to seek is beyond the scope of this blog post. In spite of that, here is an incomplete list of some forms of non-opioid-based pain management (both Western and alternative therapies):

  • Non-opioid painkillers, such as the NSAIDS acetaminophen, ibuprofen, and aspirin.

  • Selective anticonvulsants, such as gabapentin for peripheral or perceived pain.

  • Antidepressants for total pain and dealing with adaptive learning.

  • Topical agents, like capsaicin for muscle pain.

  • Meditation and group therapy to manage on a day-to-day basis.

  • Multi-modal or multidisciplinary approaches to pain management, such as CBT.

  • TENS (transcutaneous electrical nerve stimulation) with medical devices.

You’re not alone.

When you’re in pain, you don’t really care about anything but making it stop. But the risk with opioid painkillers often supersedes any short-term benefit they may offer. Still, there are times when the use of synthetic, opioid-like medications will be appropriate, such as with surgery or end-stage cancer.

“As a person in recovery, you need first to be honest with yourself. Are you asking for pain control to get away from the pain, or really just because you want to get off?”

No one is suggesting that a person needs to be callously refused when the pain is excruciating. The important point is that, as a person in recovery, you need first to be honest with yourself. Are you asking for pain control to get away from the pain, or really just because you want to get off?

With the management options out there, you can be assured to live a full, happy life. All you need to do is to begin the process to get your life back. It’s not a scary as you might think.

Ultimately, all pain is perception. You do have a choice whether to let it rule you. And you have the final say in how it affects you in the core of who you are as a human being.

Daniel D. Maurer is a freelance writer, an award-winning Hazelden author, and a public speaker on recovery from addiction. He lives with his family in St. Paul, Minnesota.

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