If you have found yourself addicted to opiates (or if you are concerned about a loved one who seems to have developed an opiate addiction), you may be familiar with the conventional wisdom surrounding addiction–that users, once they have been through detox, have as their main goal to stay free of whatever addictive substance thy were taking.
After all, opiate detox is often challenging, and once a user has been through a monitored detox, he or she will likely feel an improved sense of clarity. Ideally, a person who was formerly addicted to opiates will want to stay away from this class of drugs.
However, in the case of severe injury or other extreme pain, someone who was formerly addicted to opiates, or someone in active recovery) may find that pain medication is necessary in order to manage pain and continue to lead a functional life. For someone whose life was previously devastated by drug use, this may sound frightening. But in the face of debilitating pain, it may seem as though they are faced with an impossible conundrum.
However, because every case of addiction and pain management is different, a physician who has an understanding of your addiction history and your current pain can typically work with you to figure out a pain management plan that not only takes into account your struggles with addiction, but also helps you manage your pain so you can live a full and productive life. Because relapse during or after pain management is possible, a responsible physician will take great care to ensure that your pain is well-managed while minimizing your risk of relapse.
This is a difficult balance to achieve: over-medicating (or prescribing stronger medications) to someone in recovery may make relapse more likely. But on the other hand, under-medicating (which leaves the patient still in considerable pain) means that self-medication is more likely.
How Can You Manage Pain After Opiate Detox?
Some patients choose to manage their pain without the use of opiates at all after they have been through detox. While this is the best choice for some, for others, a combination of the severity of pain, individual pain tolerance, and activity level may mean that a plan involving opiates is preferred. Of course, a responsible physician will discuss your history with you before prescribing painkillers. Generally speaking, a doctor who is helping you manage your pain will consider the whether your pain is acute or chronic, as well as the severity of your pain.
While many patients with acute (short-term) pain will receive similar treatment regardless of whether they have a history of addiction or not, patients with chronic pain tend to be more difficult to treat. If you are suffering from chronic pain and will likely need long-term pain management plans, your physician will generally consider the following:
Using Weaker Medications
While all opiates theoretically have some addictive potential, weaker medications tend to be less addictive. Many of these drugs are unscheduled or over the counter. Particularly if your drug of choice in active addiction was a stronger opiate, your doctor may want you to start with a less strong drug. Then, if pain is still getting in the way of everyday life, you may be able to try a low dose of a something stronger, depending on your physician recommendation.
Of course, depending on your individual circumstances, a strong NSAID or other non-narcotic painkiller may be enough to manage your pain. In some cases, especially in cases of a less severe injury, your physician may suggest starting with an NSAID or other anti-inflammatory. If this does not work, a stronger medication may be indicated.
Using a Minimally Effective Dose
Because higher doses may make relapse more likely, prescribing the lowest effective dose is one way your doctor may help you manage your pain while making a relapse (or the temptation to relapse) more likely. Usually, your doctor will start you on a low dose and then increase the dose if pain is still very severe.
Tapering the Dose Periodically to Evaluate Tolerance
As those who have been addicted to them already know, opiates tend to create a tolerance in users relatively quickly. Because of this concern. if you are on a long-term pain management plan, your doctor may periodically ask you to wean off the dose to both see how much of a tolerance you’ve built and to reduce that tolerance if you have it.
Checking in With You
For patients who receive opiates as part of acute pain management, it is often essential to check in with a primary-care physician after the full course of medication has been taken. Similarly, if you are receiving opiates as part of a long-term pain-management plan, your doctor will likely check in with you periodically. It’s important to be honest about whether you are taking the medication as prescribed and about whether or not you feel worried about relapse. If you want to stay free of addiction and are concerned about relapse, be sure to talk to your doctor. He or she can then work with you to help you prevent relapse while still managing your symptoms of pain and allowing you to lead a more fulfilling life.
It’s important to remember that, because each person’s experience with pain and with addiction is different, pain management in each person with a history of addiction will be different. It may sound like an insurmountable challenge, but if pain is getting in the way of your quality of life, a pain management plan that takes into account a history of addiction may be able to get you well on your way to feeling better.
Going through opiate detox, whether for the first time or for an additional time, is often a daunting process, but by seeking information, you have taken an important first step. If you’re ready to start your journey to improved health, our trained counselors are available to help you 24 hours a day, seven days a week. Give them a call at 866-802-6848 today!