Pain clinics are health care facilities designed to treat ongoing chronic pain. The clinics often take a multi-faceted approach that includes psychological counseling, holistic treatments, physical therapies and medication, and the doctors present the pros and cons of surgery as appropriate.
The American Board of Pain Medicine notes that pain physicians also look at occupational, behavioral and social issues to assess the sources and triggers for the pain. For many patients, the clinics administer prescription pain relievers, including opioid-based medications like oxycodone, hydrocodone, morphine and methadone. This presents clinics with a particular challenge as the extended use of narcotic painkillers can result in physical dependence and addiction. Pain clinic doctors monitor the pain medication use, but people develop addictions at different rates, so an addiction can take hold despite the best intentions.
Chronic Pain Statistics
There are several statistics compiled on the American Academy of Pain Medicine (AAPM) website, including the following:
- Upwards of 100 million Americans suffer from chronic pain
- The leading disability for Americans under the age of 45 is back pain
- Frequent back pain afflicts 26 million Americans between the ages of 20 and 64
- 51% of people who suffer from pain feel they have little or no control over it
A 2006 report by National Institute of Health Statistics provides data on the most common types of pain, which include the following:
- 27% of the pain occurs in the lower back
- 15% involves severe headaches or migraines
- 15% occurs in the neck and 4% in the face
“Voices of Chronic Pain,” an American Pain Foundation survey published in 2006, provides even more key statistics on chronic pain, including the following:
- 96% of opioid-using chronic pain patients suffer from lower back pain
- Other leading ailments included joint pain (90%), muscle pain (88%) and arthritis (82%)
- 91% of opioid-using patients reported severe pain (led by fibromyalgia at 75%)
- Chronic headache or migraine sufferers lived with the pain for an average of 16 years
- The most important concern for 96% of the respondents was severe flashes of pain
The survey also found that the average patient takes prescription medication 18.3 times per week, and the most commonly used pain medications include Vicodin (44%), Percocet (18%) and OxyContin (16%).
Painkiller Addiction and Dependence
In a 2009 edition of The Journal of Pain, experts from the American Pain Society (APS) and the AAPM published a comprehensive guideline for opioid-use in chronic pain management. The guide issues several recommendations, including the following:
- Diligent opioid-use monitoring such as pill counts, drug tests and caregiver interviews
- Limit or avoid the use of methadone in treating breakthrough and as-needed pain
- Opioid therapies must be stopped for patients diverting medication or acting aberrantly
- Patients on high doses require ongoing evaluations to check for adverse effects
- Patients should be educated on opioid-related impairments and risks
The authors highlighted the adverse harm, risks and outcomes that can occur from ongoing opioid use. In many cases, unintended addictions and dependencies develop during the normal course of pain management. In 2012, the Pain Physician journal presented data on the importance of the guidelines and oversight, including the following:
- One-third of chronic pain patients might be abusing their opioid medication
- The rates of illicit drug use are significantly higher with these patients
- Opioid prescriptions appear to be rapidly increasing primarily from non-pain physicians
- The majority of opioid-related fatalities involve increased supply, higher dosage, doctor shopping and patients with multiple conditions
Alarmingly, the study also suggested that 60% of the opioid-related fatalities might occur during use within the aforementioned guidelines.
Prescription Drug Addiction Treatment
If an opioid addiction develops, treatment plans are largely determined by the patient’s pain profile. For example, end-of-life situations might call for different strategies than for an otherwise healthy person with chronic pain. Regardless, there are several treatments commonly associated with opioid addiction care, including the following:
- Tapered withdrawal that gradually weans the opioids out of the system
- Screenings and integrated treatment for any concurrent mental health disorders
- Behavioral therapies that encourage healthier mental and emotional activity
- Counseling to identify internal and external cues that trigger opioid cravings
- Group therapy to discuss coping mechanisms and develop support networks
Treatment centers also collaborate with the pain clinic to provide ongoing pain management that does not involve narcotic medications.
Non-Opioid Pain Management
Most pain clinics and many addiction centers are equipped to provide non-opioid pain management, and these treatments are often good options for recovering addicts. There are a variety of pain-relief treatments available to recovering addicts, including the following:
- Injections to provide local anesthesia to relieve pain and swelling
- Targeted exercise and deep-muscle massage to increase body function
- Aquatic therapies such as hot tubs and low-impact, water-based activities
- Electrical stimulation to treat the nerve fibers associated with the pain
- Holistic treatments such as hypnosis, yoga, meditation and breathing exercises
- Eastern practices like acupressure and needles-based acupuncture
If opioids are absolutely necessary, buprenorphine and methadone provide long-lasting relief without the euphoric effects that commonly trigger a relapse. However, due to their long half-lives, these drugs are also associated with a growing number of opioid-related overdose deaths.
Pain and Addiction Help
Ongoing chronic pain should never prevent a person from getting treatment for painkiller addiction. Our admissions coordinators can discuss options for people who suffer from pain and addiction, and we can even check health insurance policies for treatment benefits. We are available 24 hours a day so please call our toll-free helpline now.