Emerald Coast Pain Blog

Recently, I have been involved in addiction medicine. I initially got into that field due to having patients who were being discharged due to signs of addiction. Lately, I’ve been seeing people who never were my pain management patients and I have learned a lot from them. First, I realize that the majority of them fall into either the baby boomer crowd or their children. I am amazed at the number of young people addicted to various drugs. After examining their situations, I realize that many of them had some deeper reason for their addiction. I realized that many of them were self medicating for some psychological issue. After deeper analysis I determined that many of them had depression or anxiety. They would tell me that the drugs made them “feel normal”. Anxiety seemed to be more prevalent than depression, but depression was definitely number two. They were utilizing the drugs to dull their sensations to living and thus dull the depression or anxiety. Obviously, most of the people I would deal with were addicted to opiate medications but some admitted to multiple addictions. Some people amazed me by what they were taking but they all seemed to be self medicating. The sad thing about this is that most of these people probably would never recover until their psychological issues are improved. Many of these people have already been through psychiatric therapy but failed. Many of them been through rehab and failed. Most of all, most of them were in denial that besides being an addict, they also had a psychiatric syndrome. That makes it hard to treat them since being in denial means that they don’t want to see a shrink. Also, they find that the medications to treat anxiety and depression are not as pleasurable as the meds they abuse and thus they generally complain of side effects or barely give the medications a real chance. This is a shame because many of them could be cured (recovered) if they just could treat their depression and anxiety. Obviously, they have cravings to the drugs and this is something that we treat with the oral medications for the addiction but just like any addiction, they can be weaned down off the drug in time. Other issues I see in these people include poor environmental surrounding. Things such as poverty, stress, low esteem and no support network. Many of these cannot be changed but I feel that narcotics anonymous helps with some of these. I strongly encourage them to attend narcotics anonymous regularly and those would do generally do better. I image that poverty and stress cause people to abuse medications to dull their senses to their environment. These people, who have minimal support networks, poverty and stress tend to be very prone to relapse. That’s where outpatient addiction therapy usually ends and they either end up back on street medication or at a methadone clinic. I think outpatient treatment of opiate addiction was a good idea by the government. It gets these people off the streets looking for pills and comittting crimes. The outpatient therapy works for many and maybe these patients still are addicts but they are controlled addicts and stable enough to function in society. The only thing that is missing is reasonably priced psychiatric care which as stated above is the only real way to get these patients recovered.