Once the drugs are stopped, you will eventually feel a lot better and may have the unrealistic expectation that you will not want to use or even think about drugs anymore. Because using drugs to relieve pain had become such a common practice, it is always possible that even as you feel better, you will think about and even crave drugs. Wanting the drug when it’s absent is called craving. This does not have to be the compulsive style of “I gotta get high” that some addicts feel, but could be more like “I’m hurting and I need something to take the pain away even though it won’t be good for me in the long run.” This makes sense, because the pills did relieve your pain! So, thinking about drugs when you are in pain is not something you should feel bad or ashamed about. If you’re at this point in the book, chances are opiates didn’t work for you overall. Possibly you became addicted, or the medications stopped taking the pain away but you took them anyway, or the medications caused intractable side effects, or your function decreased while you were on the medications. But if you took an opioid, it did work in some way to help you feel better, if only for a short while. Now, in recovery, the negatives far outweigh the positives of using drugs, and you are committed to abstinence from opiates. That doesn’t mean that you won’t crave them from time to time when you are hurting physically and/or emotionally. Craving is a normal part of the process of drug dependence and recovery. Wanting relief from pain makes sense, but pain recovery consists of dealing with the pain differently. It requires your attitude to change about this short-term measure that is ineffective in the long run, so you act in a positive way and don’t take the drug. Maintaining balance in pain recovery means doing your best to not use opiate pain medications, hopefully ever again. Relapse prevention requires knowing that you are having a craving. You need to be aware of the craving so that you can take appropriate action and not take the drug. You must know that you are thinking about using a drug—you must bring the unconscious thought into your consciousness. After you do that, it is imperative to discuss the cravings with someone you trust who is knowledgeable. This person could be a sponsor in a twelve-step fellowship or a peer in a pain-recovery support group. It could be a health professional, counselor, or family member who understands pain recovery. Other things you can do to relieve craving include:
- Going to a meeting.
- Talking about how you were feeling before the craving occurred.
- Going for a walk or other gentle exercise (whatever will keep you busy without making your pain worse).
- Doing something kind to be helpful to someone else.
- Reading or watching a movie (preferably with someone else).
- Writing a list of the things in your life you are grateful for.
- Exploring, with a trusted person, any precipitating event, feeling, or need that might be related to that particular craving.
What If I Develop acute Pain?
If you have a history of addiction and develop acute pain, for example, from surgery or a broken bone, then you may need to take opioids for a limited period of time. If this is the case and you can’t do without them, take the smallest dose possible for as short a period of time as possible. Have someone hold and dispense the medication for you and stop as soon as you can. Sometime in the future you may find that you have to weigh the option of taking opioid pain medications for a medical condition or procedure. First ask yourself, “Do I really need them?” Get counsel from a doctor, sponsor, and others whom you trust. Rather than deciding to take medications impulsively, slow the process down, bounce it around, write about it, pray about it in a way that makes sense to you, and explore your thoughts, emotions, body, and spirit about it. This blog post is an excerpt from Pain Recovery – How to Find Balance and Reduce Suffering from Chronic Pain by Mel Pohl, MD, FASAM, Frank Szabo, LADC, Daniel Shiode, PhD, Robert Hunter, PhD; Published by Central Recovery Press (CRP).