addiction pain management

Addiction To Pain Killers

pain

 

WHAT ABOUT PAIN

I have been in a lot of pain in the past 24 hours. As a runner, I have the privilege of experiencing a myriad of physical aliments associated with running on pavement (with the wrong shoes). First bursitis in my hip and now shin splints. Last night, I couldn’t run. My shins hurt so bad they felt like they were on fire. My feet were abnormally swollen, I felt fatigued and run down. And I thought to myself “This is not fun”.

I know I should get better shoes, ice my shins, stretch properly, run less, rest more and watch my sodium intake. All I kept thinking though was “I’m turning into my father.” Both my parents suffer from rheumatoid arthritis. I grew up listening to their pain stories.

PAIN BODY-MIND CONNECTION

Pain is a sophisticated story teller. One of those stories is about how my mother’s arthritis flared up at 19 and she was sent to a rehab for almost 30 days, pumped with steroids. And all of a sudden, my shins started to hurt more, and my heart started to pound and a puddle of embarrassing tears formed silently in my eyes. What a bummer!

This morning at the doctor’s office I rated my pain as a 10 out of 10. But then I started thinking, was it really that bad? See, the problem with pain is, it’s very subjective. We don’t have a pain “meter”. We rely on the patient’s subjective account of how much it hurts. I guarantee you, that rating feels correct.

My pain felt like a 10. But what makes my experience different from any other runner who has experienced shin splints, is my parent’s story and the fear of having the same painful fate. Fear. Fear is powerful. Fear can shoot your pain scale through the roof. You mind, your thinking is powerful. It will fuel physical pain like oxygen does fire, keeping it alive and roaring. When you are in physical pain, you are in emotional pain too.

EMOTIONAL PAIN

That morning on the Diane Rehm show the topic was prescription drug abuse, with a focus on the Oxycontin epidemic. You can listen to it here. As usual Diane had invited an impressive panel of pain doctors, substance abuse experts and a sheriff. The debate was very interesting, informative and important. Then a heroin addict in recovery called and made the most important point in the whole show. He talked about emotional pain.

Sure, we can do research and come up with telling statistics. We can blame Purdue or sue them for producing such an “evil” drug. We can talk about prevention, education and ways to decrease abuse and diversion while still helping people who suffer with chronic pain.

But are we talking enough about emotional pain?

In my years of experience working with people addicted to opiates, emotional pain is the one, single, most important aspect of their addiction and recovery. This is simply an observation, but emotional pain is the determining factor in whether or not that temporary prescription your dentist gave you for Hydrocodone is going to be just a pill or is going to turn into your love, you lifeline and ultimately your worst nightmare.

We are a pill popping society. The pharmaceutical companies and pill pushing doctors have perpetuated this “fast food” like culture of making your problems disappear. No one wants to talk about the underlying emotional problems. That’s a painful, grueling, long process. We can’t bare feeling exposed, powerless, weak, sad, lonely, fearful.

Many of my clients would initially talk about how their doctor didn’t warn them enough about the risks of becoming addicted and how a seemingly innocent prescription turned into something they needed to function every day. Even when they didn’t have any of the risk factors to becoming addicted such as biological/family predisposition or prior history, they became addicted.

After a year or so in therapy I saw a common thread in their stories. How the pills did more than just kill back pain, how they liked the way it made them feel and how that was an escape from their reality. They would slowly they start to open up about the emotional heartache and how they used to pills to numb, to forget.

Teenagers are the most at risk  of developing an addiction to prescription drugs. These pills are more available to them. Their parents believe they are safer because they are legal and a doctor is prescribing them. They often find these pills in the parents’ medicine cabinet.

But what else is happening in our families that we are not talking about? Why are we so afraid to expose our demons? So stubborn when it comes to change? What is the larger responsibility that our schools and communities have on this epidemic?

And most importantly, why aren’t we in therapy more?

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