Chronic Pain and Going to Treatment

By P. Casey Arrillaga, LCSW, LCDC

Over 50 million adults in the United States live with chronic pain. Of these, over 17 million experience a significant impact on their daily activities and quality of life. Unfortunately, many of these people are at high risk of developing an addiction, otherwise known as a substance use disorder. At such time as they realize they need help, some will hesitate, because they fear giving up the addictive medications that are so often prescribed for chronic pain. In this post, we’ll look at the realities of chronic pain and how it can be addressed safely so that those who have it can still get the treatment they need.

What We Know So Far

Chronic pain is bodily pain that lasts for at least three months, and it can persist for years and even decades. For some people, chronic pain is a defining feature of their lives. The Center for Disease Control estimates that over 50 million U.S. adults, or about 1 in every 5, experience chronic pain. Of these a little over 17 million find that the pain gets in the way of daily activities and thus has a significant negative impact on their lives. This level of chronic pain is known as high-impact chronic pain.

Out of the general population, some groups are at higher risk for chronic pain. Some of these statistics are less surprising, such as that chronic pain is 4 to 6 times as prominent in at-risk populations including Native Americans  and people whose incomes are below the poverty line, or people who generally report poor health or disability. Other facts may be more surprising, such as seeing that chronic pain rates are about twice as high in people who are separated or divorced as those who are married, or that those in rural areas are about twice as likely to have chronic pain as those who live in or near cities. Perhaps most surprisingly, federal researchers found the bisexual adults experienced chronic pain at about 1 ½ times the rate of people who identified as straight or gay.

Chronic pain impacts family, work, and social life. It has been linked to a number of mental health conditions, including increased rates of depression, dementia (including Alzheimer’s), substance use, and risk of suicide. The association between chronic pain and depression is strong enough that research shows that children with chronic abdominal pain are likely to become adults with depression. It is not certain whether the pain or depression starts first, or if they are so intertwined that it cannot be known where the trouble starts. Even without resolving this chicken-or-egg debate, the link between them is clear.

Suicidal thinking, sometimes called suicidal ideation [SI], more clearly seems to be motivated by chronic pain. People with chronic pain are about twice as likely to have SI as those who don’t have such pain. They are 2-3 times as likely to have at least one suicide attempt, and they are 9 times as likely to die by suicide. Part of this association is based on the fact that so many people with chronic pain are prescribed opioid painkillers. Even among those who do not develop a problem with the painkillers, these prescriptions provide easy access to a lethal method for suicide, to the point that among chronic pain patients with SI, 75% say they would overdose on their opioid medications as their preferred plan.

Adding to the problem with having opioid painkillers go hand in hand with chronic pain is the fact that opioids are so inherently addictive. This has to do with the similarity between these drugs and the natural chemicals our brain produces to achieve a sense of wellbeing and motivation, and to control pain. Furthermore, our brains can quickly become reliant on the use of such drugs, so that people who take them do not feel like they can function without them. Chronic pain patients are particularly at risk for this, because they are already dealing with pain that they want to escape. Once they become reliant on opioid medications to deal with that pain, it is hard to imagine being okay without the drugs. If they become addicted to the medications, they may want more and more, which in many cases leads to obtaining them illegally and/or moving to use of other opioid drugs including fentanyl and heroin.

What Can Be Done?

People who are in this kind of predicament clearly need treatment, but they are often scared to accept it because even if they can beat the addiction, the chronic pain is still there. Luckily, we can offer hope to anyone in this position. At Windmill, we have helped many people find non-addictive solutions to their addictions, other mental health disorders, and their pain. A comprehensive treatment plan includes our medical team helping each client to first safely get them off the opioids, then working with them to find the best medications, our therapists helping the client find solutions to the emotional cognitive issues that might otherwise make it tempting to return to opioid use, and our certified physical and nutrition team members individualizing activity and nutritional plans. Our entire team has the common goal of setting the client up for success. We also offer access to cutting edge programs including Brain Frequency and NET that can help the client find unique solutions.

The Bottom Line

Chronic pain is a serious and widespread problem. It often leads to addiction and other mental health issues that can become life-threatening. It also makes it harder for people who have it to accept treatment, out of fear that they can’t be okay. Luckily, there is help available to help those with chronic pain live happy and fulfilling lives.

About The Author

P. Casey Arrillaga is the Team Leader for Education at Windmill Wellness Ranch, and he is the author of books including “Realistic Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.