Pain Killers, Addiction & Pain Management

by Dr. Richard Frances
and Nancy Helle

While only about two to three percent of the 34 million people who have chronic pain develop a major addictive problem from pain medication, there are many more who are addicts—several million—who abuse painkillers when they can get them for any reason. There are also many who suffer silently because they are afraid to get addicted.

The treatment of chronic pain, pain killers and addiction, and the new, rapidly expanding profession of Pain Management were the focus of a recent seminar at Silver Hill Hospital in New Canaan, Connecticut, a behavioral health and substance abuse treatment center. About 100 people attended the seminar, which featured experts who discussed the treatment of both medically and psychologically induced pain and addiction.

Genetic factors play a major role in determining who is likely to become addicted to painkillers. Those whose families have a history of alcoholism or drug abuse are most at risk; they have a biological, inherited tendency to addiction. For this reason, doctors need to asses patients’ medical history carefully before prescribing painkilling drugs, as well as carefully monitor the effects of the treatment on the patient.

The medical profession is making tremendous progress in erasing the stigma attached to the use of opiates to alleviate pain. It has taken a long time, but the use of opioids (medications derived from opiates) to alleviate pain is now generally sanctioned in appropriate cases, and for most patients, the prognosis is very positive. Along with 12 step programs, the use of opiates has been successful in preventing withdrawal symptoms, reducing drug craving and normalizing physiological symptoms.

Pain Management involves a number of approaches, including behavioral treatment as well as medication. Three factors are involved: patient related, pain related and the medication selected. It is essential for the medical/mental health profession to understand both pain management and addiction, and to evaluate each patient carefully to determine optimal treatment.

Silver Hill Hospital provides a full range of services for adults and adolescents, from inpatient to partial hospital, halfway houses and outpatient programs. For information: 1-800-899-4455. Dr. Francis is President and Medical Director of Silver Hill, and Ms. Helle is director of public relations.

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