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Chronic Pain and Addiction

Not surprisingly, people who suffer from chronic pain may experience judgment regarding their condition or medication prescriptions. I’ve had some clients tell me they hate going to the emergency department because they feel like the staff assumes they are seeking drugs, rather than experiencing real, valid pain. Other clients mentioned they’ve lost friendships just because they are prescribed OxyContin, a type of opioid.

There is now a stigma when it comes to pain medication. But why? With the opioid crisis in full swing, we have all read horror stories about overdoses and death related to painkillers. Addiction has a negative connotation because when people are addicted to substances, they may be more likely to engage in hurtful and destructive behaviors (for example, stealing or lying).

But how does someone who is prescribed pain medication become addicted? Do they wake up one morning and realize they are addicted to their medications? Or is it more insidious than that? And, if someone becomes addicted, what can they do about it?

How do people become addicted to their medications?

This is a tough question. There is no single way people typically become addicted. Some medical providers simply over-prescribe.  Other people become addicted to medications after a surgery.

So, how does the mind and body become addicted? Here is an example: imagine your daily routine. You wake-up in the morning, brush your teeth, and the first thing you do is go to the kitchen for a cup of coffee. This is behavioral. It is habit. You need a cup of coffee to get through the day (or at least you think you do). This is how anyone can become psychologically addicted to medications too. It becomes habit to take pills that help you feel better, and we develop a belief system that we can’t function without them.

Then, there is the physical component. Unfortunately, the body can develop a tolerance to certain medications (Volkow & Koroshetz, 2017). When this occurs, the dose of medication no longer addresses the pain and more is required to feel an effect. Therefore, some patients take more medication than prescribed.

How do I know if I’m addicted to medications?

There are several red flags that generally occur when people cannot stop taking their medications. They may need to take more than prescribed (and then run out at the end of the month). I’ve observed people “doctor shop” or go to the emergency department to have additional medications available. Or, one is spending a great deal of time thinking about their medications (having enough, taking them, following a dosing schedule, etc.). Other signs may include changes in memory, irritability, anger, worry, or increased conflicts with loved ones.

What do I do if I think I’m addicted to my medications?

If you have concerns or have noticed that you are not taking your medications as prescribed, there are a couple of options.

  • You can purchase a locking alarm pill box that will only distribute the medication at a certain time
  • Ask a partner or loved one to distribute the medications for you, assuming they are trustworthy and willing to help.

If you have a concern that you may be addicted to your medications, first speak with your doctor. A doctor may be able to work with you on a treatment plan. Furthermore, intensive inpatient or outpatient treatment programs can help you through detoxing off your medications and starting your recovery journey.

Chronic pain can be a debilitating medical condition. It can also be difficult to diagnose and treat. With so many complications and complexities, it is no wonder that those who suffer from chronic pain are at risk of developing an addiction. If you or anyone you know is in this position, please consider seeking out a behavioral and mental health professional who can provide evidence-based treatments.

By Yvonne DelZenero, Ph.D.