Does the Subjective Nature of Pain Increase the Risk of Addiction?

Does the Subjective Nature of Pain Increase the Risk of Addiction?

Addiction to prescription painkillers was once an epidemic; in many ways, that label continues to apply. One of the major problems in treating medical problems is the subjective nature of pain—one patient may perceive pain from a condition as manageable, while someone else with the same condition may think the pain is debilitating. The subjective nature of pain makes it difficult for healthcare providers to treat pain while reducing the risks of addiction.

Whether pain is chronic or acute, it is subjective to the perception of the person experiencing it. In 1997, the Joint Commission (TJC) introduced a plan to ensure the proper assessment and management of pain. TJC accredits and certifies more than 20,500 healthcare organizations and programs within the US; in 2001, they put into effect a plan that requires all healthcare providers to assess the level of pain on every initial patient visit. They also implemented standards to manage each patient’s pain level.

Pamela L. Pentin wrote a commentary on drug seeking and pain management for the American Medical Association journal of ethics, and she argues that the new standards of pain assessment and management are misguided. It essentially allowed patients to treat themselves by rating their pain based on their own perception: during the initial implementation of the new standards, many healthcare providers would not allow patients to settle for a pain level of 4/10 or higher. The commentary also notes that the pharmaceutical industry introduced new, longer-acting opiate painkillers around the same time the new standards were introduced, so the test does not account for all available medications.

Statistics on Prescription Painkillers in the US

A Drug Abuse Warning Network (DAWN) study found that more than 1.2 million people visited the emergency department in 2011 due to non-medical use of prescription medicines. DAWN also found that painkillers caused 49 percent of the total emergency department visits in 2011 due to non-medical use; furthermore, 29 percent of those emergency department visits were due to a prescription narcotic painkiller rather than a non-narcotic, over-the-counter substance. Between 2004 and 2011, medical emergencies related to non-medical use of narcotic painkillers increased 183 percent.

The Centers for Disease Control and Prevention reports that, in 2008, 14,800 people died from a prescription painkiller overdose, which is more than the overdose deaths of heroin and cocaine combined. Since 1999, there has been a 300 percent increase in prescriptions for narcotic painkillers. There are close to half a million emergency department visits related to prescription painkillers annually, and more than 12 million Americans report using prescription painkillers recreationally. In 2010, more than two million Americans reported using a prescription painkiller non-medically for the first time, which amounts to about 5,500 people every day. The majority of people who abuse prescription painkillers get the substances for free from a friend or relative.

Subjective Pain and Addiction Risks in Treatment and Recovery

The perception of pain remains subjective even in addiction treatment and afterwards. Healthcare providers have difficulty treating chronic or acute pain not only due to the subjective nature of pain, but they also because no addiction to the same painkiller is the exact same. When someone with chronic or acute pain becomes addicted to a narcotic painkiller, she needs professional treatment to recover. While being treated for addiction, the subjective nature of the patient’s pain throughout treatment can complicate recovery efforts. If alternative pain relief methods seem inadequate for pain, then patients are more likely to revert to substance abuse and addiction. If a painkiller addict completes rehab and enters into recovery, her subjective pain may still increase the risk of relapse. It is essential for patients with chronic pain and addiction to receive professional treatment in a Dual Diagnosis facility to address their co-occurring disorders.

Find Treatment For Chronic Pain and Prescription Painkiller Addiction

If you or someone you love struggles with chronic pain and prescription painkiller addiction, please call our toll-free helpline now. Our admissions coordinators are standing by 24 hours a day to help you find the treatment program that will work for you. Experience how much better life can be without prescription drugs and call us today.