Treatment Centers And Clinics
There are numerous treatment centers and clinics where individuals facing opioid addiction or abusing prescription drugs can receive treatment. It is important to remember that all cases of pain pill addiction are not the same. Some may be more or less severe, resulting in different types of treatment.
The Hazelden Betty Ford Foundation notes that treatment itself for conditions like pain pill addiction can include a variety of items and strategies, including nutritional planning, mental health services, and medical detox. Types of rehabilitation and facilities themselves, according to the foundation, can include inpatient clinics that are staffed around the clock day treatment, where an individual receives treatment throughout the week intensive outpatient programs, where a person receives an extensive amount of care and programming and continuing care, which can just be for a few hours each week.
These types of treatments and facilities may be covered by health insurance. The U.S. Department of Health and Human Services offers resources and information that can help individuals learn whether or how much their insurance may cover the treatment.
Treatment For Opiate Addiction
There are many treatment options to choose from, but research suggests the most effective form of treatment for Opiate addiction is inpatient detox followed by inpatient rehab. Inpatient rehab centers have specialized programs for individuals suffering from this type of substance use disorder. These programs help patients dig deep within themselves to uncover the root cause of their drug use. Knowing what caused patients to use drugs or alcohol in the first place will help prevent future triggers while in recovery.
Many individuals quickly find that the rewards of progressing through a treatment program far outweigh the high they formerly gained from drug use.
Effective forms of therapy used during treatment often include cognitive behavioral therapy, individual and group counseling, and 12-step programs.
Featured Centers Offering Opiate Addiction Treatment
Reviewed by Certified Addiction Professional: February 14, 2019
Theresa Parisi
What Is Addiction To Pain Medication
Substance use disorder is considered a progressive condition that starts at a low level and increases in severity. Fortunately, addiction can generally be noticed and acted on in the early stages, no matter the substance. One of the most common substance use disorders is an addiction to pain medication, with an estimated 9.7 million people abusing prescription pain relievers in 2019.1
Addiction to pain medication is a common result of initially misusing the prescribed medication. For example, people with chronic pain or post-surgery patients are often prescribed strong painkillers to help mitigate the pain and maintain a normal daily life. However, if this medication is misused, it can lead to pain pill addiction.
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Medications To Avoid In Recovery
Pain affects everyone, and that includes recovering addicts. A number of medications are too risky for those in recovery to use. Whether you have taken a fall, pulled a muscle, or had a wisdom tooth pulled, you must be overly cautious when it comes to any form of pain medication. The wrong medication can take you down the road to relapse, so be sure your doctor is full aware of the problems you have had with addiction and knows you are in recovery. Some of the medications to avoid in recovery include:
Its dangerous to take an opiate during recovery. Because you have been re-training your brain and body, even a small amount of an opiate will jeopardize your recovery and pose a high risk of relapse.
Medicare Covers Pain Relief Surgery
Although surgery may not be the first recommendation for pain relief, it can be part of the treatment plan for several conditions and diseases that cause pain. For example, a doctor may recommend surgery for joint repair to a patient with chronic arthritis. Medicare Part B will cover surgeries that are considered medically necessary to treat or diagnose a condition or disease. Therefore, if the doctor can present the necessary medical codes, Part B may cover pain relief surgery.
Medical procedure costs are hard to estimate, as there are usually several parts of Medicare involved. If a hospital admits a beneficiary for surgery, Part A, Part B, and Part D may pay for a part of their services.
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Counseling And Mental Health
This service can be beneficial to those who are currently experiencing or have already been treated for pain pill addiction. According to the U.S. Department of Health and Human Services in its Substance Abuse and Mental Health Services Administration , federal law requires patients who receive treatment in an OTP to receive medical, counseling, vocational, educational, and other assessment and treatment services, in addition to prescribed medication.
A booklet provided by the American Society of Addiction Medicine notes that counseling should be performed by a qualified health professional, and can take place in or beyond a specific center where a person is receiving medication and treatment. The process of counseling itself can help an individual facing addiction understand underlying causes or factors contributing to their condition, such as low self-worth, difficult life situations, and negative peer groups, ASAM notes.
Seek The Support Of A Therapist During This Time
You might be less likely to relapse during your period of taking pain medication if you are simultaneously meeting with a therapist who has experience with recovering addicts. Find a therapist to help guide you through this. And if you wish to only see a therapist for a temporary period of time, know that thats okay too.
Remember, just because you need pain medication does not mean youve broken your commitment to recovery. Many people would agree that taking pain medication for a medical purpose and a temporary period of time is only considered a relapse if it becomes something for more than medical purposes. Ultimately, your number one obligation is to keep yourself healthy, and as long as you approach your pain management honestly and with full support, you are on a good path to making it through addiction-free.
If you or someone you know is seeking help with addiction, please visit our directory of treatment centers or call to start the path to recovery today.
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Why Do People Become Addicted To Pain Medication
One of the most common reasons that people develop pain pill addiction is through a prescription for pain mediation. Painkiller addiction is a common result of tolerance to prescription pain relief, meaning more of the drug is needed to achieve the same effects. This can progress into taking more than prescribed or taking the prescribed amount more frequently than indicated. Approximately 21% to 29% of people with chronic pain who are prescribed opioid pain medication misuse them. 3
In either case, this is considered misusing the drug. Over time, this misuse can potentially develop into an addiction, which is indicated by a compulsion to obtain and consume more of the drug despite adverse effects. The urge to take the pain medication could be due to pain relief or seeking the drugs pleasurable effects., which is a large contributor to addiction and a strong reinforcing agent to the cycle of abuse.
Medicare Covers Physical And Occupational Therapy
Physical and occupational therapy are two other popular forms of pain relief. Both types of therapy are similar, and Medicare covers them the same way. Therapy is considered a doctor service and thus covered under Part B.
Medicare Part B covers medically necessary physical and occupational therapy sessions. As long as the sessions continue to be needed, Part B will cover it. Recently, there were caps on how much Part B would pay for therapy sessions. However, those rules are no longer at play.
Part B has an annual deductible of $185, as of 2019. After the beneficiary pays the deductible, Part B will pay 80% of covered services, and the beneficiary must pay the remaining 20%. For example, if a beneficiary has a physical therapy session at the beginning of the year, they would have to pay up to $185 out-of-pocket for that session. If the session is more than $185, Part B will cover 80% of the difference, and the beneficiary will be billed for the remainder. From then until the end of the year, Part B will immediately cover 80% of allowable charges.
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Risk Assessment And Stratification
For proper risk assessment and stratification, often-used terminology must be clearly defined:
Addiction:
Addiction is a primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.13
It is critical to distinguish addiction from substance abuse or misuse, which are defined as follows:
Abuse:
A maladaptive pattern of substance use, leading to clinically significant impairment or distress as manifested by 1 or more behaviorally based criteria.14
Misuse:
Gourlay, Heit, and Almahrezi list the following steps physicians should take as a part of universal precautions for pain management16:
Seeking Help For An Addiction
According to a statistic from the National Institute on Drug Abuse, 40 to 60% of people with a drug addiction relapsemuch like people suffering from diabetes, hypertension, and asthma. Thus drug addiction should be treated like any other chronic illness relapse serves as a trigger for renewed intervention. Though it can be difficult to determine when to use medication and when not to use medication for pain management, if youre suffering from an addiction, your best bet is to be completely honest about past addictions and recovery. Sometimes medical standpoints can be hard to understand and there can be a lot of jargonso always ask questions if you arent sure!
One thing thats certain, if you are in recovery, you dont want to relapse. Contact us today if you have questions about proper treatment for addiction. Relapse may be a possibility, but you dont want to find out the hard way
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Medicare Covers Prescription Pain Medications
One of the most common ways to manage chronic pain is with prescription painkillers, many of which are opioids. Opioids such as hydrocodone, oxycodone, and oxymorphone have been go-to prescriptions for years. Although these medications relieve pain, they can also cause several side effects such as dizziness, sleepiness, and, often, addiction.
Opioids are not a recommended long-term solution for pain relief. However, doctors may recommend them for the short-term. Thats how Medicare Part D covers them. Medicare Part D is the primary source of prescription drug coverage under Medicare. While each Part D prescription drug plan is different, opioids generally have quantity limits.
Quantity limits restrict certain medications from being overused. If the prescription has a quantity limit, then the plan will only cover a specific amount of the drug each time its filled. Also, there may be time restrictions between prescriptions. If a beneficiarys health care provider thinks the restriction shouldnt apply to their patient, they can request an exception from the plan.
Part D plans must cover at least two medications in each therapy class. Therefore, doctors will have at least a couple of options for pain relief.
Taking Pain Medication During Addiction Recovery
You can safely take pain medication during recovery from addiction if you carefully plan before your procedure. If your surgery is unavoidable and healing will be painful, you should consider the following steps to avoid relapsing on pain medications:
- Talk to your doctor about your concerns.
- Be open and honest with your treating physician about your past with addiction.
- Let them know that you are in recovery and need to be careful about pain medications, especially addictive pills containing opioids.
- Your doctor might suggest alternative medications or holistic treatment that do not involve potentially addictive drugs to treat pain.
- Discuss the aftercare process for your surgery.
- Ask your doctor about what to expect when you heal from your procedure.
- You want to know how much pain you should expect and how long this pain should last.
- If your pain should only be intense for the first few days following surgery, your doctor might recommend switching from opioid pain medication to something non-addictive, like aspirin or ibuprofen, after your pain intensity peaks.
- Also, discuss what actions will help you avoid pain, like how much bed rest you should get or when you can ease into regular activities.
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Pain Management For People In Addiction Recovery Has Become A Huge Topic Of Concern Due To The Opioid Epidemic In Our Nation
Physicians are presented with challenges when people with substance abuse issues are experiencing pain. On the one hand, they do not want to prescribe narcotics for fear of the individual relapsing or even possibly overdosing. On the other hand, they do not want a lack of adequate pain relief to lead the person to using drugs or alcohol to help manage the pain.
The American Psychiatric Association Task Force outlines the diagnostic criteria for substance dependence in their Diagnostic and Statistical Manual of Mental Disorders as a maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested in three or more of the following, occurring any time in a 12-month period:
Lifelong Abstinence And Addiction
Not all addictions demand lifelong abstinence. There are situations, such as eating disorders, where those affected must learn how to manage their behavior appropriately rather than using abstinence for life as the yardstick to measure success.
Since its not reasonable to expect that a recovering addict undergo surgery and receive no pain medication in the hours and days following the procedure, the idea of complete abstinence from pain medication isnt realistic. No one can guarantee that they will never suffer a severe injury that requires the administration of pain medication by paramedics or emergency room doctors.
If the probability exists that someone in recovery may need to take pain medications, the best way to handle the situation is to have a plan in place.
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Managing Chronic Pain In Addiction Treatment
Whether short-term acute pain or seemingly endless chronic pain, the result is the same while a person experiences it. Pain can interfere with daily activities, causing people to feel helpless and hopeless. Pains intensity varies depending on the cause, ranging from dull and nagging discomfort to severe pain with hard throbbing or stabbing sensations.
Managing Chronic Pain In Recovery
When you have chronic pain, know that recovering from opioid addiction does not mean that you will not be able to manage your pain. While using opioids to manage acute or chronic pain may not be possible, there are numerous non-opioid pain management interventions, including: 8, 9, 11
- Non-opioid medications.
- Cognitive-behavioral therapy .
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Tools For Risk Assessment
Consider the following case studies as a guide through the following tools for risk assessment:
Case study III
- Patient is a 45-year-old female with failed back surgery or post-laminectomy syndrome no further surgical procedures are planned. Patient did not respond to physical therapy and is prescribed gabapentin, cyclobenzaprine, and oxycodone. UDT is negative for illicit substances and positive for prescribed medication. A random pill count suggests that she takes more medications than prescribed and she frequently runs out of her prescribed opiates early.
What is happening here? There are a number of possibilities to consider: incomplete relief of pain because of inadequate dosage a new diagnosis worsening of pain generator tolerance seeking euphoria or selling or sharing medication .
Case study IV
- A 74-year-old female with 5 previous back surgeries has chronic pain and is prescribed methadone and uses oxycodone for breakthrough pain. When she comes alone for an office visit, her pain is better with methadone only and she does not request oxycodone. When her son accompanies her to a visit, she insists on oxycodone prescriptions along with methadone. She has not shown up for pill counts on at least 3 occasions. The prescribing physician believes that this patient needs treatment and methadone is sufficient and that her son may be using or diverting medications.
The expert panel discussed many tools for comprehensive risk assessment:
Urine drug screening
Strategies And Recommendations For Management Of The Addicted Patient
Consider the following case study to guide you through the treatment options that follow:
Case study V: cocaine addiction and severe pain
- After 2 previous lumbar fusions, a 55-year-old female develops severe back and leg pain and is unable to walk. As a result, she is wheelchair bound. Examination of her MRI and X-ray reveals spinal stenosis above the 2 previous fusions. The surgeon rules out further surgery and recommends pain management. Routine UDT confirms cocaine use. The patient denies cocaine use. She is not interested in spinal interventions, physical therapy, or adjunctive medications and wants only opioids. Her prescribing physician required a consultation with an addiction specialist and arranged an appointment. She did not keep the appointment on 3 occasions.
What other testing should the physician order? Mass spectrometry confirmation of the point-of-service cocaine positive result is important. Several prescribed medications and over-the-counter medications can result in a false positive result for many substances. For example zolpidem, coca leaf tea, salicylates, and fluconazole can cause a false positive for cocaine.22
When illicit drugs appear in UDT
When prescribed opioid drug serum concentrations are inappropriate
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