How Chronic Pain Can Lead to Drug Abuse

Pain is a normal part of life. It is our body’s reaction to illness or injury – a warning that something is wrong. Usually, pain lessens as soon as the body recovers. The hurting stops and things go back to normal. But this doesn’t happen all the time. Not when it’s chronic pain.

Chronic pain is a persistent pain that’s ongoing and lasts longer than three months. It lingers on even after the illness or injury has gone away. Chronic pain can limit mobility and reduce strength, endurance, and flexibility. This may make it hard to get through daily activities and tasks.

Chronic pain may last for months or even years. It may feel dull or sharp, causing an aching or burning sensation in affected areas. The pain may be intermittent, steady, or on and off. According to the Centers for Disease Control, 20.4% of adults in the US had chronic pain in 2019.

Currently, it’s the leading cause of long-term disability in the country, affecting about 100 million Americans. Studies show 1 in 4 people with chronic pain will develop chronic pain syndrome (CPS). This occurs when they experience mental health issues like anxiety and depression, on top of the pain.

Chronic pain symptoms

Chronic pain, like other long-term health issues, leads to complications beyond the physical symptoms. It causes depression, feelings of guilt, poor sleep, loss of interest in sex, suicidal thoughts, exhaustion, stress, and anxiety. The consistent pain makes it hard for one to manage tasks, keep up with work or attend a social gathering. This leads to problems with relationships and work. Some studies suggest that the severity of these issues is directly proportional to the pain.

How chronic pain leads to addiction:

Chronic pain intensifies mental health issues that cause addiction

Many studies show a strong link between chronic pain and mental health issues. In one of these studies 10-87% of chronic patients had depressive and anxiety symptoms. Personality disorders are also common among these types of patients. Chronic pain and mental health disorders are linked because they both share neural pathways, making it hard for the brain to distinguish them.

In addition, chronic pain has some profound social and behavioral effects that feed into a mental health condition. Prolonged chronic pain causes social isolation that intensifies issues like anxiety and depression. That’s where addiction comes in.

Experts are learning more and more about the strong link between mental health issues and addiction. According to NIDA, people who develop mental disorders are also diagnosed with substance use disorders. Another report by the National Bureau of Economic Research says that mental issues are responsible for the consumption of the following: 40% of cigarettes, 44% of cocaine, and 38% of alcohol.

Self-medication is by far the most common culprit behind most dual diagnoses. For example, a chronic pain patient with low energy takes crystal meth to increase their drive to get things done. Meth addiction can happen the first time it’s used. To make things worse, the drug can cause horrible side effects on the body. Meth mouth is one of the most common physical side effects of meth use.

Treatment involves prescription opioids that can be highly addictive

Prescription opioids are one of the common drugs that doctors prescribe for chronic pain issues. Since the early 1990s, doctors have been prescribing opioid painkillers like morphine, hydrocodone, codeine, and oxycodone for pain problems. These medicines manage pain well and can improve quality of life when used correctly. But unfortunately, anyone who uses opioids is at risk of developing an addiction.

Short-term use of opioid pain relievers rarely causes addiction. However, when a patient takes them for a long time (or incorrectly), they are likely to abuse the drug, develop tolerance and end up with addiction.

Opioids are highly addictive. They make the body and brain believe that the drug is necessary for survival. So the chronic pain patient will want to keep taking the medication. But as they develop a tolerance to the prescribed dose, they may find that they need even more medication to relieve the pain. This may lead to dependence.

This is why patients have to adhere to their doctor’s recommendations at all times. Opioids are not only addictive but also potentially life-threatening. On average, opioid overdoses account for 90 deaths in America every day. According to WHO, 70% of drug use deaths are opioid-related – with over 30% of these deaths arising from an overdose.

Withdrawal symptoms cause patients to continue using drugs

Many chronic pain patients become dependent on prescription opioids to avoid pain. But when one takes the medication for a long time, they become tolerant. Over time, the body needs more drugs to achieve the same effect. Extended use alters the way neural pathways work in the brain. And these neurons start depending on the drug to function.

As a result, the patient becomes physically sick when they stop using opioid medication. So, they use more drugs to avoid pain and withdrawal symptoms.

Patients try out alternative drugs to relieve pain

Prescription opioids are hard to obtain. Some patients may opt for alternative drugs that are cheaper and easily accessible – like morphine and heroin. Research suggests that misuse of opioid pain medicines like Vicodin and OxyContin may open the door for heroin use.

According to NIH, about 4-6% of those who misuse opioid medicines switch to heroin. But a staggering 80% of those who use heroin, begin by misusing prescription opioids.

Managing chronic pain

Prescription opioids are often the last resort for chronic pain management among non-cancer patients. Most patients benefit from psychological treatments, exercises, physical therapy, lifestyle changes, and NSAIDs. But in cases where opioid medications have to be prescribed, it is crucial that they work closely with their doctor to prevent it leading to drug abuse.

Patients who end up with drug use issues will benefit from addiction treatment. Treatment centers have qualified health care professionals who help address behavioral addictions. The best ones adhere to the guidance of the American Society of Addiction Medicine when treating co-occurring addiction and chronic pain issues.

How Can Relapse Be a Part of Drug Recovery?

There’s a lot to feel good about when your loved one goes through an arduous recovery journey and then comes out clean and sober. Sadly, even after rehab though, your loved one may relapse at some point. Relapse doesn’t happen to everyone in recovery, but it does happen to many people. That’s why newer schools of thought on addiction feel that the painful occurrence of relapse is actually a very important part of the sobriety journey. According to the National Institute on Drug Abuse, 40-60% of those recovering from substance use disorders will relapse during their path to recovery. This should help put the struggle of your loved one doing illegal drugs into perspective, that they aren’t alone.

Addiction is a chronic disease or mental illness whose nature is a barrier to sobriety. Your loved one, like other patients, faces a consistently high risk of relapse because addiction alters the brain’s function and structure. Alcohol and drug use trigger dopamine production in the brain’s reward pathway. Dopamine is a neurotransmitter that regulates the brain’s pleasure and reward centers and emotional responses. These changes influence the way the brain prioritizes what’s important.

The brain of a patient who has developed an addiction recognizes substance use as important – even more than survival. That’s partly why those struggling with addiction take risks to continue abusing substances. Addiction also affects the prefrontal cortex – a part of the brain that identifies issues and plans solutions. So when a person relapses, it’s not because they are weak or lack morals, but because of something that’s way beyond their control. And even after treatment, some of these changes might persist.

What is relapse?

Relapse is when someone goes back to using drugs or alcohol after a period of sobriety. The person may “slip up” and have a drink (or use a drug) and then stop again. Slips are hardly seen as relapses, but they can trigger stronger cravings for harder drug use or more alcohol. On the other hand, full relapse is when the person in recovery intentionally seeks drugs or alcohol and no longer cares for their treatment.

Is addiction an incurable disease?

The National Institute on Drug Abuse in the United States indicates that people in addiction recovery have a 40 to 60% chance of relapse. This puts addiction relapse at the same level as other chronic conditions like hypertension and asthma, which have a 50 to 70% relapse rate.

According to NIDA, addiction has no cure. But it can be managed successfully. Like other chronic illnesses, there’s medication to address the problem. However, the patient may need to go through lifestyle changes, routine maintenance, and checkups to prevent relapse. They also have to learn new ways of thinking. All in all, relapse is not failure. It only shows that it’s time to reinstate, adjust or try out a new treatment.

Relapse as part of the recovery process

Addiction is a chronic brain disease with biological, behavioral, emotional, physical, and social aspects. It is characterized by an inability to control drug or alcohol use. The chronic nature of addiction makes relapse part of the healing process as opposed to failure. As mentioned earlier, drug addiction disrupts brain circuitry and causes dependency. At this point, one is bound to experience side effects like drug cravings and withdrawal symptoms when they stop using. Unless they use their substance of choice, they may not feel “normal.” Relapse may seem like an excellent way to get back to “normalcy,” combat intense cravings, and relieve withdrawal symptoms. That’s why relapse can be a form of self-medication.

Drug relapse is a common part of the recovery process. When it happens and is handled correctly, it can strengthen one’s commitment to long-term sobriety. Recovery is the journey of maintaining long-term sobriety, reaching new goals, and facing life with new, healthier strategies. A hitch on the road doesn’t mean that all is lost. Yes, it might feel overwhelming – but with the right help, your loved one can get back on the right track.

Strategies to avoid relapse or mitigate its effects

More than half of the people in recovery relapse. But the fact that it is common doesn’t mean that you should not try to prevent it. An addiction relapse not only undoes the hard work, but it’s also potentially life-threatening. Relapsing can result in binging that can even lead to overdose. Here are some strategies to help prevent relapse or mitigate its effects.

Reaching out for help

People in recovery often feel humiliated and devastated when they slip or relapse. So, the last thing you want to do is reprimand them or come out as judgmental. You also don’t want to leave them to their own fate. Instead, try to encourage them to go back to their support network or treatment. It doesn’t matter how many times one relapses. In fact, experts agree that one is likely to have a successful long-term addiction recovery when there is more repetition of positive reinforcing habits.

Attending long-term treatment programs

Recovery from alcohol and drug addiction is not a quick fix. A single medication or a month of therapy may not guarantee a clean life. Often, one may need to engage in intensive long-term treatment, accompanied by continual support for a better outcome. A study with 1000+ addiction patients discovered that relapse rates reduced for every nine weeks a person spent in treatment. Sustained recovery also increased in the study for participants who had ongoing treatment with aftercare.

Identifying and managing triggers

Treatment programs integrate therapies that teach patients how to cope with internal and external stressors that may trigger a relapse. Mental health issues like anxiety, stress, depression, and mood changes tend to co-occur with substance abuse. When someone in recovery gets anxious or stressed, they may crave, think about, and eventually use substances. Triggers can be specific – like certain places or people, or very general – like hanging around people who are using. Evidence-based therapies help those in recovery recognize their personal relapse triggers and even train them to cope.

Lifestyle changes

Managing triggers is a great relapse prevention strategy. But you also want to encourage your loved one to make positive changes over the long term to build a healthier life. They can learn and use healthy coping mechanisms for negative emotions: recognize and manage mental issues: and develop positive activities like meditation, exercise, or art.

More Than Rehab is here to help. We have decades of experience in treating addiction, from the root-causes, to the after effects people experience once they become sober. If you, or a loved one needs help with their addiction, please don’t hesitate to call us! We are available 24/7.