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A Guide for Using Pain Medication in Recovery

Stephen F. Grinstead& Sheila Thares

For someone recovering from chemical dependency the use of mood altering prescription medication can often lead to relapse.  The primary goal of this pamphlet is for you to learn how to develop a plan that will prevent sabotaging an effective recovery program, while at the same time avoiding other addiction problems or a destructive pattern of relapse, (i.e.,  ineffective pain management and/or abuse of your pain medication). 

This pamphlet is a result of many years of study, researching literature on outcome based treatment, and personal experience.  It is designed for people recovering from any chemical dependency who are facing an invasive surgical procedure (medical or dental) that could entail the use of psychoactive medication.  It is also intended for others who may not be in recovery, but have some risk factors for dependency and want to avoid becoming chemically dependent.  Included in this publication are some strategic action steps that you can take to safely and effectively prepare yourself for an upcoming surgical procedure. 

To accomplish these goals you will need to do more than just read this pamphlet.  You will need to discuss your responses to each of the guidelines below with another person who can help you sort out the thoughts and feelings that may surface as a result of these exercises.  If you don’t have a counselor, you can do this work with the assistance of a self-help group sponsor who is willing to support you through this process.  Discussing what you’re learning from this process with another person or a group of people will improve your ability to develop a plan that will prevent relapse.

When a person is in recovery for chemical dependency, whether the substance be prescription drugs, alcohol, marijuana, etc., the risk of relapse is always present.  One issue that tends to be especially problematic and a relapse trigger for recovering alcoholics and/or addicts is pain.  It is unrealistic to expect that we will never have a medical or dental situation where pain management is needed.  In addition, if the person in recovery also suffers from a chronic pain condition, relapse prevention becomes even more crucial.  Below are guidelines for people in recovery who want to minimize their risk of relapse.

1.            During early recovery postpone non-urgent dental work (except preventative or restorative) and elective surgical procedures requiring mind-altering medications.  When you do need to be on medication, make sure that an addiction medicine practitioner/specialist is used for consultation and/or prescribing that medication.

2.            If you need to be on medication, have your sponsor, significant other, or an appropriate support person hold and dispense the medication.  Keep only a 24-hour supply available (unless this is a chronic condition, then other precautions must be developed).

3.            Consult with an addiction medicine practitioner/specialist about using non-addictive medications such as an anti-inflammatory, or other over-the-counter analgesics. 

4.            Be open to exploring all non-chemical pain management modalities.  Some of the more common ones are acupuncture, chiropractic, physical therapy, massage therapy, and hydrotherapy.  In addition, identifying and managing uncomfortable emotions may also decrease your pain significantly.

5.            Be aware of your stress levels and have a stress management program such as meditation, exercise, relaxation, music, etc. in place.  If you lower your stress, you will usually lower your pain as a result.

6.            Take personal responsibility to augment your support group meetings in order to decrease isolation as well as urges and cravings.

7.            Inform all of your health care providers about being in recovery and be aware of the importance of consulting with an addiction medicine practitioner/specialist in the event that mind-altering medication is needed.  There may be times you need to be on medication, but the risk of relapse can be minimized if open communication is maintained between the addiction medicine practitioner/specialist, yourself, and other health care providers.

8.            Do not overwork, especially if you are in pain or sick.  Add one extra day off to your return to work plan to avoid fatigue and promote healing. 

9.            Be open and aware of the cross-addiction concept.  Decline “helpful” offers to use someone else’s prescriptions.  Any psychoactive chemical could trigger a relapse of your addiction because all mood altering drugs enter the limbic system as Dopamine.  This explains why non-polyaddicted alcoholics can relapse to alcohol after receiving opiates.

10.       As depression is common for people with chronic pain, consider the possibility of taking appropriate antidepressants if needed. 

11.       Be aware of the importance of proper nutrition and exercise as a vital part of chronic pain recovery.  Stretch slowly at first, then structure progressive walking at least once a day, or twice if necessary to complete the designated distance.  Increase the distance as you are able.  Add strengthening exercises if cleared by your health care provider.  Remember, protein assists the healing of injuries, therefore; it is important to create a nutrition plan for tissue repair.

12.     Explore your past beliefs and role models from childhood regarding pain and pain management.  Look for healthy role models for pain management in recovery.


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