Have an injury, need surgery, or are facing chronic pain that interferes with your daily life. You need treatment for your pain. But you also have a history of opioid or narcotic addiction and you’re not sure how you’ll handle pain medication.
Opioids are medicines that relax the brain and relieve pain. They are also highly addictive. Although doctors are prescribing them less frequently than before, they are still a common choice for pain control. In 2019, more than 150 million prescriptions were written in the US for opioid medications such as:
A history of opioid misuse can make it difficult to control pain, and not just because of the risk of addiction, says Trent Emerick, MD, director of the pain medicine fellowship program at the University of Pittsburgh Pain Medicine Program. /UPMC.
“Yes, there are more inherent dangers, like taking a medication that can trigger cravings you’ve worked so hard to avoid during recovery,” he says. But past opioid abuse also means you have a higher tolerance for drugs and a lower tolerance for pain.
“Whether on prescription opioids or not, you need to have good pain control, or even better pain control than other people who have never taken opioids before,” he says. “No treat the pain and trying to deal with it on your own is probably the biggest risk of all.”
Science shows that taking opioids for more than 3 days increases the risk of dependence. Talk to your doctor to find out if another type of treatment might work just as well or better for your pain. Some alternatives include:
Non-prescription pain medications. Research shows that a combination of ibuprofen and paracetamol it is as effective in controlling pain as opioids.
“I can’t say it enough: if you need a pharmaceutical treatment for pain after a procedure, for example, chances are good that Tylenol and ibuprofen will take care of that,” says Tildabeth Doscher, MD. She is director of addiction medicine fellowships at the University at Buffalo.
Physical therapy. A physical therapist can work with you to create an exercise program to improve your movement and function and decrease your pain. They can also give you access to other useful tools, such as whirlpool baths, ultrasound, and deep muscle massage. massage.
Acupuncture. In this practice, a trained acupuncturist inserts small, thin needles into different places on your fur interrupt certain pain signals.
Vaccines or nerve blocks. For muscle spasms either neuralgiainjections with local anesthetics or other medications can help reduce pain.
Psychological help. cognitive behavioral therapy it can help “re-educate” your brain’s perception of pain.
“Pain psychology services are a huge and growing field in the world of pain management, specifically for patients who have a history of chronic pain or opioid addiction or abuse after surgery,” says Emerick.
“If you can make a televisit or a face-to-face visit once or twice to talk to a psychologist, it can often help…reset your frame of mind so you can say to yourself, ‘Okay, I can get through this.’ ”
In some cases, you and your doctor may decide that opioids are the best way to control your pain. To decrease both your pain and your risk of dependency:
- Be honest about your addiction history. Have an honest talk with your doctor at the first opportunity you get. “You want to make it very clear to your providers that this is a problem, and that includes mentioning any family history, as addiction is a hereditary disease,” Doscher says.
- Understand your pain management goals. While it’s important to address pain that interferes with your daily life, don’t expect zero pain, Doscher says. “This idea that we have to be pain free is very unique to Americans, but it’s false,” he says. “It’s an important symptom that tells our body what we can and can’t do.”
- Face your fears. If you are afraid of pain, you will probably feel it more intensely. When you recognize that you’re going to feel some discomfort, you can help your body better handle it, Doscher says.
- Be your own advocate. Make sure your doctor knows your comfort level with the medication and set limits that feel right to you. “You can tell your doctor, ‘I want the minimum dose and no more than 3 days. Also, please don’t fill it back for me because this is a problem I’ve had in the past,’” Doscher says.
Your doctor should be able to guide you along the path of pain control that feels right for you, says Emerick.
“I see patients who come in with a history of opioid misuse and never want to touch them again, so we came up with a plan to avoid opioids,” he says. “Other patients are not as worried about a relapse and are more than willing to try opioids as long as they are closely supervised.”
Even in some critical situations, such as a traumatic injury, there are ways to reduce the risk of addiction.
“With life-threatening emergencies, we may turn to intravenous or intramuscular opioids instead of oral options,” Doscher says. “That way, the risk of overtaking them is zero. We just don’t want to flip that switch again.”
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