Last November, the Centers for Disease Control and Prevention predicted the United States will for the first time experience more than 100,000 drug overdose deaths in a 12-month period. In Texas, those deaths were up 36.4% from the year before.
The increase in overdoses has been due to opioids, as well as synthetic opioids, cocaine and semi-synthetic opioids, and psychostimulants.
Addiction treatment programs will work on the addiction, but what happens when someone has an injury or a surgery that started the use of opioids? What about the pain that might still be lingering?
Driftwood Recovery, an addiction treatment center in Driftwood, developed a pain recovery program in 2016 that is intended to work on both the addiction and the chronic pain.
Dr. Ronald Siegel, an assistant professor of psychology at Harvard Medical School and a consultant on Driftwood Recovery’s pain program, said the program is “taking seriously the interaction between chronic pain and substance abuse disorders.”
Driftwood Recovery “had the realization, which is quite true, that a large number of people who are addicted to substances began because they had a pain disorder, and they began with opioids,” Siegel said.
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What’s causing the pain?
Dr. Rey Ximenes, Driftwood Recovery’s medical director, said he’s seen so many people “where I questioned whether or not they had addiction or were they just consumed with a pain problem.”
The program recognizes that there are both physical reasons for the pain as well as psychological.
“The pain is absolutely real,” Siegel said. “One of the biggest misconceptions is this idea that it’s all in your head.”
For example: You might have anxiety that is causing your stomach to be upset, but that pain is real, even if it is the anxiety that is fueling it and there is nothing structurally wrong with your stomach.
“The worry about the pain then contributes to tensing the muscles, which increases the pain, then the person starts to worry more,” Siegel said. “They can get in a cycle like this in which fear is creating muscle tension for a very long time.”
In people who have had an injury, the actual damage might have long healed, but the pain remains. And the fear of the pain worsens the pain, Siegel said.
This worry also makes people avoid things they normally would do or give up the things they like to do to avoid pain, he said.
“They stop lifting and bending… when they stop using muscles they become weaker and more vulnerable,” Siegel said. “They have a functional disorder. Their very natural reaction to the pain is keeping them tied to the disorder.”
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Treating pain, addiction together
The Driftwood Recovery treatment program includes starting with normal movements, while helping to manage the fear about the pain that is going to come out, Siegel said. Usually, the program helps them get off pain medications gradually, rather than just removing it all at once. Most of the time people leave without needing pain medications, Ximenes said.
Ximenes also works on what is physically going on with patients. That could mean therapy to help ligaments, tendons and joints including acupuncture and prolotherapy injections.
“The three things that will make you heal are how you move, how you eat and how you think,” Ximenes said. He and the exercise trainers work on the movement through classes and gym work and outdoor activities such as kayaking and walking trails. The kitchen works on healthy food, and therapists work on the psychological including individual and group therapy and mindfulness.
Driftwood Recovery has clients look at the trauma of the back pain as well as why they might not have healed from the pain.
“There’s nothing as powerful as returning to full, physical. normal activity to realize ‘I’m OK. I don’t have to return to pain.’ The goal in the program is living,” Siegel said.
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Diftwood treats people 18 and older and most people stay for between 30 to 90 days. Sometimes insurance covers some of the cost, but it can be tens of thousands of dollars. Driftwood requires upfront payment.
About 7% of the people in the chronic pain recovery program return for additional treatment.
Sometimes patients come to Driftwood believing themselves to be completely disabled by their pain disorder, “but they left jogging,” Siegel said. Other times, the improvement is more partial, allowing them to better structure their lives to work with the pain rather than be weakened by it.
“Pain is the perception the patient has of it,” Ximenes said. “It doesn’t matter what I think about it; it’s how the patient thinks about it. We teach people how to down regulate it…. pain needs to warn them, but not impair them.”
Driftwood Recovery
1905 Elder Hill Road, Driftwood.
