People in recovery from addiction are often scared to take prescription pills for fear that it will “reactivate” their urges and lead to relapse. Some will go so far as to refuse opiate pain killers after major surgery. Some members of 12 Step programs even advise others to forgo medication that their doctors have recommended.
This attitude can be severely destructive. Pain slows down the healing process, and untreated pain is more likely to lead to relapse than properly treated pain. Even if your drug of choice was heroin or prescription opiates, you should not refuse appropriate, doctor-prescribed medication.
If you have severe, chronic pain, and need to take opiates for a long period of time, you may become physically dependent on them and undergo withdrawal when these medications are stopped. People often confuse physical dependence with addiction, but they are not the same thing.
Difference between Addiction and Dependence
Addiction is a compulsive use of a drug despite negative consequences. Dependence is simply needing a drug to avoid physical symptoms. If the consequences of dependence are improved health and decreased pain, it is not addiction. Most painkiller patients who become dependent do not become addicted. Don’t let fear of dependence keep you suffering. Using doctor-prescribed medication as prescribed is not a relapse.
But be aware that some people become addicted to pain killers as evidenced by a recent blog: Teen injury turns into oxycodone addiction.
Here are some tips for people in recovery on how to safely deal with severe pain using prescription pills:
1. Tell all your doctors about your history of addiction – They’ll be cautious in prescribing pain killers for you. If however, non-opiate medications are effective, don’t be afraid to speak up. If a doctor treats this as a drug seeking mission – find another doctor. If you’re in the hospital and feel that your pain medication is inadequate, ask to speak with the patient advocate or ombudsman.
2. Explore alternative methods of pain control – Some people find relief with acupuncture, massage, electrical nerve stimulation and other non-drug methods of pain treatment. They can’t hurt, and they might help, give it a try. However, don’t be afraid to admit if you aren’t getting what you need.
3. See a pain specialist – Physicians trained in pain control are much more likely to know the best way to deal with it than those who haven’t worked in this area. Some of there practices maybe the opposite of what you’d expect, and there are several new drugs in the pipeline which may offer new ways of relieving pain which non-specialists may not be aware of.
4. If you need to use opiates, try to maintain a steady level of pain relief – Research finds that people who are given opiates on demand are less likely to develop addiction than those who have to wait for medication to be given to them at a specific time. This is because if you are in pain and waiting for medication, you will start to develop a psychological association between the medication and the relief. Also, the “up and down” feeling is reminiscent of what most addicts experience on the street. If you simply stay at a steady, well-medicated level, you won’t have this situation. One way of achieving this is with a patient-operated morphine (or another opiate) pump. It sounds strange but keeping yourself comfortable is less likely to get you in trouble than waiting in pain as long as possible and then taking the drug.
5. Tell your sponsor or other recovery support people about your use of pain medications – If you’re afraid that you won’t take them as prescribed, have a sponsor or friend keep the medication for you and give it to you as needed, keeping in mind that you should try for a steady state. Ask yourself: “Am I in physical pain or do I just want distraction?” If you’re honest with yourself, you’ll know if you’re simply drug-seeking.
6. People on methadone may need higher doses of pain killers than others do – Some people wrongly assume that if you are on methadone, you feel no pain and need no pain medication. This is not true, but because of tolerance, methadone patients may need extremely high doses (which could kill others) to get the relief they need. Again, don’t be afraid to ask if you’re not comfortable.
7. If you attend support meetings, talk about how you’re feeling when you’re there – Just talking about pain sometimes helps relieve it because fear and loneliness often make pain worse. Try to attend meetings if at all possible.
8. Alcohol Anonymous has a very useful pamphlet – “The AA Member and Other Medications,” describes how members have dealt with the use of antidepressants and pain medication. If someone in the program tells you that, “You’re not sober, you have relapsed,” because you have taken pain medication, ask to see their medical license and hand them a copy of the pamphlet for the program’s official position on the issue.
The bottom-line is no one wants to see someone in recovery relapse by taking prescribed pain medication, but if managed responsibly, it can be the right decision that keeps you sober.