Are opiates still used for chronic pain if you’re in recovery? No! No, no and no. It’s absolutely not allowed in either drug abuse treatment or recovery. It doesn’t matter what your condition is; it’s not acceptable and not allowed. Rehabs believe that no level of opioid use for pain is safe. They believe a former opioid addict, or alcoholic for that matter, is incapable of controlling their drug use except by abstinence. They believe that one dose will lead to another and the person will become readdicted. And they might be right.
However, millions of people do use opioids for pain without abusing them. They take them as directed and do not become addicted. But, these people are probably not predisposed to addiction by genetics and past psychological trauma. The mechanisms of addiction are still poorly understood, but drug rehabs typically believe that pain can be managed by alternative therapies. This is probably not true in all cases, but that’s what they believe, and they will expect you to get sufficient relief from a number of alternatives to opioids, such as:
- Massage, especially Reiki
- Herbal therapy
- Nutritional support
- Non-opioid pain relievers
- Physical therapy
- Nerve blocks and other similar procedures
- TENS therapy
- Oxygen or ozone therapy
Suboxone and Methadone
These are the only exceptions for any kind of opioid therapy. Rehabs allow these drugs because they’re being used for MAT or medication-assisted treatment. Rehabs see these drugs as a way for former opioid abusers to stay clean from their drug of choice. And the truth is, methadone is a highly effective pain reliever, probably better than oxycodone and certainly better than oral morphine. So, if you have chronic pain, you may be able to get relief from pain and drug cravings and withdrawal at the same time.
Unfortunately, the same isn’t true of buprenorphine, the narcotic component of Suboxone. Although buprenorphine is indicated for and used for chronic pain, it’s truly sucky as an analgesic drug, paling in comparison to oxycodone or even hydrocodone for severe and chronic pain. It’s just not a good pain-killer, unless you happen to be a cat. Cats respond well to buprenorphine and appear to get a great deal of relief from it. However, in humans, it’s not so much. However, some people do get significant pain relief from buprenorphine. Everyone is different.
Buprenorphine is a partial agonist. This means it can only bind to and activate the brain’s opioid receptors partially. This limits its ability to relieve pain. It does not have the full-agonist effects of methadone, oxycodone, fentanyl, morphine and hydromorphone, to name a few. The other problem with buprenorphine is its dismal BA or bioavailabiity profile. The BA is the percentage of an ingested drug that actually makes it to the target organ, in this case, the brain. Swallowed buprenorphine has almost no effect at all. That’s why the drug is taken sublingually or under the tongue. From there, it’s rapidly absorbed into the system, but its BA is still only about 30 percent. That means that 70 percent of the dose is lost. Compare this to oxycodone’s oral BA of up to 88 percent, and you will see the difference. Oxycodone is also highly effective by mouth and doesn’t need to be taken sublingually.
Interventional Pain Medicine
People with both a legitimate and documented chronic pain issue, such as rheumatoid arthritis, for example, can sometimes be successfully treated with opioids and still maintain their sobriety. There are specialist physicians in the pain management field called interventional pain management doctors. These doctors will use a variety of methods to relieve your pain and if they know about your drug abuse history, will probably try to avoid as much opioid use as they can, but opioids are not totally out of the question. They might be amenable to methadone, which is highly effective and available for pain management in doses of 5 and 10 milligrams. You can get your monthly supply at a pharmacy and won’t have to attend a methadone clinic every day.
Call us for Help
While you’re in rehab and recovery, expect to encounter a lot of resistance to any kind of opioid use other than buprenorphine and methadone. Neither drug produces much euphoria, and it’s a main reason why they’re used for medication-assisted opioid abuse treatment. If you’re confused, it’s understandable. A call to one of our professional drug counselors will help to answer your questions. Just call 833-820-2922 anytime for the best compassionate solutions for your situation.