Help  for Those Concerned about Addiction and Chronic Pain

DrC_PictureDr. Stephen Colameco has practiced addiction medicine for over 25 years. He is certified by the American Board of Addiction Medicine,  the American Board of Family Medicine, and he has been recognized as a Fellow by the American Society of Addiction Medicine. He currently holds an medical school academic appointment as an Assistant Clinical Professor at the Rowan University School of Osteopathic Medicine. Dr. Colameco lectures and writes on topics related to chronic pain, addiction, and mental health.

Addiction, Physical Pain, and Emotional Suffering

This website is intended primarily as a resource for those seeking help for addiction or for chronic pain when complicated by addiction issues or concerns.

book coverIn his book, Chronic Pain: A Way Out (2012), Dr. Colameco describes the interplay between pain and addiction; he offers steps to help create a treatment path that includes evidence-based medical treatments, physical modalities, counseling, self-care education and alternative approaches. This book  is intended as a  resource for not only for those who suffer with chronic pain, but also for their families and healthcare providers. This book includes portions of the previously published 12-Step recovery guide: 12-Steps for Those Afflicted with Chronic Pain. The 12-Steps are intended to help individuals recover from the emotional suffering that so often accompanies chronic pain.  

12StepCoverWhen chronic pain is complicated by emotional suffering, doctors often refer to this condition as the "chronic pain syndrome". Those who develop this syndrome are at risk for increasing physical, emotional, and social deterioration over time as well as for the abuse of prescribed medications. The revised edition of 12 Steps for Those Afflicted with Chronic Pain: A Guide to Recovery from Emotional and Spiritual Suffering (2013) is not intended to replace, but rather to supplement medical treatments. For those who are already familiar with 12-Step recovery, this book provides a means of applying the 12-Step approach to chronic pain. For others, this book provides an introduction to the 12 Steps, recovery stories, inspirational readings, and recovery exercises.

Chronic pain and addiction are complex disorders that are often related. Research shows that addicts experience more pain than the general population. Individuals treated with opioids (narcotics) for chronic pain may be at risk for addiction. In both chronic pain and addiction psychological, social and environmental factors dynamically interact to alter how the brain functions. Science tells us that the brain pathways involved in pain and addiction overlap. Psychological factors such as mood, beliefs, and thought processing play key roles in both disorders; many individuals with these conditions also suffer from anxiety, depression, PTSD and other psychiatric conditions. For all of these reasons, the best treatment for pain and addiction need a holistic, biopsychosocial approach. This is not just Dr. Colameco's opinion. In 2009, the American Pain Society stated in a medical practice guideline that "As chronic noncancer pain is often a complex biopsychosocial condition, clinicians who prescribe continuous opioid treatment should routinely integrate psychotherapeutic interventions, functional restoration, interdisciplinary therapy, and other non-opioid therapies."

In 12-Steps for those Afflicted with Chronic Chronic Pain: A Guide to Recovery from Emotional and Spiritual Suffering (2005), Dr. Colameco wrote, "Sometimes these medications (opioids) do more than deaden pain; they may also numb feelings... Opiates are never the answer for depression, fear, anxiety, guilt, worry or anger. In fact, numbing our feelings is altogether wrong; it delays getting real help that might relieve our suffering..."

Newer research implicates opioids themselves as  a possible cause of pain. Evidence is mounting that opioids lower the pain threshold and pain tolerance because of a condition known as opioid-induced hyperalgesia.  Opioids actually makes pain worse for many patients;  a number of studies have shown that many if not most patients receiving high dose opioid treatment will experience less pain once opioids are withdrawn.

Medications alone, whether they be an opioid for chronic pain or Suboxone (TM) for addiction, are rarely adequate to treat these conditions.  Effective treatment requires a commitment to recovery. Often, this means a combination of counseling, medications, exercise, support group participation, and complementary (alternative) therapies.

It is Dr. Colameco's hope that you will be able to find the information you need on this website. Please feel free to contact Dr. Colameco, especially in regard to how this site can be improved.