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Chronic Pain

Chronic Pain and Addiction

Research has shown that more than 50 million Americans suffer from various types of chronic pain . Joint pain, back pain and headaches appear to be the most common causes of chronic pain. Chronic pain can take a huge toll on the individual, preventing them from working, playing or even socializing.
In many cases, the person with chronic pain suffers from some form of depression as their quality of life continues to deteriorate. Many people fear that the only solution to relieve their chronic pain lies in taking opiates or medication for chronic pain treatment(which they might end up addicted to).

Definition of Chronic Pain

Pain is best described as a signal to the individual that tissue damage has occurred or may be occurring. Pain can be acute or chronic, with acute pain lasting a short time.. The time frame may be as brief as seconds or as long as a few weeks. Chronic pain however, is defined as pain that lasts beyond the healing of an injury, continues for a period of several months or longer, or occurs frequently for months on end.

To develop the most effective treatment, health care professionals also classify pain based on its characteristics, its cause, or the mechanisms in the body or the mind that are probably involved in sustaining it. During this process a person’s pain usually falls into several categories which are referred to as “nociceptive”, “neuropathic”, and “psychogenic.”

Types of Pain

  1. Nociceptive Pain:
    We believe nociceptive pain to be caused by the ongoing activation of pain receptors in either the surface or deep tissues of the body. Two types of nociceptive pain have been identified:

    1. Somatic Pain
      Somatic Pain is generally caused by an injury to the skin, muscles, bone, joint or connective tissues. Deep somatic pain is usually experienced as either dull or aching and described as localized in one area. Somatic pain that results from an injury to the skin or tissues just below, is often sharper in feeling and people report a burning or prickly sensation.
      Somatic pain can often involve the inflammation of injured tissue. Inflammation is a normal response of the body to injury and is considered essential for the healing process to take place. Inflammation, however, that does not disappear within a reasonable period of time can result in a chronic and painful disease.
    2. Visceral Pain
      Visceral pain is best described as the pain that originates from ongoing injury to the internal organs or tissues that support them. When the injured tissue is a hollow structure in the body, the pain is often poorly localized and causing painful cramping. When the injured structure is not a hollow organ, the pain may be pressure-like, deep and stabbing and possibly easier to recognize.
  2. Neuropathic Pain:
    Neuropathic pain is believed to be caused by modifications found in the central nervous system that sustain pain even after an injury heals. In most cases, the injury that initiates the pain involves the peripheral nerves or the central nervous system itself. It can be associated with trauma or with many different types of disease. There are a number of neuropathic pain syndromes, including diabetic neuropathy, trigeminal neuralgia, postherpetic neuralgia (“shingles”), post-stroke pain, and complex regional pain. People who experience neuropathic pain describe it as a strange pain, which feels like electricity running through the area or creates a burning sensation.
  3. Psychogenic Pain:
    Most patients with chronic pain have experienced some degree of emotional upheaval. These emotions, including depression or anxiety, can create situations that are difficult for a person to deal with. Emotional distress may not only be a consequence of the pain, but may also contribute to the pain itself. Psychogenic pain is best explained by the pain that results from a person’s psychological problems.

Pain Medication and Opioid: Addiction versus Physical Dependence

Addiction is defined by the American Pain Society as a pattern of compulsive drug use characterized by a continued craving for an opioid and the need to use the opioid for effects other than pain relief. Addiction is characterized by the presence of:

  • Loss of control or compulsive drug use.
  • Continual drug use in spite of adverse consequences.
  • An obsession or preoccupation with obtaining and using the drug.

As a person’s addiction continues to progress, their life becomes more and more unmanageable. The acquisition and use of drugs is the addict’s number one priority. Relationships with loved ones begin to deteriorate; the person begins to miss work and is less productive when there. In addition there is a noticeable gradual decline in social activities. Another characteristic of addiction is the creation of a tolerance, which means more of the drug is needed to achieve the same effect.

Physical dependence has absolutely nothing to do with addiction.

A person who has developed a physical dependence to drugs will experience symptoms of withdrawal if the drug is abruptly discontinued. Even If a person is taking opioids over a continuous period of time and taking them as prescribed, a physical dependency is still expected to occur. This does not mean the person is considered addicted.

It is important to note that the use of opioids is usually the last option a physician has. Most people have already tried physical therapy, TENS unit, NSDID’s, local anesthetic injections, biofeedback, hypnosis, muscle relaxants or in some cases, even surgery. When everything else has been tried and failed to adequately relieve the pain, the physician can prescribe opioids.

Opioids of Choice:

  • Methadone
  • OxyContin
  • Hydrocodone
  • Codeine
  • Vicodin
  • Percodan
  • Percocet
  • Dilaudid
  • Lorcet
  • Fentanyl

These medications are rarely taken alone. They are usually taken in conjunction with aspirin, anti-inflammatory drugs, antidepressants, muscle relaxers and other medications.

Avoiding Withdrawal from Opioids

Most people who have been taking opioids for the treatment of chronic pain have been doing so on a continuous basis and for a prolonged period of time. This could indicate a physical dependency on the medication. If someone has become physically dependent and abruptly discontinues the use of opioids, withdrawal symptoms are unavoidable. The good news is that under proper medical supervision the symptoms associated with withdrawal are manageable and can be greatly reduced.

To effectively manage the symptoms associated with discontinuing the use of opioids, it is suggested that your physician be notified and an assessment be completed by one of many addiction treatment centers, specializing in the detox of opioids. At Soba Detox, a person’s symptoms are effectively managed by independent physicians specializing in addiction medicine. In addition, the person is provided the emotional support they may require as they begin to experience feelings and emotions, drug free.

Abruptly discontinuing the use of prescription medication or opioids for chronic pain could be life threatening. At Club Soba Detox one of our independent physicians can design an individualized detoxification protocol to assist in detox of opioids.

Soba Living is licensed by the California Department of Alcohol and Drug Programs