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Narcotic pain pills (hydrocodone, oxycontin, ultram etc.) work well to relieve serious pain, they are also very addictive if used improperly, and the risk of addiction increases dramatically for anyone with a history of substance abuse.

For someone in recovery from addiction and in serious acute or chronic pain, this combination of efficacy and risk poses a real dilemma, and although no one wants to gamble hard earned sobriety, neither is living in pain an acceptable option.

So what to do?

In years past, the answer given at 12 steps meetings and by doctors was, "tough out the pain, and don't risk an addiction." Times and have changed, and medical opinions have too, and most doctors will now recommend potent analgesics to anyone in serious pain, regardless of their past.

Although pain medications with a high abuse potential certainly threaten sobriety, so too does chronic pain, and unremitting and untreated pain can lead to psychiatric distress, and often to relapse. Asking someone to just "tough it out" doesn’t seem an acceptable option anymore.

Unmanaged pain reduces quality of life and threatens sobriety, and so pain should not get ignored; yet this does not automatically mean that narcotic analgesics are needed. Many pain-patients learn techniques, such as yoga, meditation and breathing exercises, that when combined with over-the-counter pain relievers (Acetaminophen, Ibuprofen) offer acceptable pain relief, with no risk of addiction.

For others, only potent drugs will offer any real respite from serious pain, and although behavioral pain management techniques can offer some relief, narcotic drugs are required. For these patients, drugs should be used, but only in a very controlled and limited manner.

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Page last updated Aug 05, 2010

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