The media is finally highlighting and doing a pretty good job in discussing the dangers of opiate dependence in relation to pain management. The Fine Line Between Pain Management And Opiate Addiction Those of use working in the chemical dependency field have been watching this snowball over the past decade. In the late 1990′s there were news articles about hilly billy heroin (otherwise known as OxyContin) overrunning rural counties in Maine and Kentucky. Celebrities have been dying from their dependence to prescription medications for years, i.e. Heath Ledger. The media and publicists refer to it as medication mismanagement or an unfortunate interaction with medications. One of my favorite surfers, Andy Irons, died in 2010 from a prescription drug overdose. At the time, and to this day, no one speaks of Irons as an addict. Just that he died of an overdose related to prescription medications.
As a therapist in this field I am witness to the struggle of hundreds of addicts as they fight for their recovery. Some come by the disease innocently, hooked by an open script from a dentist, multiple knee surgeries, and so forth. Others use the relationship with the doctor as a means to protect their disease. “I am not going to stop taking the xanax, my doctor ordered it” or “I still need one vicodin because my back is really damaged and the doctor says that is all that will help.” My personal approach to those responses is simple, please sign the release of information and let us call your doctor together. The disease informs the client that there is no way that Jamie is going to talk to my doctor. This becomes a wonderful opportunity to educate the client about the disease of addiction and how it continues to try to protect itself, even when the client knows that they want to get healthy.
So knowing that there continues to be an increase in prescription drug dependence were do we go from here. I believe that the chemical dependence field must take charge and become a leader in how we treat chronic pain. Our counselors should take an active role in the development and use of non-narcotic pain management programs. The author of this article does a nice job identifying some effective approaches to treating pain without the use of opiates. There needs to be additional programing using EMDR and the mindfulness based therapies. Our field must educate medical professionals and share our knowledge on chemical dependence. Our national groups like NAADAC and ACA and government agencies like SAMSHA and NIDA need to fund campaigns educating the public and professionals to break away from the “pill a day” mentality that fuels our healthcare system. Change is possible but it will require groups of professionals to saying there is a different way to do this.
–Jamie Loffredo, MA LPC NCC CAADC