Can Chronic Pain be Treated Alongside of Opiate Addiction?

Can Chronic Pain be Treated Alongside of Opiate Addiction?


One of the biggest problems for recovering opiate addicts is that they often are struggling with chronic pain issues along with their addiction to opiates.

One of the solutions for this problem has been a relatively new drug that is marketed as “Suboxone,” which is actually unique because it is only a “partial opiate.”

So a “full opiate” is something like heroin or vicodin or oxycontin, and those “full opiates” will flood the opiate receptors in the brain and overwhelm the receptors and cause the person to eventually go into a coma and die from taking too many opiates.

Suboxone is different because it is only a “partial opiate,” meaning that as soon as it fills up the opiate receptors in the brain, it stops. It does not flood the brain and overwhelm it in the same way that “full opiates” do. Therefore, while you can get “well” by taking Suboxone, you do not exactly get high by taking it, which lowers its abuse potential quite a bit.

And while using Suboxone for pain is actually an off-label use of the drug, it still works to some extent depending on the situation and the type of pain. And if a struggling opiate addict is trying to get off of “full opiates” and they also have an issue with some sort of chronic pain, then Suboxone may fit the bill perfectly.

Unfortunately though, Suboxone is not cheap. Meanwhile, other drugs for treating pain that are “full opiates” are far cheaper.

North Jersey says that, regarding Buprenorphine (Suboxone), “the Food and Drug Administration (FDA) places Schedule III buprenorphine drugs under the same labeling requirements as Schedule II opioids despite lower risks, making it harder for both consumers and healthcare providers to make the distinction.” Also, they state that “Insurers make it more difficult for patients to obtain buprenorphine, whether by offering inadequate coverage for buprenorphine-based products or by requiring patients to try numerous less expensive (though riskier) Schedule II drugs before they will allow patients to obtain buprenorphine.”

The problem is that Suboxone is newer and has to be full cost, rather than the lower price that would come from a generic. And alternatives like methadone, which can be used in a similar way, are far cheaper but unfortunately they have much higher abuse potential.

This is an issue now because of the opiate crisis that is causing so many people in the US to struggle with opiate drugs. The crisis has reached a point in which we want to find solutions every where that we possibly can because so many people are dying from this.

Perhaps we can implement some sort of voucher system to help pay for Suboxone for struggling opiate addicts. A similar proposal is on the table for certain places in order to create a voucher system to get opiate addicts into addiction treatment in places where they might not be able to afford it, or their insurance would not normally cover it. The idea is that our tax money should shoulder some of that cost so that we can get these people the help that they need. In a similar way, if a struggling opiate addict cannot afford Suboxone, we might implement some sort of system by which they could still receive Suboxone, because it might be the best possible treatment choice for them at the time.

In order to understand how pain is treated in the human body, we have to look at the way that opiates function. What does a drug such as Vicodin or Oxycontin really do when it reaches the brain? How does it reduce our pain?

Understand that there are two things going on in the human body when there is pain being felt. One, there is the source of the pain–for example, an inflammation of an injured area of the body, such as a broken leg. Then two, the body is sending a signal to the brain that indicates the pain, alerting the brain that there is a problem and that there is an injury. So there is the source of the pain, and then there is the pain signal that is sent to the brain.

In the case of opiates like vicodin or heroin or oxycontin, the drug is filling up the opiate receptors in the brain and it is essentially “doping” the brain and causing the brain to not care as much about the pain signals that it is receiving. The throbbing inflammation is still there in the body, and the opiate based drugs are not doing anything to change the amount of inflammation that is occurring, and they are not actually reducing the pain signal in any way. All the opiate does is to cause the brain to ignore the pain signal. It is a bit like sticking a rag into the clanging bells of an alarm clock–the bells will continue to clang together, but you won’t hear it as much because you stuck a rag in between them. The rag in this case is opiate based drugs, and the clanging bells are your pain.

Now compare this to other kinds of drugs such as an NSAID that is used to treat pain–the NSAID such as Ibuprofen actually reduces the amount of inflammation that is happening in the body, and therefore it is reducing the source of the pain. Instead of doping the brain and trying to get it to ignore the pain signal, the NSAID actually reduces the amount of pain signals being sent. It reduces the actual pain and can even be curative in some cases.

However, current attitudes towards medicine have us all a bit too entitled. We expect that, due to advances in medical technology, we should be able to exist pain-free for the most part when we are under medical care. The thinking is that “They should be able to medicate away my pain by now.” We expect to have our pain level of 9 be taken down to a level of 1 or 2 at the most, and anything more is disappointing.

And of course there are other ways to treat pain in the body other than putting chemicals and drugs into it. Perhaps if we are going to effectively treat chronic pain in the recovering opiate addict then we are going to have to explore all of our options and tap into every possible resource. So that might mean that you would need to explore physical therapy, massage therapy, and some other alternative methods of treating pain so that you reduce the need for actual chemicals and medication.

The shift in attitude is critical in order to adopt the right approach to pain management. If you have an attitude of entitlement then you are never going to be happy or satisfied with the way that your pain is being handled unless you are completely comatose from using far too many opiates. Obviously that approach is not really helping you and will eventually destroy you because of the addiction component, so you need to seek alternative methods that may not feel like a “full dose of heroin” in terms of treating your pain. We need to explore all of the alternatives and find a more reasonable path in learning how to live with our chronic pain in a way that is also supportive of our recovery efforts. Good luck!