One of the biggest concerns for pain management patients who have become physically dependent and psychologically addicted to opioid pain medications.

This article explores the problems with the long-term use of opioids for chronic pain and looks at pain management without the use of narcotic medications.

The Burden of Chronic Pain and Addiction

Dealing with chronic pain and addiction at the same time can feel like almost too much for one person to bear. Chronic pain by itself has the potential to upend a person’s life. It can make work or school extremely difficult, if not impossible. It often strains relationships and can lead to depression and apathy. 

When a person with chronic pain finally finds temporary relief in a medication, it can seem like a godsend at first. But sooner or later, they discover the shortcomings of all opioid pain medications. Opioids are probably still the most effective medicines we have for moderate to severe pain on a short-term basis. 

The problem is that there is nothing short-term about chronic pain. While doctors have become more well-informed about the dangerous pitfalls of opioid dependence since the OxyContin crisis — addiction continues to be a problem for pain management patients. Too few pain management doctors and their patients are aware of the effective, non-narcotic alternatives. 

Dependence and Tolerance 

When a person relies on opioid painkillers for a longer period, several things happen. One is that they almost always begin to develop a tolerance. This means that over time the same dosage of oxycodone, hydrocodone, or another opioid analgesic no longer gives them the same amount of relief. 

The other is that they eventually become dependent on the medication. Not just for pain relief, but to feel “okay”. When you take an opioid daily, after some time, often as little as a month or two, you become dependent. This means that if you abruptly stop taking the medicine, not only will you lose the pain relief it had been providing, but you will also experience flu-like withdrawal symptoms. 

Problems with long-term use of opioid painkillers for chronic pain include:

• Patients develop a tolerance, requiring more and more of the medication.
• You become dependent over time and will experience withdrawal if you stop.
• Side effects like constipation, drowsiness, lethargy, and withdrawal symptoms.
• Tolerance can lead to taking more than prescribed or seeking other sources. 

The Difference Between Dependence and Addiction

Many pain management patients are sensitive about the word addiction. This is understandable and it comes largely from the fact that addiction is still somewhat stigmatized in this country, although it shouldn’t be. Another big part of the puzzle is that most people don’t completely understand addiction. The terms dependence and addiction are often used interchangeably, for example, even though they have different meanings. 

Dependence vs. Addiction:

• Dependence: Being dependent on a painkiller or other narcotic means that your body has become accustomed to it being in your system and if it is suddenly absent, you will have physical withdrawal symptoms. That is, your body has become dependent upon the medication to function normally. 
• Addiction: Addiction is sometimes called psychological dependence. When a person is addicted to a medication, it means that they have come to rely on it for peace of mind, happiness, contentment, etc. The drug has become one of the most important, if not the most important things in their life. The idea of being without it is frightening and upsetting, even unimaginable. In extreme cases, they will sacrifice other needs, even forgoing food or drink, the need for shelter, etc. if they need to in order to continue using the drug. 

It’s possible to be both dependent on a drug and addicted to it. It’s common actually. People who are dependent on medication often become addicted to it as well. People who become addicted almost always use a drug often enough and in enough quantity that they become physically dependent as well (if it is a drug you can become physically dependent on).

Can You Manage Chronic Pain Without Narcotic Meds?

This is a question that we are asked often and the answer is YES. Many chronic pain patients believe that the only alternative to opioids for pain relief is aspirin or ibuprofen and that they will be miserable and in discomfort most of the time. This is a myth. 

The reality is that science has been hard at work on non-narcotic pain relief methods for decades. America’s OxyContin crisis has only served to accelerate that timeline. If there’s any positive that came from the opioid epidemic, it’s that more funding than ever is flowing into pain management research with non-narcotic medications. The need is great. Addiction is a huge problem, but people with chronic pain need real solutions that will improve their quality of life. 

The Synergy of Ibuprofen, Acetaminophen and NSAIDs

We can already sense you rolling your eyes, but withhold your judgment and keep reading. A recent clinical study discovered that when taken in combination, acetaminophen (aka Tylenol) and ibuprofen (aka Advil, Motrin) are extremely effective at relieving pain — sometimes even outperforming opioids. Yes, you read that right. 

Anyone who has had a root canal or major dental work can tell you that tooth and jaw pain can be some of the most intense discomfort there is. Well, it was dental surgeons who first discovered just how well ibuprofen and acetaminophen used together work. There is a medicine being sold not called Maxigesic which combines the two and is being used by oral surgeons and dentists. 

Other over-the-counter NSAID pain relievers like naproxen (Aleve) can provide lasting relief for moderate pain and in combination with local anesthetics and topical pain relievers like those listed below, they can even handle more serious pain. 

Local Anesthetics for Chronic Pain

Local anesthetics are medicines that provide targeted relief at the specific site of pain. They have many advantages. The big one is obviously that they do not have the potential for dependence or addiction. The need for pain management combined with America’s struggle with opioid addiction has raised the demand for more practical solutions for chronic pain. 

This has helped fuel research into non-narcotic pain relief that has begun paying off. A new generation of local anesthetics, like Exparel (Bupivacaine), are being used following surgery to avoid the need for opioids, for example. Lidocaine is another local anesthetic that has been around for some time and can provide very effective painkiller properties without the threat of dependence or addiction.

Non-Narcotic Topical Pain Relievers

Topical pain relievers are medicines you spread on your skin or apply with a patch. Diclofenac is a topical NSAID (like Advil) that works great for many chronic pain patients. Capsaicin, which comes from hot peppers, works to slay pain too; and you can buy it over the counter (Salon Pas patches). Lidocaine is very effective as well, and you can get it at non-prescription strength in both sprays and patches (like Aspercreme patches).

Atlanta Detox Center Offers Freedom From Addiction

Successful pain management while avoiding dependence and addiction can be a challenge. But the team at Atlanta Detox Center is well-versed in the latest pain management developments. If you or someone you love is struggling with chronic pain and opioid addiction or dependence, we can help.

Atlanta Detox Center is Georgia’s premier substance use disorder treatment program. We feature comfortable, hotel-like accommodations and comprehensive medical detox support. We offer more than just detox. You will get everything you need to build a life free of addiction here. 

You and your loved ones deserve the Atlanta Detox Center standard of care. Give us a call at (470) 450-2355 or reach out to us via our Contact Page to begin a better life today.