Dealing with medication in recovery

March 31, 2017
Johann Kassim

Some addicts have abstained from pain relief medication only to find themselves relapsing. They justified it as being able to cope with the pain. Hence, recovering addicts are open to relapses on both sides of the argument. With pain-relief medications, you are prone to cravings. That may lead to a full-blown relapse if left unmonitored. Those who go without proper pain treatment may resort to self-medication. Self-medicating becomes the relapse.

This controversy makes treating addicts with medicine a delicate issue. The complication has a solution in proper medical procedures. These methods resemble a balancing act based on a couple of core principles. They are as follows:

  • Addressing legal issues;
  • Recognizing substance abuse terminology;
  • Seeing the difference between active addiction and recovery; and
  • Management strategies for medication in two types of pain: acute and chronic pain.
  • The medication addressed in this article will be a focus on pain-relief medication. For it poses the most controversy for the recovering addict.  

A Basic Principle

At Solace, we believe that the fundamental principle for medicating addicts is to focus on pain elimination. We don't control drugs based on its potential towards addiction. Keeping this focus in mind, we use the patient’s level of pain as a signal for appropriate medication. This procedure forms the basis for effective pain management.

The Joint Commission on Accreditation of Healthcare Organizations suggests a numerical scale of 1 – 10 for adults. On that scale, 10 represents severe pain. Having such a scale will help to ease the implementation of appropriate medication. It will also facilitate mutual understanding for the pain at hand. Finally, this system is reproducible. Thus, allowing clinicians to be more consistent with the management of pain medicine. This consistency is necessary to combat the elusiveness and indecision around addict-patients.

Legal Issues

Opiophobia is the fear of legal consequences resultant of over prescription of opioids. Many clinicians have this phobia. As a result, under prescribe necessary opiates for pain management of addict-patients. As mentioned earlier, addicts are prone to relapses on both sides of prescription. So, it would be unethical to under prescribe, especially if the pain is severe.

Laws in the U.S. did not remove the fears of Opiophobia. The Uniform Controlled Substance Act 1970 minimized medicines to maintain and treat detoxification. Clinicians were still vulnerable to lawsuits from over-prescription of opiates to addicts.

The Psychotropic Substances Act 1978 helped clinicians to give opioids for pain relief. It gave doctors the responsibility to treat patients according to international medical standards. The act contributed to protecting clinicians from ambiguity.

Medical professionals need to follow these procedures when dispensing medicines:

- To document the dosage;

- To document dosing intervals;

- To record the amount provided, and the timing of the next medication.

They are to do all this regardless of their patient's addictive history. The routine documentation helps clinicians perform their clinical task. It can also protect them from unwanted legal consequences of opioid dispensation. These clear-cut legal guidelines to opioid dispensation have eased complications. Our doctors at Solace Sabah, follow the guidelines that protect both themselves and the patients they treat.

Substance Abuse Medication Terminology

The problem with treating addicts is the use of terms. Clinicians are prone to use global words such as physical dependence and tolerance. These terms enable them to describe addictive tendencies of their patients. But, they are also generic, and thus, unhelpful to the addict-patient.  

The terms are helpful to patients who are non-addicts, but who develop a dependency on a particular medicine. Hence, it is very misleading to use those very same terms on the addict populace. It's because addicts are substance dependent. Appreciating this difference is vital to weeding out true addiction to drugs. At the same time, clinicians can understand standard drug-dependency of their non-addict patients. Thus, medical professionals need to be familiar with substance abuse terminology. They need to be able to see the difference between the addict and non-addict dependency.

Addiction is any abuse of illegal drugs such as marijuana and meth. Or misuse of controlled substances, such as opioids. All this in aid of relieving emotional pain instead of physical pain relief. Drug-seeking behaviors of the addict are different to seeking genuine relief. It's important to see that both addicts/non-addicts will seek pain-relief. Only addicts will portray these drug-seeking behaviors. Hence, the importance of discerning these differences.

The phenomena of “pseudo-addiction” happen when patients hoard their medication. They do this out of fear of under-prescription due to perceived Opiophobia.

At Solace Sabah, we avoid this by appreciating the difference between addicts and non-addicts. We also avoid it by following the procedures hitherto stated. We value the importance of using substance abuse terminologies. We appreciate the nature of addiction and the necessity for pain relief in recovery.

Active Addiction Versus Recovery

There is a marked difference with medicines in recovery as opposed to drugs in addiction. In active addiction, addicts used drugs as part of an addictive process. In recovery, the use of opioids is to relieve genuine pain.

At Solace, we are very much aware of these differences. It is important that our patients continue to take their medications as prescribed. Our clinicians will watch you for any consequence that may harm your recovery. We take such consequences with grave concern. We are here to treat addiction, not to start a new one.

In continuing care, we encourage our clients to visit the psychiatrists for updates. Take care of yourself and taper the medicines according to medical advice. We want you to be free from flippant clinical practices outside. Thus, it's important to be truthful when dealing with outside physicians.

Prioritise recovery and check your intent behind the taking of prescribed medications. Is it for natural pain-relief? Or is it for emotional comfort? Last but not least, only use medications when needed.

Medication Management Strategies

The clinical goal for pain-relief medication in recovery is to end the pain. At Solace Sabah, we manage pain from two out of three categories of pain-relief. The last group, "End of Life"; is pain management for palliative care centers. As we deal with addiction care, our concern is only with the type of pain that follows:

Medication for Acute Pain

The goal of pain management is to end the pain. A person’s functionality comes secondary when dealing with this type of pain. At Solace Sabah, we will have a careful look at your addictive history. We may have to prescribe controversial medicine if the pain is too unbearable. In such interventions, there will be a process of careful rehabilitation and care. Our aim is to manage the pain first, then, treat the addiction when functionality returns.

Medication for Chronic Pain

The purpose of pain management is to end the suffering. At the same time, maintain the patient’s functionality on the long-run. Due to being a life-long illness, medical recourses for dealing with chronic pain will have to tally with the values of recovery. In this case, it would be unwise to put patients on long-term addictive medications. But, we can substitute those for non-addictive meds that are capable of alleviating the chronic pain.

Dealing with medication in recovery

We understand the difficulty our patients go through with medicines in recovery. On one side, there is a need to abstain from narcotics. Yet, on the other hand, pain exists in all its forms. Without proper medical intervention and reasoning, the addict will either take extreme strides.

In approaching the issue, you might abstain to the detriment of your well-being. On the other hand, you might also overindulge in medicines as a replacement for the drugs. It's due to this that at Solace Sabah we ask that you place your trust in us. We have the professional experience to take care of you that no other medical facility can. It's because we understand the need for treating pain in recovery.

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