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Frequently Asked Questions About Pain Management

 

What is non-addictive pain management?

Non-addictive pain management empowers you to live pain free, without worrying about the risk of dependency or addiction. Usually it involves non-invasive treatments such as injections, nerve blocks, and other advanced procedures that are highly effective in treating chronic pain and – depending on the type of treatment delivered – can stay effective for months or even years at a time.

Other forms of non-addictive pain management include therapeutic massage, physical therapy, acupuncture, and other complementary medicine disciplines.

Addressing your emotional and psychological well-being are essential components of managing chronic pain. Our beliefs about ourselves and the things we tell ourselves throughout the day have a profound impact on how we experience and cope with our pain, and even affect the intensity of our suffering. In order to effectively and safely manage chronic pain without increasing the risk for dependency and addiction, we must address the whole person, providing both physical as well as emotional, mental, and psychological support and care.

Do you prescribe potentially addictive prescription drugs?

Yes, when appropriate and after a comprehensive evaluation. There are many situations where prescribing an opiate or other potentially addictive medication is completely appropriate and necessary. As doctors specializing in the treatment of both chronic pain and addiction, we carefully monitor our patients, assess the risks, benefits, and alternatives of every treatment, including prescribing potentially addictive medicines, and are responsible in the manner in which we prescribe any medication. Our goal is to compassionately help our patients change their relationship with pain, improve their functioning and participation in the enjoyment of life, while minimizing the risks for addiction and dependency, which can destroy lives and families.

As patients, it is important to understand the potential risks of any medication you take – prescribed or otherwise – and to be constantly on the alert for side effects, physical or mental impairment, as well as dependency or addiction signs or symptoms. Communication with your physician is imperative.

All medicine, including opioids and other habit-forming medications, can be very effective and beneficial when used appropriately, responsibly, and with a clear understanding of the risks and the benefits. Your health and wellness is a partnership with your healthcare team. Stay educated. Ask questions. Consider the possibility that there are many options to effectively manage pain other than just pills. Working together, we can help you rebuild your life.

What is chronic pain?

“While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap — sprained back, serious infection, or there may be an ongoing cause of pain — arthritis, cancer, ear infection, but some people suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system). A person may have two or more co-existing chronic pain conditions. Such conditions can include chronic fatigue syndrome, endometriosis, fibromyalgia, inflammatory bowel disease, interstitial cystitis, temporomandibular joint dysfunction, and vulvodynia. It is not known whether these disorders share a common cause.”

Source: National Institute of Neurological Disorders and Stroke (NINDS)

How can pain impact your life?

“When pain becomes such a problem that it interferes with life’s work and normal activities, a person may become the victim of a vicious circle. Pain may cause a person to become preoccupied with the pain, depressed, and irritable. Depression and irritability often leads to insomnia and weariness, leading to more irritability, depression, and pain. This state is called the “terrible triad” of suffering, sleeplessness, and sadness. The urge to stop the pain can make some people drug-dependent, and may drive others to have repeated surgeries, or resort to questionable treatments. The situation can often be as hard on the family as it is on the person suffering with the pain.”

Source: Ohio State University, Wexner Medical Center

What is addiction?

Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her. Although the initial decision to take drugs is voluntary for most people, the brain changes that occur over time challenge an addicted person’s self control and hamper his or her ability to resist intense impulses to take drugs.

Fortunately, treatments are available to help people counter addiction’s powerful disruptive effects. Research shows that combining addiction treatment medications with behavioral therapy is the best way to ensure success for most patients.Treatment approaches that are tailored to each patient’s drug abuse patterns and any co-occurring medical, psychiatric, and social problems can lead to sustained recovery and a life without drug abuse.

Similar to other chronic, relapsing diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed successfully. And as with other chronic diseases, it is not uncommon for a person to relapse and begin abusing drugs again. Relapse, however, does not signal treatment failure—rather, it indicates that treatment should be reinstated or adjusted or that an alternative treatment is needed to help the individual regain control and recover.

Source: The National Institute on Drug Abuse 

“Addiction is the search for emotional satisfaction—for a sense of security, a sense of being loved, even a sense of control over life. But the gratification is temporary and illusory, and the behavior results instead in greater self-disgust, reduced psychological security, and poorer coping ability. That’s what all addictions have in common.”

Source: Stanton Peele, Ph.D., J.D., Psycholoy Today

What prescription drugs are addictive?

Because of their mind-altering properties, the most commonly abused prescription drugs are:

  • Opioids, such as oxycodone (Oxycontin) and those containing hydrocodone (Vicodin), used to treat pain
  • Anti-anxiety medications and sedatives, such as alprazolam (Xanax) and diazepam (Valium), used to treat anxiety
  • Muscle relaxants, such as Soma, Flexeril, Robaxin, Skelaxin, and Xanaflex
  • Sleep medicines, such as zolpidem (Ambien), used to treat sleep disorders
  • Stimulants, such as methylphenidate (Ritalin), used to treat ADHD and certain sleep disorders

Source: The Mayo Clinic

What is dependency?

Substance dependence is the medical term used to describe abuse of drugs or alcohol that continues, even when significant problems related to their use have developed.

Signs of dependence include:

  • Tolerance to or need for increased amounts of the drug to get an effect
  • Withdrawal symptoms that happen if you decrease or stop using the drug that you find difficult to cut down or quit
  • Spending a lot of time to obtain, use, and recover from the effects of using drugs
  • Withdrawal from social and recreational activities
  • Continued use of the drug even though you are aware of the physical, psychological, and family or social problems that are caused by your ongoing drug abuse

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