What is chronic pain?

Chronic pain generally persists for six months or more and continues after the expected cessation of the pain. Acute pain occurs in response to a specific, time-limited medical problem. Chronic pain tends to elicit severe depression as a result of long-term limitations and hopelessness.

It is important to remember that one can become physically dependent upon a drug, but not addicted. Addiction is characterized by a loss of control over the substance or behavior, preoccupation with the substance or behaviors, and continued use despite emotional, physical, legal, or social consequences. A person with chronic pain may need to be withdrawn from medications in order to proceed with the next step in the pain management protocol. However, medications can be abused and lead to addiction, which may necessitate further treatment.

What are the warning signs of addiction with chronic pain?

Using more than intended of prescribed medication

Preoccupation with obtaining prescription medication, e.g., doctor shopping

Experiencing withdrawal symptoms when not taking the medication (e.g. increased anxiety, irritability, or perceived pain)

Reports of lost or stolen prescriptions

Continued reports of no pain relief whatsoever by prescribed medications

Increased problems with family, occupation, etc. due to prescription drug use

What can be done?

An evaluation can be recommended to the patient to establish if there is addiction along with the chronic pain. The course of treatment differs accordingly. The Illinois Institute for Addiction Recovery (IIAR) at Proctor Hospital, BroMenn Regional Medical Center, and Ingalls Memorial Hospital has a program tailored specifically to the person with chronic pain. The IIAR will evaluate the patient and admit if necessary for a more intensive evaluation. During the patient’s stay, the primary care physician will be involved in the process, which will include consultation with pain specialists. The Chronic Pain Team determines if formal addiction treatment will be recommended in conjunction with the ongoing management of the chronic pain. If formal addiction treatment is not recommended after the intensive evaluation, the patient will continue through the detoxification period. If addiction treatment is recommended, the patient will find a structured, medical process that introduces him or her to the principles of a recovery program. The patient is educated on the disease of addiction as well as the skills necessary to maintain a recovery program. The patient remains in treatment with a variable length of stay up to 90 days. Following treatment, the most effective long-term solution to helping the person maintain sobriety is completing continuing care, medical follow-up, adjunctive psychotherapy, and regular attendance at 12 step meetings such as Narcotics Anonymous.

How can someone get help?

The first step is to determine if there is a problem. A Certified Addictions Counselor can effectively perform an assessment to determine what level of care is most appropriate. For a free confidential assessment, call the Illinois Institute for Addiction Recovery at (800) 522-3784. An assessment can be completed 24 hours a day, 7 days a week. Appointments are preferred, but walk-ins are always welcome.

Sources: American Psychiatric Association, Food and Drug Administration, The National Pain Foundation, American Medical Association