BY MEL POHL — Chronic Pain occurs as a complicated web of emotions and physical symptoms.  The most common way to treat pain is to use opioid medications, which actually complicate the course of chronic pain. For some who develop addiction matters become much worse. At the Making Workers Comp Work conference we will review the interactions of pain, suffering and addiction as they interface in your clients with suggestions for intervention and treatment.

Opioids complicate the course of many work comp cases and are a poor choice as a mainstay for the treatment of chronic pain. I believe the pharmaceutical industry has promoted medication as the sole treatment, and in combination with physicians we have a conundrum of overuse of medications and inadequate treatment of chronic pain.

The importance of understanding the fundamentals of treatment of pain and suffering with opioids, including side effects, opioid induced hyperalgesia, and emotional pain vs. physical pain, cannot be underestimated. I would like to share with you treatment alternatives to opioids for Chronic Pain Syndrome, including cognitive behavioral interventions, physical modalities and meditative practice.  Additionally we will discuss reasons why doctors have so much trouble discontinuing drugs that are ineffective and causing horrible side effects.

By describing addictive disease as a complicating factor for some with chronic pain, especially those who are treated with opioids, and identifying key factors that can optimize positive outcomes with patients who are doing poorly on opioid treatment regimens, we can begin to develop a treatment which may result in return, to work or, at least, improvement in function. In the 30 years I have worked in addiction treatment programs detoxing people from opioids and other reward-inducing drugs, I have gained an understanding that if a person exhibits problematic drug use, drug treatment with opioids is not going to be effective for chronic pain. Alternative treatments are effective for treating people with both conditions, and should be more widely utilized over intensely addictive opioid medications. I ask you to consider the following questions:

-How can you tell who will get in trouble with opioids?

-Does everyone who takes pain medications become addicted?

-What’s the difference between drug dependence and addiction and problematic drug use?

Let me know your answers here by writing them in the blog.