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People in Addiction Recovery Struggle to Manage Chronic Pain

Many people in addiction recovery also have chronic pain associated with illnesses or injuries. The stigma and public ignorance about addiction and recovery, combined with the epidemic of prescription opioid abuse, create frustrating barriers for many people to get quality, effective care for their pain management.

A recent article in The Philadelphia Inquirer by an anesthesiologist at the Hospital of the University of Pennsylvania identifies the problems built into our healthcare system and culture that contribute to the struggle that people with chronic pain have in getting relief. She describes chronic pain as "a staggering burden, reducing overall quality of life, social functioning, and psychological well-being". She cites a dated but significant research report estimating that pain costs the U. S. public $100 billion a year in associated health care, lost wages, and legal costs. And we know that with as we live longer, the problem is likely to get worse.

FACT: A very small percentage of people taking opioid pain relievers for chronic pain conditions are likely to abuse the medicine. But the epidemic of prescription opioid abuse in our culture is a double whammy for recovering folks. The uneducated public, as well as some medical professionals, often lump recovering people into the same "drug-seeking" category as active addicts when all they are doing is seeking appropriate care for their pain.

Quality Treatment Requires Communication

A related healthcare issue is the poor communication across medical specialties responsible for managing patients with chronic pain. People with pain from orthopedic injuries or chronic diseases may also be taking psychiatric medicine via their primary care physician or a psychiatrist. This means that two or three different doctors may be involved in their treatment. The interactions among  medicines for pain symptom and psychiatric symptom management can be complex and actually be life threatening, so coordination of medicines is crucial. Plus, those with depression may have suicidal thoughts so there are psychiatric risks as well as medical ones.

Specialists often see a patient's problem from the point of view of the tool bag they bring to the treatment room. I experienced this first hand when my relatively minor ongoing neck and shoulder injuries flared up at the same time a few years ago, endangering the possibility of me not being able to go on a long-planned ski trip. Skiing is one of my passions, so I was dreading what the doctors would tell me.

The neck specialist gave me some exercises to do, offered me pain medicine if I needed it, and said "ski at your own risk". The shoulder doctor gave me some different exercises to do, also offered me pain medicine, and deferred to the neck doctor about skiing. I wondered out loud to them if the injuries were related and this concern was ignored. Neither doctor consulted with the other. Saying to myself that I wanted to get a more comprehensive approach to my problem, but knowing that I really wanted to "shop around" for a better answer, led me to see a chiropractor for the first time.

The chiropractor approached both problems as one interrelated issue. He consulted with the neck and shoulder doctor to confirm some medical issues before discussing a treatment plan with me. He had treatment approaches that focused on the problem holistically and, most important to me, he spent time talking to me to educate me about my injuries, to learn more about my attitude and approach to various treatment options. He learned how important skiing was to me and gave me advice on how to protect myself better from injury and encouraged me to go on my ski trip and make sure I have a great time.

Advocate for Your Own Quality Treatment

The lack of communication across disciplines is common, which is sad, because I've seen the benefits of what just an occasional five minute phone consult between specialists can do to improve the quality of care for their patients. I encourage my clients to advocate for their own care by insisting that their doctors talk to each other. I see part of my job as helping them coordinate their pain management by talking to their specialists and encouraging communication across disciplines.

So take control of your situation by asking your doctors to talk to each other. You're already in enough pain--it won't hurt to ask them.

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