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Chronic Pain and Opiate Addiction Don’t Have to Go Hand in Hand
By Jamie Becker
“If I had $20 to spend on food for my family or to buy heroin and get high, I would get high.” This was told to me by someone in recovery from a heroin addiction. Their addiction didn’t begin with heroin, nor did they set out to become an addict; no one does. It began with a legitimately prescribed narcotic pain medication to help deal with an overuse injury as a result of working for 30 years in the construction industry.
Our country and communities are currently facing an opiate addiction epidemic. Opioids are a class of narcotic pain medication that includes prescription drugs like OxyContin, Percocet and morphine (heroin is also an opiate). In 2014, 61 percent of U.S. drug overdose deaths involved opioids. The epidemic has led to a similar increase in heroin usage and overdoses since prescription opioids are often a gateway to heroin abuse.
Chronic pain and the role of prescription narcotic painkillers to treat it have been thrust into the public spotlight. Pain affects more Americans than diabetes, heart disease and cancer combined. Chronic pain can also be a very real source of stress and takes a toll that is physical, mental, emotional and financial.
It’s easy to see how the idea of taking medication to make the pain go away is an attractive option for people. However, it’s easy to build up a tolerance to opioids and soon need higher doses to get the same effect. This tolerance can lead to abuse – continued use of the drug despite problems with relationships, work, school, health or safety. Abuse can eventually lead to addiction – uncontrollable drug-seeking behavior no matter the consequences.
Work and Chronic Pain
We know there are professions such as healthcare, construction and landscaping where injuries are more likely to occur and where people are at an increased risk for developing chronic pain. People may not be comfortable discussing these kinds of work-related issues, but ignoring them can have a real impact on worker safety and health and on employers’ businesses.
“Every effort should be made to prevent illnesses and injuries that lead to pain, including the progression of acute pain to a chronic condition,” says LIUNA General Secretary-Treasurer and LHSFNA Labor Co-Chairman Armand E. Sabitoni. “Reconciling how to work safely while managing chronic pain is a very serious issue that the LHSFNA is working to address on behalf of both LIUNA members and signatory contractors.”
Prescription drugs have become a legitimate safety concern when it comes to dealing with chronic pain. It’s an issue employers are trying to address in drug-free workplace policies and safety programs, while also trying to balance employees’ right to privacy over their medications and associated health conditions.
Treating Chronic Pain
Though opioids carry substantial risk, especially when compared with other treatments for chronic pain, there are times when these medications are appropriate and effective. The concern is that prescription opioids are often the first line of defense for doctors and an expectation of patients when addressing chronic pain.
There is a national effort underway to reduce the treatment of chronic pain with narcotic painkillers. Several recommendations for doctors include:
- Not using opioids first. Try other methods such as Tylenol, ibuprofen or ice
- Only write opioid prescriptions for short term use (3-7 days), preferably no longer
- Don’t start with long-acting opiates and use the lowest possible dose
- Talk to the patient about expectations – 100% pain-free may not be realistic
- If a prescription is given, make sure the patient knows the risk
- Check prescription tracking systems to make sure patients are not getting medicine somewhere else
The LHSFNA has made addressing opioid addiction a priority and will continue to monitor and share information on this important topic regularly. While there is not a simple solution, it will be important for all sides to work together to address the safety, health and social concerns resulting from this epidemic.
[Jamie Becker is the LHSFNA’s Director of Health Promotion.]