Coexisting Addiction and Pain in People Receiving Methadone for Addiction

Abstract

The aim of this qualitative study was to examine the narratives of people who experience chronic pain (lasting 6 months or more) and were receiving methadone for the treatment of their opiate addiction through a major methadone clinic. This paper featured the pathway of how the participants developed chronic pain and addiction, and their beliefs of how prescription opioids would impact their addiction in the future. Thirty-four participants who experienced chronic pain and received methadone for treatment of opiate addiction were willing to tell the story of their experiences. The findings in three areas are presented: (a) whether participants experienced addiction first or pain first and how their exposures to addictive substances influenced their experiences, (b) the significance of recreational drug use and patterns of abuse behaviors leading to chronic pain, and (c) participants’ experiences and beliefs about the potential for abuse of prescription opioid used for treatment of pain.

Health Care Experiences when Pain and Substance Use Disorder Coexist: “Just Because I'm an Addict Doesn't Mean I Don't Have Pain”

“…Prevalence reports and costs to our society are important indicators; however, people with these intertwined problems of SUD and chronic pain face significant challenges to their health. For some individuals, pain can lead to SUD through treatment with opioid analgesics, and pain can cause relapse in those with known SUD [6]. Furthermore, SUDs can make pain worse through active injuries that are masked through substance use [6–8].…”

“…For some individuals, pain can lead to SUD through treatment with opioid analgesics, and pain can cause relapse in those with known SUD [6]. Furthermore, SUDs can make pain worse through active injuries that are masked through substance use [6–8]. When study participants' drug use was out of control, they had worse pain; when pain was out of control, the experience caused their cravings to become worse [6].…”

“…Furthermore, SUDs can make pain worse through active injuries that are masked through substance use [6–8]. When study participants' drug use was out of control, they had worse pain; when pain was out of control, the experience caused their cravings to become worse [6]. Each caused a reciprocal and mutually reinforcing cascade [6].…”

“…When study participants' drug use was out of control, they had worse pain; when pain was out of control, the experience caused their cravings to become worse [6]. Each caused a reciprocal and mutually reinforcing cascade [6]. Management of patients with these coexisting health problems has not always been successful.…”

“…Early studies highlighted the importance of identifying the comorbidities of chronic pain and SUD [16–19]. Current findings continue to show that physical illnesses, such as arthritis, low back pain, headache, and chronic pain from injuries, are prevalent among individuals with SUD, and result from excess use and risky behaviors [6,20]. Despite these painful medical conditions, those with SUD have many unmet health care needs.…”