For most recovering addicts, maintaining sobriety means not taking mood-altering substances of any kind, even prescription medications. But when you’re sick or injured, the normal rules of recovery no longer apply.
When you’re facing surgery or other medical treatment, or need to manage acute or chronic pain, you’re going to need to take mood-altering drugs, even if you are in recovery from addiction. Pain isn’t just a fact of life that you need to learn to tolerate — it’s a sign that something is wrong in your body. Uncontrolled pain can have consequences, including delayed healing, reduced immunity, and increased risk of anxiety or depression. Anesthesia and pain medications during and after surgery can reduce the risk of complications and help you survive the procedure.
But if you’re a recovering addict, the thought of using potentially addictive narcotic painkillers to manage pain can be scary — even more so if opiates were your drug of choice. Whether you still use a methadone maintenance treatment program to control opiate withdrawal symptoms or you’ve already completed your methadone maintenance, you need to be careful when using narcotics. Make sure your doctor understands and respects your history of addiction. If you’re facing chronic pain, consider using less addictive pain therapies.
Get Addiction Specialists Involved in Your Care
Many surgeons and primary care doctors don’t fully understand how administering narcotic painkillers to recovering addicts can put them at risk of relapse. It’s not their fault — addiction simply isn’t their area of expertise. It’s up to you as the patient to make sure your doctor understands the risks and consults an addiction specialist before prescribing anesthetics or painkillers.
An addictionologist can help your doctor understand the risks of prescribing painkillers to a recovering addict, and can help your doctor be prepared to recognize the signs of impeding relapse. This way, you can lower the risk of your doctor inadvertently encouraging relapse by refilling your prescriptions more than is necessary. But that’s the not the only reason consulting an addiction specialist is an important part of pain management in recovery.
As a recovering addict, you will have developed a tolerance to specific types of drugs. Even if your drug of choice was illegal, you may have what’s known as a cross-tolerance for certain prescription drugs. That means you’d need to take higher doses of those drugs to feel the same effects. Problems could arise if you had, for example, a cross-tolerance for a specific type of local anesthesia, and your doctor didn’t realize it. By understanding your drug tolerances and cross-tolerances, your doctor can choose the anesthetics and painkillers that will best work for you.
If you’re going to need to take narcotic painkillers for any length of time, it’s a good idea to ask someone else — a spouse or other loved one — to fill your prescriptions and administer your pain medications to you. When someone else is administering your pain medication every four to six hours as directed, it’s more difficult to take an extra dose. If you think you need your medication more frequently, gradually start taking your medication at shorter and shorter intervals, otherwise there is a chance you could relapse.
You should also arrange to see a counselor before and after any surgery or other medical treatment involving pain medication. Your counselor can help you cope with fears of relapse and any drug cravings or withdrawals. You should plan to stay in counseling for at least two and a half months after any surgical procedure — this should give you enough time to both finish your course of painkillers and come to terms with any cravings or addictive thoughts that may emerge.
Explore Non-Addictive Pain Therapies
Non-addictive pain treatment is another option for recovering addicts, especially those facing chronic pain. Narcotic painkillers aren’t the only medications that can relieve pain; other options include antidepressants, drugs used to treat epilepsy, and drugs used to treat arrhythmia. Drug-free pain relief methods can include acupuncture, chiropractic, exercise, physical therapy, biofeedback, and occupational therapy. Emotional distress is often a large component of physical pain; psychotherapy and relaxation techniques can help. Hypnosis and tai chi have also been found to be extremely helpful for people managing chronic pain conditions.
Just because you’re a recovering addict, doesn’t mean you can’t benefit from pain relief. Uncontrolled pain can have serious consequences for your recovery after injury or surgery. Don’t let your history of substance abuse stop you from receiving the medical care you need.