Killers, Addiction & Pain Management
Dr. Richard Frances
and Nancy Helle
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.
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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