Is Prescription Drug Abuse/Addiction a Problem in Chronic Pain Management?Written By: Dr. Stephen F. Grinstead, LMFT, ACRPS, CADC-II Date: January 22nd, 2009. Topic: Member Blogs.
There has been a tremendous amount of controversy about the use of narcotics (also referred to as opiates) for long-term chronic pain management. Some sources and research say it’s not safe, others say it is safe with precautions. For the vast majority of people suffering with chronic pain, I believe long-term opiate use may be safely used with adequate precautions in most patients, but for 10 to 15% of the people, the usual precautions will not be enough.
I was very interested in a posting on www.medicalnews.com
titled “Prescription Opioid Abuse, Addiction Less Common Than Many Believe.” While some of the information was very interesting I do not agree with the way they minimize the problem. In fact, I submitted my comments (that you can read below) that I hope they will post. To read the original Medicalnews.com article please Click Here.
I do in fact agree with some of observations and findings from this article. However, I do not think their 3.3 to 3.7 percent numbers are an accurate total picture of the extent of the problem. One reason may be the way problems are screened by different pain management providers. Many of the patients I’ve dealt with over the past 26 years in pain management have a great track record of fooling healthcare professionals. Fortunately, we are getting better at detection and intervention.
The other factor I believe needs to be explored is the rate of prescription medication abuse/addiction when the patient has a personal history or family history of any addictive or mental health disorders. I have seen many research studies indicating that the problem is much higher than the rates their research found. In some studies the rates are as high as 40 percent. I myself use a conservative (for me) 10 percent estimate that includes prescription medication abuse, pseudoaddiction, or addiction.
According to researched published in Pain Physician Journal; as recently as 2006, 90 percent of people in the US receiving treatment for pain management were prescribed opiate medication. Of that number 9 percent to 41 percent had opiate abuse/addiction problems. The research also stated that 16 percent of pain management patients experienced illicit drug use along with their prescribed medication, and as high as 34 percent in other research they reviewed. These numbers give a picture of the overall problem of chronic pain abuse/addiction problems in the general population. What is harder to quantify is the extent of this problem in the recovering community.
Whenever I asked the following question at trainings, “How many of you know someone in long-term recovery who has relapsed over pain management issues?” most of the audience raises their hands. The reasons vary, but more often than not they either take the wrong medication or too much. Others try to tough the pain out and end up relapsing back to their original drug of choice.
Living with chronic pain is difficult for anyone, but especially for someone with coexisting medication abuse, addiction or other psychological disorders. They can become severely depressed and discouraged. Healthcare providers often become confused and frustrated when their treatment interventions are ineffective and frequently blame their patients.
To learn more about my views of how to address this problem, please read my article Addressing the Problem of Prescription Drug Abuse/Addiction that you can download for free on our Ariticles page.
You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are living with chronic pain, especially if you’re in recovery or believe you may have a medication problem and want to learn how to develop a plan for managing your pain and medication effectively, please go to our Publications page and check out my book the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.
To listen to a radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.
To read the latest issue of Chronic Pain Solutions Newsletter please Click here. If you want to sign up for the newsletter, please Click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.
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