Use or Abuse: Two Sides of the Same Coin
The following are examples of behavioral differences between those living with chronic pain, and those living with addiction.
Both can be life altering and both deserve appropriate care.
Ms. Cooper distills the differences into 7 factors, which show the diametrically opposed stances of addicted people and pain patients.
The Person Living with Addiction
- Medications cause a decreased quality of life.
- The person is out of control with medication, i.e. craving, do not take medications as ordered, and have repeated outlandish stories for losing prescriptions.
- The person exhibits a wanton disregard for possible damaging effects.
- The person is indifferent to considering any untried non-opioid related therapies.
- The person is unwilling to undergo new diagnostic tests that could lead to a helpful intervention and they don’t have a reasonable explanation for refusal. (This must be considered in addition to other behaviors, some patients are simply worn out with feeling like a guinea pig.)
- The person breaks their opioid contract.
- The person is in denial and is unwilling to acknowledge the benefits of integrative care even when there is no reason they can’t. (The opposite of #9 for chronic pain patients.
The Person Living with Chronic Pain
- Medications improve the person’s quality of life.
- The person manages their medications appropriately.
- If the person experiences uncomfortable side effects, they work with the physician to evaluate benefits and risks.
- The person is concerned about the source of their pain and wants to know about possible non-opioid interventions. (This does not include refusal to repeat procedures that haven’t worked. Repeating the same thing expecting different results is not reasonable.)
- The person wants diagnostic tests to investigate why previous interventions haven’t worked. (One example, a problem in the sacral plexus may be found on a pelvic MRI vs. lumbar spine imaging. Having an additional piece of information guide the physician to target a different area to relieve similar symptoms.)
- The person follows the contract for the use of opioids.
- The person is proactive in their pain care and is willing to try different self-help measures to find what works for them individually, when possible. They understand mental, emotional, social, and spiritual balance is important to managing physical pain and improving their quality of life (see number one).
When you look at these traits side-by-side, the differences are very clear and there’s no overlap.