Pain Management In and After Detox
Preventative or proactive and reactive assessment and treatment of chronic pain remains a challenge for healthcare providers and systems, especially for those who have a history of substance abuse and dependence. Many patients, especially those in ethnic minorities, those with cognitive impairment, the elderly, and those at the end of life are left with inadequate pain treatment and care.
The American Pain Society reported that nearly 50 million Americans experience chronic moderate to severe pain on a daily basis. Approximately 4.3 million Americans engaged in the nonmedical use of prescription opioids in 2014 in an attempt to manage pain according to a report by the National Survey on Drug Use and Health. As a result, there is a high rate of harm and death associated with the medical and nonmedical use of prescription opioids and substance use disorders. Approximately 2.1 million Americans were suffering from opioid-related substance use disorders according to the National Institute on Drug Abuse.
The goal of acute and chronic pain treatment is to maximize functional level while providing pain relief with the minimum effective dose. Management of chronic moderate to severe pain can help improve the quality of life, positively affect medical outcomes as well as reduce healthcare costs, lost work productivity, and overall harm and death associated with substance use and abuse.
A few ways to manage pain during or after detox and treatment for substance use disorder include prescription restriction, physical activity and therapy, and telehealth services.
Guidelines and standards have been recommended by the Joint Commission on Accreditation of Healthcare Organizations, the World Health Organization, and in 2016, the Centers for Disease Control and Prevention (CDC) developed the CDC Guideline for Prescribing Opioids for Chronic Pain to improve the safety and quality of pain treatment in America.
The CDC guidelines urge that opioids only be used to treat patients with chronic pain due to active cancer treatment, palliative care, and end-of-life care with exceptions and restrictions for those with severe chronic pain.
The CDC guidelines recommend that the physician thoroughly reviews the patient’s history and current state of health to determine if and when to initiate and continue the use of opioids. Next, the physician must inform the patient of the risks and benefits of opioid use. If the pros outweigh the cons, the physician can then recommend a prescription, dosage, duration, and an exit strategy for tapering and eventual discontinuation.
Those who currently have or have a history of substance use disorders are recommended to utilize non-narcotic medications that include non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or a non-schedule prescription such as Neurontin. If opioid medication is essential over other medications, it’s vital to be honest with your healthcare provider(s) and family or friends, be proactive in treatment, attend all follow-ups, and adhere to rules for usage and discontinuation.
Another excellent pain treatment option for those who currently have or are in recovery from a substance use disorder is moderate physical activity and physical and occupational therapy.
Exercise is defined as any physical activity that requires energy and increases the heart and breathing rate and can include sports, yoga, pilates, weight lifting, tai chi, hiking and horseback riding (equine-assisted therapy).
Withdrawal symptoms and complications are typically managed by medications, however, exercise can provide many of the same benefits. Physical activity is a vital component of detox and rehabilitation and an overall healthy life and is proven to prevent the initiation, maintenance and escalation of substance use, treat substance dependence, and can even help prevent relapse or reinstatement of substance use during and after detox and treatment for substance dependence, depression or anxiety.
Exercise directly raises the levels of mood-enhancing neurotransmitters and feel-good endorphins, releases muscle tension, improves circulation, the quality of sleep and mental and physical energy as well as reduces levels of the stress hormone, cortisol and balances other hormones. In addition, exercise helps prevent obesity, high blood pressure, diabetes, other diseases, and increases survival of cancer and the average length of life.
The CDC recommends a minimum of 60 minutes of moderate physical activity a day to profit from these potential benefits.
And lastly, the National Institutes of Health recently conducted a study and found potential in utilizing real-time, secure, HIPAA-compliant data, voice, video and media services to integrate cognitive-behavioral pain management approaches into treatment.
Telemedicine services can offer at-risk patients — especially the elderly, those with chronic conditions or cognitive impairment — a better understanding of pain, improved physical functioning and confidence in newly learned skills to deal with and overcome pain. Brief interventions delivered through mobile and electronic applications can effectively connect patients, doctors, and medical facilities and effectively teach patients with chronic disease to manage pain without relying on or abusing opioids.
For more information on how to manage pain, please call: (877) 262-6566.