Medication Assisted Treatment and Pain in an Aging Population

Chronic pain doesn’t mean you always have to suffer. [1]

The word chronic means constant, lasting a long time, or coming back again and again. When you have pain that has bothered you for more than 3 months and doesn’t seem to get better with time, you may be experiencing chronic pain.

Major causes of chronic pain include lower back problems, nerve damage, and migraine headaches. Pain also can be a part of many diseases, such as sickle cell anemia, arthritis, pancreatitis, fibromyalgia, and HIV/AIDS. There are many other causes of pain, and sometimes the cause is unknown.

Chronic pain can be difficult to bear, even awful. It can lead you to lose sleep, to become anxious and depressed, to have a hard time keeping up on the job, to let go of relationships, and to stop doing things you did before. These changes can add stress, produce more pain, and trigger new health problems. If unmanaged, pain can become the center of your life.  Does this sound familiar?

In many cases, chronic pain is a lifelong condition. However, by managing your pain, you can usually continue to enjoy the activities that matter to you. One of the most important things you can do to manage your pain is to safeguard your recovery from mental illness or addiction. A clear mind helps you think better, so that you take the right steps to manage your pain.

 Chronic Pain and Opioid Dependence

Opioid use disorder can affect people of all ages, racial, ethnic, sexual and gender minorities; income classes; and geographic areas. Older adults are among the groups affected by this problem because they often use prescription opioids to cope with painful chronic conditions, such as arthritis, or procedures, such as surgery. As a result of chronic pain, older adults may use prescription opioids for a long time, which presents a risk for developing an opioid use disorder. In addition, as people age, medications affect them more strongly and are slower to leave their systems so the side effects of opioids can be severe. Among the risks that older adults who use opioids face are death, hospitalization, and use of emergency departments.

We can work with your healthcare provider by providing integrated care

Medical professionals may be able to determine what is causing your pain and help you to deal with that problem by prescribing opiate pain medications. If you have chronic pain, however, becoming dependent on opiate pain medications over time is a reality.

If a person does develop an opioid dependence, scientific evidence shows that substance use disorders, including opioid use disorder, can be treated effectively and recovery is possible (Surgeon General, 2016). Treatment involves a comprehensive, interdisciplinary set of solutions, which include: treating a person’s individual needs, including pain control; providing readily available treatment, including medication-assisted treatment for opioid use disorder; ensuring sufficient length of treatment; and providing any necessary behavioral therapies.

Even if the source of pain remains a mystery, Marin Treatment Center can work with you and your medical provider to try different strategies until you find a combination that reduces your suffering and medication dependence. We are here to help you.

Why older adults may respond better in an Opioid Treatment Program instead of a physician’s office setting

Marin Treatment Center is an Opioid Treatment Program (OTP) and specializes in working with people with opioid use problems. We can help support you by providing medically managed Medication Assisted Treatment, one-on-one counseling therapy, pain management planning, and care coordination between healthcare providers, so that you do not need to go through this alone.  Independent physician’s practices typically do not provide this level of comprehensive therapy and treatment services.

Aging often involves chronic conditions such as degeneration in bones, joints, and muscles (Molton and Terrill, 2014). About 40 percent of older adults report pain, as compared to 30 percent of the general population (Le Roux et al., 2016). In addition, mental health issues such as trauma, anxiety, depression, loss of loved ones and loss of social connections can contribute to relying on opioids and other substances such as alcohol to ease emotional and physical pain.

Opioids can have an especially negative impact on aging adults, because as people age bodies processes medications much slower. Older adults frequently use multiple medications, and the accumulation of medications can interact with opioids and cause serious and sometimes fatal outcomes. For example, in the instances when older adults who use opioid pain medications and combine anti-anxiety medication, such as a benzodiazepine and opioid pain medications.

Work with care providers to create a pain management plan (SAMHSA)

Chronic pain differs from person to person and from one moment to the next. That’s why you need to have a pain management plan that’s designed for you. This plan may include both action steps and medications for overall management of pain, plus guidance on what to do when you have episodes of acute pain.

It’s important to note that pain management is a process. You and your care providers will need to monitor your plan on an ongoing basis and make adjustments as needed, so that it continues to help you manage your pain and so you avoid becoming overly dependent on pain medications.

Counseling can help

Your medical care providers may recommend you for a kind of counseling that has been quite helpful for many people in pain, as well as for people in recovery. This counseling, called cognitive–behavioral therapy, is usually offered individually in private sessions, or in small groups that can last for several weeks. Whichever route you chose to take, you will learn how to manage your attitude toward pain to change how you experience it, and gain support and insight into how to distinguish physical pain from emotional pain, and what steps you need to take to get through difficult times.

Keep up your recovery from mental illness

Many people with chronic pain have anxiety, depression, or PTSD. These conditions can make pain feel worse. They also can make it difficult to stick to a pain management plan. If you are affected by these symptoms, your pain management plan may need to include extra mental health supports such as counseling, participation in a mutual-help group, or medications to treat the mental illness.

Maintain your addiction recovery

Relapse prevention is very important to pain management, and vice versa. Fortunately, many of the things that help with pain— such as having a positive attitude, keeping busy, and learning coping skills—help control cravings and prevent relapse. Taking an active part in your pain management has a double reward, because it can strengthen your recovery from addiction while helping you manage your pain.

No one medical professional can have expert knowledge about every aspect of your health. If your care providers need more information and more help for you, they may refer you to other experts, such as specialists, such as Marin Treatment Center, a nutritionist or psychiatrist. Referrals do not mean that your care providers think you are a street addict, or that your pain is imaginary, or that you aren’t worth bothering about. Having a team of people to help you manage your pain and well-being can improve your chances of success. If you get a referral to Marin Treatment Center, make the appointment as soon as possible and we can talk to you about how we can help.

Maintain your addiction recovery

Relapse prevention is very important to pain management, and vice versa. Fortunately, many of the things that help with pain— such as having a positive attitude, keeping busy, and learning coping skills—help control cravings for drugs and prevent relapse. Taking an active part in your pain management has a double reward because it can strengthen your recovery from addiction while helping you manage your pain.

No one medical professional can have expert knowledge about every aspect of your health. If your care providers need more information, they may refer you to other experts, such as specialists, such as Marin Treatment Center, or psychiatrists. Referrals do not mean that your care providers think you are a street addict, or that your pain is imaginary, or that you aren’t worth bothering about. Having a team of people to help you manage your pain and well-being can improve your chances of success. If you get a referral to Marin Treatment Center, make the appointment as soon as possible and we can talk to you about how we can help.

[1] You Can Manage Your Chronic Pain To Live a Good Life (SAMHSA)