Q&A: Straight Talk on Addiction and Pain Management

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Headaches, backaches, injuries – we all experience varying degrees of pain from time to time. And it’s natural to want to remedy that pain. Occasional use of pain medication can be an effective way to treat pain. But what happens if infrequent use turns into prolonged use or even addiction?

Local events have brought to light ongoing issues of prescription drug abuse happening in our area and across the nation. We sat down with Jennifer Bowler, BSN, RN-BC, LADC, manager, Behavioral Health Services at Renown Heath, for a Q&A about addiction. 

What is addiction?

Addiction is the repeated use of substances or behaviors despite clear evidence of increasing consequences secondary to such use. It occurs when a drug starts to cause problems in a person’s life, beginning a cycle of use and consequences, followed by increased use and more serious consequences.

Prescription drug addiction is just one form of this disease. For some who become addicted to a prescription drug, the process may start with an injury that requires the use of pain medication, or a surgery that takes time to heal.

What are common medications that people can get addicted to?

Potentially addictive medications include:

  • Narcotic pain medications – prescribed for severe pain not helped by other painkillers
  • Benzodiazepines – often prescribed for intermittent insomnia or anxiety
  • Stimulants – may be given to people with weight problems or for treatment of attention/hyperactivity disorder

What are signs that you or a loved one may have a prescription drug problem?

Prescription drug abuse can be very difficult to detect. Many prescription drugs, such as painkillers and sedatives, produce effects that impair speech, movement, gait, thinking, etc. Since they are frequently necessary for someone to function, many families will have a hard time determining when a loved one crosses from medical use to addiction.

The following are telltale signs that could indicate an addiction to prescription drugs:

  • Obsessing about medication – thinking about the pills, counting pills, worrying about running out, or carrying all medications with them
  • Keeping a number of empty prescription bottles
  • Seeing more than one doctor to obtain prescriptions
  • Filling prescriptions for the same drug at different pharmacies
  • Inappropriate use – taking a medication even after the symptoms have passed or for a purpose other than the reason it was prescribed
  • Lying about medications and defensiveness about how much and what is being taken
  • Exaggerating symptoms to a doctor to obtain more medication
  • Running out of a medication early, before refills are due
  • Significant behavioral changes, such as: sleeping habits, appetite changes, substantial weight loss or gain, withdrawal from family and friends, anger, shortness of temper, loss of interest in hobbies or leisure activities
  • Trouble at work, including tardiness, absenteeism and poor performance
  • Falling asleep in inappropriate places, or appearing drowsy or tired on a consistent basis
  • Being secretive about medications

It is important to keep in mind that addiction is a disease, which if left untreated, can have dire consequences. If the behavior continues, over time the disease progresses and the circumstances will continue to get worse. 

What are the next steps if you think you or a loved one are addicted or becoming dangerously close to addiction?

Family members, medical doctors or friends may be the first to become aware of the seriousness of the issue. Caring intervention may be the first step in getting help. It is not necessary for the person to continue their use for years, move on to other drugs or experience huge losses.

It is important to remember in patients with chronic pain or anxiety symptoms that there is a tremendous amount of fear about losing a medication, damaging a relationship with the prescriber or being judged. The earlier this cycle is broken, the better the chance of avoiding destructive life events.

For the person that becomes addicted, denial can be a major roadblock to getting help. Denial is not always a conscious choice, but can be a reflexive or unconscious reaction to a problem. The drug abuser may deny the presence and severity of their disease to themselves and others.

If an intervention doesn’t help, there are other options available.

Renown Behavioral Health offers outpatient detoxification treatment in our Partial Hospitalization Program. This program is an alternative to inpatient detoxification for alcohol, opiates, benzodiazepines, THC, and stimulants. It is staffed with nurses who monitor symptoms on a daily basis, and patients also see a psychiatrist two times per week. Patients participate in groups, case management, individual psychotherapy and medication management five days per week from 9 a.m. to 3 p.m. Patients learn alternative strategies for dealing with their symptoms and will have a coordinated plan that may include referrals for complementary non-medication therapies.

In addition, some Renown physicians are accepting new patients for addiction outpatient therapy. Please contact the Renown Behavioral Health Programs line at 775-982-5318 option “2” or call Nancy Allen, patient care coordinator, at 775-982-5419 to schedule a confidential assessment and discuss treatment options.

What should someone do who has a history of addiction or is in recovery when they need medical treatment?

Any addicted individual should be concerned about medical care that involves being prescribed potentially cross addictive medications. Make sure you tell your care provider about your health history, drug history and know that it will take a coordinated treatment effort to prevent relapse.

Seeing a therapist with knowledge of addiction disorders and cross addiction along with being actively involved in a recovery program (such as Alcoholics Anonymous or Narcotics Anonymous with sponsorship) will help prevent relapse – involving others is the key.

What other community resources are available?

Organizations throughout the community have come together to increase conversations about the serious and ongoing issue of prescription drug abuse. If you or someone you know is dealing with addiction or going through withdrawal, please contact the Substance Abuse Hotline at 775-825-HELP (4357) or visit Healthier Nevada.

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