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Examining the opioid crisis – Part II: Pain management, pill dependency and holistic alternatives

Mirmont Treatment Center September 28, 2017 Substance Use Disorders

Linda Degnan-Solomons has seen her share of pain. In her role as a nurse and pain management specialist at Mirmont Treatment Center, part of Main Line Health, Degnan-Solomons treats firemen and other first responders who have often had major accidents or injuries performing their jobs every day. Many of them, understandably, have been prescribed painkillers, commonly opioids, which provide instant relief from the stress, anxiety and pain associated with their jobs. Opioids, like hydrocodone and oxycodone, have become standard for chronic pain management.

Opioid effects include almost immediate feeling of well-being, making brain want more

But the drugs do more than relieve pain. They produce a feeling of well-being that makes the brain desire more. And the more the person takes, the greater “tolerance” the brain develops. Soon, the drug is needed in greater quantities to produce the same euphoric effect, which often leads to dependency and addiction, and in some cases, harder drugs.

Yet it all goes back to pain, says Degnan-Solomons, “Chronic pain is usually the reason they get addicted in the first place.”

The same goes for some of the young people Degnan-Solomons meets who may have been given prescription painkillers for surgery but then became dependent on the feel-good effects of the medication. Or, as is common these days, they’ve happened upon a half-used bottle of painkillers in their parents’ medicine cabinet. Degnan-Solomons adds, “I’ve had kids who’ve come in and said, once they took that first Percocet, they loved how it made them feel and instantly wanted more pills.”

Addiction is a disease with three components: biological, psychological and sociological.  Genetics can predispose people to developing an addiction sometime in their lives while stress, depression, anxiety and trauma can contribute to or accelerate the disease. School, friends and culture can all play a part in our susceptibility to abusing substances.

Degnan-Solomons uses the example of Joe* who grew up in a chaotic home as a child and used sports as an outlet for his frustration and to alleviate stress. Then one day he gets injured playing his sport, sees a health care provider and comes home with a prescription for pain relievers. Soon he realizes that the pain pills not only help his physical pain but also numb him from his unhappy family life. Soon he needs more and more due to his increased tolerance and the chemical changes happening in his brain. Eventually he needs the pills to function.

Most health care professionals agree that pain medicine and management is critical to helping patients recover from surgeries, injuries and accidents that cause pain that impacts their daily lives. Yet the challenge for doctors, nurses, behavioral health specialists and patients is: how do we manage pain or reach for a nonmedicinal technique or method to relieve pain when it’s so much faster, easier and cheaper to get a prescription painkiller?

Holistic therapies and ways to manage pain without medication

Degnan-Solomons asserts there’s no shortage of effective ways to relieve pain without medication. At Mirmont Treatment Center, some of the holistic therapies used to treat pain include meditation and mindfulness-based stress reduction (MBSR), which involves quieting the mind and body, and paying attention only to the present moment. MBSR has proven effective at relieving anxiety and stress, which trigger and exacerbate pain.

Other Mirmont practices include yoga, reiki, using healing energy with hands, and qi gong, another energy modality that helps quiet the mind, slows things down, and helps patients get centered and comfortable in their own bodies. Ear acupuncture, involving thin needles placed at precise points in the outer ear, helps relieve patients of feelings of anxiety and pain, and puts them in a quiet, relaxed state. Each type of therapy is taught by trained practitioners who are also well versed in rehab and recovery. Holistic therapies at Mirmont are seamlessly integrated into the 12-step recovery foundation, exposing patients to alternatives and giving them tools they can use for the rest of their lives.

“Each technique is gentle,” says Degnan-Solomons, who also teaches her patients self-acupressure as a way to relieve pain. Using their own fingers to compress certain energy points on the body can produce relaxation and a pain-relieving effect on their specific pain areas. Says Degnan-Solomons, “Patients are amazed how well self-administered acupressure works to decrease their pain.”

Body awareness is first step in pain management without medication

Degnan-Solomons points out that pain pills only treat the symptoms rather than the root cause of pain. In fact, the pills often mask the pain, which allows the person to continue being active in ways that can cause re-injury without knowing it. Being aware of the body and one’s pain is difficult for many patients who have numbed themselves with medication for a long time—but it is the first step in managing it, she says. At Mirmont, patients develop this mind-body-spirit awareness through a comprehensive treatment approach that includes holistic modalities.

Pain management at Mirmont also includes talking it out. “Chronic pain is complicated, you can’t see it like a broken arm or leg,” says Degnan-Solomons, who works hand-in-hand with counselors, psychiatrists and nurse practitioners, providing guidance and therapy as well as non-addictive medications for pain. Patients are encouraged to talk about their anxiety and any issues they’re having because talking through things can release mental and physical tension, thus relieving pain.

Accepting pain, preventing pain

Degnan-Solomons understands the pain cycle herself, having dealt with her own back pain from a car accident at age 25. “Until I found yoga,” she says, “I didn’t know how to recuperate when I got into a pain cycle.” Now she aims to prevent back pain from starting in the first place with a weekly yoga class, stretching, hot packs, exercise, making healthy food choices, meditation and a monthly massage. “If I get into an episodic pain cycle, I get my hot packs out and do some stretches. It takes body awareness, time and perseverance to deal with chronic pain.”

Accepting pain, or what Degnan-Solomons refers to as “sensitivity,” and learning to live with it, while also having the right supports in place, such as yoga, massage, acupressure and meditation—is part of the recovery journey without the medication.

Nonetheless, there continue to be barriers to using holistic techniques. Many health care providers are not educated in holistic modalities for pain relief and therefore do not recommend them. In addition, the cost of getting a holistic treatment is usually out-of-pocket, making it more expensive or cost-prohibitive for many.

For those who balk at the idea of putting down their painkillers and paying out-of-pocket for holistic alternatives, however, there’s always a way to reprioritize. You just have to be willing, advises Degnan-Solomons. Getting off of cigarettes, for example, frees up an extra $50 a month that could be used for membership at a local healing massage venue. By cutting out a couple of Starbucks coffees a week, most people could afford a yoga or Pilates class. Or simply making time in each day to get quiet and breathe and exhale pain from the body can help people begin to rely on themselves and the body’s own ability to heal.

If you or a loved one is dealing with an opioid addiction or you simply have questions, talk to the recovery specialists at Mirmont Treatment Center. Call 1.800.846.4656 for a confidential appointment or contact us online using our secure form.

* For privacy, the patient’s name has been changed.