Does anyone have any ideas for pain management WITHOUT narcotics

Posted by JoeyC @staywell25, Jan 20 4:14pm

My insurance has denied my claim for an emergency surgery to remove my gall bladder. They said that the fact that I was not taking the pain meds(dilaudid) I must not be in pain. Blood pressure was 178/115. I was protecting my sobriety and only taking tylenol and steroids. I AM a recovered addict and I can tolerate pain, not active addiction.

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Profile picture for monkeymeg @monkeymeg

Hi! In my experiences, acupuncture was helpful. Also, if you have an open mind, try reiki. I was a huge skeptic, but was more helpful for my pain than even acupuncture was. Check it out!

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@monkeymeg

You have offered some great ideas. I'm not familiar with Reiki, so I searched for some information. Here is a link to information on the practice of Reiki from the Cleveland Clinic website for anyone else who might be unfamiliar with it: https://health.clevelandclinic.org/reiki.

I've also been helped by acupuncture, massages, mild exercise (like stretching), and lidocaine pain patches. All of these, combined with NAISDs and/or Acetophenidin (Tylenol), work together to help. Of course, physical activity is important as well. Even when pain is at its worst, and you don't feel like moving, it is still important to find some easy stretches as well as moderate exercises that can be done seated.

Dealing with chronic pain requires as many tools as possible. Putting them together can certainly result in a reduction of pain, without the need for heavy pain-killing medications.

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Joey your situation is not unique and I don't know where you're receiving treatment from or from who but read below and see how this fits you. Since you're in Philly like me I suggest you seek treatment at one of the large teaching hospitals who have the expertise in addiction. As far as controlling your pain you need a different type of narcotic that is not an antagonist which is what your typical narcotics are. I'm certain you can find a pain doctor with a background in addiction medicine in the Philly area. You shouldn't have to suffer in pain, it is not beneficial to your health.
As far as your insurance company and surgery it makes perfect sense. When you received treatment for your addiction is was because you had the symptoms and associated factors demonstrating you were an addict. Medical decision making to establish patient treatment follows a pathway and what you are demonstrating to the insurance company is that you are not sick. I don't know who your carrier is but if you go to any emergency room in the nation in acute pain and requiring gall bladder surgery they cannot turn you away and they must treat you and stabilize you. This should demonstrate to your carrier the degree of stress you are in and they will receive medical opinion they cannot ignore. This is known as EMTALA a law enacted in 1986

Successful Pain Management for the Recovering Addicted Patient
Abstract from PubMed Central
Successful pain management in the recovering addict provides primary care physicians with unique challenges. Pain control can be achieved in these individuals if physicians follow basic guidelines such as those put forward by the Joint Commission on Accreditation of Healthcare Organizations in their standards for pain management as well as by the World Health Organization in their stepladder approach to pain treatment. Legal concerns with using pain medications in addicted patients can be dealt with by clear documentation of indication for the medication, dose, dosing interval, and amount provided. Terms physicians need to be familiar with include physical dependence, tolerance, substance abuse, and active versus recovering addiction. Treatment is unique for 3 different types of pain: acute, chronic, and end of life. Acute pain is treated in a similar fashion for all patients regardless of addiction history. However, follow-up is important to prevent relapse. The goal of chronic pain treatment in addicted patients is the same as individuals without addictive disorders—to maximize functional level while providing pain relief. However, to minimize abuse potential, it is important to have 1 physician provide all pain medication prescriptions as well as reduce the opioid dose to a minimum effective dose, be aware of tolerance potential, wean periodically to reassess pain control, and use nonpsychotropic pain medications when possible. Patients who are at the end of their life need to receive aggressive management of pain regardless of addiction history. This management includes developing a therapeutic relationship with patients and their families so that pain medications can be used without abuse concerns. By following these strategies, physicians can successfully provide adequate pain control for individuals with histories of addiction.
Providing pain control for the 5% to 17% of the U.S. population with a substance abuse disorder of some type1 presents primary care physicians with unique challenges. When these individuals experience pain, they are less likely to receive adequate pain management than individuals in the general population.2 While relapse in a recovering individual may occur in spite of appropriate use of opioids and psychotropic medications required for effective pain management, inadequate pain relief is also a significant risk factor for relapse.3 Some of the challenges that physicians face include distinguishing between seeking pain relief and seeking drugs for the euphoric effects and identifying predictable neuroadaptations such as tolerance and physiologic dependence that can be misinterpreted as drug seeking or relapse behavior.4 In addition, comorbid psychiatric and medical illnesses may complicate effective pain management.5
This article will address 5 areas related to successful pain management in the recovering addict: (1) basic principles, (2) legal concerns, (3) substance abuse terminology, (4) active addiction versus recovery, and (5) management strategies for acute, chronic, and end-of-life pain. This information will provide physicians with a better understanding of the unique challenges of providing pain control in these individuals.

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Profile picture for rocksology @rocksology

I’m also in recovery, 19+ years and have lived in chronic pain since I got sober. I took 7 years off mindfulness training, meditation, acceptance & commitment therapy etc. I have recently been diagnosed with RA and completely understand how pain can become all encompassing and overwhelming.
The medical personnel and government have swung from overly permissible on pain medication to absolute denial. That is hard on us who are in serious pain and haven’t abused the medication. As a drug & alcohol counselor, I get it, but as a pain sufferer it’s devastating to not be provided with what gives some relief.
Today I take 5 mg prednisone daily just to be able to ease the pain in my claw hands; even though high dose prednisone has destroyed my kidneys, caused osteoporosis, heart failure and pulmonary hypertension. Heck of a trade off. It is completely discouraging, I know.
I hope you find relief my friend. What I found most helpful is learning to live with pain rather than IN the pain.
Acceptance. Modify activities and recognize triggers and limits. God bless.
Terri

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@rocksology I also have RA and Osteoporosis. I have fibromyalgia too. So living with pain is a must, not a choice since I am almost 2 years clean off opioids and narcotics. Tylenol, muscle relaxers, and gabapentin are the only things that eases my pain, if it does at all. Congratulations on your clean time. Sticking with it with chronic pain is definitely a challenge. But sometimes we don't have a choice.

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