When it comes to treating chronic pain, strong painkillers are usually prescribed by doctors. Ideally, these are intended to be used over a short period of time as they carry the risk of addiction. However, for those receiving addiction treatment, there is an obvious problem if they are also dealing with severe pain. How can these individuals get adequate treatment for their pain if it is too risky to prescribe them strong prescription medication?
Long-term substance abuse can cause plenty of damage to the body, and this can leave recovering addicts with severe pain that they are unable to get relief from due to the fact that the medication they need can be addictive. They then struggle to concentrate on their recovery because they are unable to focus due to the pain they are experiencing. Many will return to the substance to which they are receiving addiction treatment for; to them, it is the only way to ease the pain.
The good news is that a new study has shown that by combining social support with behavioural therapy, recovering addicts who also have chronic pain can be helped to overcome their addiction without the need for medication.
This affordable treatment uses the fundamental psychological theories of pain to treat those in recovery from addictions to alcohol and drugs. The study found that those receiving pain-focused treatment while in recovery from addiction had an increased ability to function as well as a reduction in the severity of their pain.
The treatment is known as ImPAT (Improving Pain during Addiction Treatment), and a number of veterans took part in ten weekly sessions. The study was conducted by researchers from the addiction centre at the University of Michigan Medical School and the Centre for Clinical Management Research at the VA Ann Arbour Healthcare System. The study found that in fifty-five of those who took part, an improvement was seen that lasted for up to a year.
The team is now working with a larger group of participants in a follow-up study. They are working with 480 non-veteran participants who are receiving addiction treatment in a residential facility. They are hoping that addiction treatment services around the world will adopt this non-expensive approach to treatment.
The idea behind the treatment is that it will address more than just the substance abuse; it is intended to address various causes of addiction, which includes chronic pain. Lead author Dr Mark Ilgen said, “These results highlight the need for addiction treatment programs to offer a multifaceted approach that doesn’t only address substance use but also the other factors that might be driving substance use, including pain. We’ve shown that it’s possible to improve pain outcomes in people with addiction, and even have some spill-over effects on their substance use.”
Dr Ilgen said that there are many people receiving treatment for addiction who also suffer from chronic pain. He added that there are not many options for them in terms of effective treatment. He said, “Past studies of psychosocial approaches for pain have often excluded people with drug or alcohol problems, addiction treatment programs do not usually have providers trained in pain care, and many pain specialists will not treat people who also have addiction. So patients are caught in the middle.”
ImPAT uses a combination of therapies to help those who are recovering from addiction deal with their chronic pain. It uses acceptance and commitment therapy in conjunction with various elements of CBT (cognitive behavioural therapy). These two treatments are not normally used alongside each other in terms of addiction treatment. They are generally used to treat those with chronic pain but not if they have an addiction. The team of researchers are hoping that they can be utilised within the addiction services industry.
The idea behind the therapy is to get patients to focus on various aspects of their lives rather than on their pain. They are taught methods of adapting to the pain they are feeling as well as how to distract themselves from pain.
Dr Ilgen said, “We want to take the focus off pain and put it onto functioning, and finding pleasurable ways to spend time. There’s also a strong link between depression and pain. Pain is responsive to mood, and mood is responsive to social support.”
Any new addiction treatment is welcome, especially one that will help those with chronic pain to overcome their substance abuse. It is often the case that chronic pain is the driving force behind a person’s addiction, so if a treatment can help those patients with non-drug ways of dealing with their pain, it has to be good news.
Sadly, many individuals both here in the UK and in the US develop addictions to alcohol and prescription medication taken to relieve the chronic pain they are experiencing. Dr Ilgen has acknowledged that there is a very urgent need to find effective non-drug treatments to help those affected by addiction.
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