With the recent deaths of Corey Haim, Brittany Murphy, and Michael Jackson, most psychotherapists and physicians, who may not necessarily work in addictions, are becoming more mindful of this growing epidemic of pain medication addiction. As a psychotherapist who specializes in addictions, I have been aware of this pervasive problem for years. In addition, in most cases, I tend to believe my clients are exhibiting “drug seeking behavior” when they are visiting doctors or emergency rooms more often. However, I truly believe there are some individuals out there who are being under treated for their intractable pain when they tell a physician they are in recovery. I had such a client recently who was not given the proper pain management after a shoulder surgery. He suffered excruciating pain for weeks after being discharged without the proper medications prescribed to alleviate his pain. Without going into details and medication management, which is certainly not my scope of practice, I have become quite concerned that some recovering addicts or alcoholics may not be getting adequate medical care for their pain because physicians have had to turn into policemen so as to avoid any legal problems. When someone who truly needs medication for pain doesn’t receive adequate relief from his or her pain, even if he or she is a recovering addict, they can become depressed, isolative, and hopeless from a real medical condition that no one is acknowledging because their doctors fear legal ramifications. This leads to being under medicated which can result in emotional or physical suffering as well as possibly initiating a relapse by self-medicating.
On the other hand, of course, is overmedicating which can bring on the addiction for someone who has been clean and sober for many years. Yes, there are certainly abuses of the system which is obvious when we pick up any newspaper about the latest death from an overdose by someone who was seeking out multiple prescriptions and no one is denying that. There are many doctors abusing the system by prescribing painkillers rather than referring clients to pain clinics, not initiating drug histories, or finding alternative treatments. This, of course, can lead to addiction if these painkillers get into the wrong hands.
So what is the solution for this problem of giving adequate care to someone who is seriously in need of pain relief, but has a history of addiction? I am not sure, but perhaps it is not only up to the physician or psychotherapist treating the addict. Of course, the client himself is responsible for seeking out adequate medical care, but perhaps it is also the responsibility for those closest to him at home or at work to keep an eye on what is going on. If you think someone in recovery is abusing the system, start noticing if he or she is making decisions that don’t align with his or her usual behavior such as using the medication to deal with emotional pain or to cope with stress. Notice if he or she is not taking the medication as prescribed. Is he or she less present in their relationships at home or at work? Are you seeing this person putting him or herself in situations that can cause danger to others such as driving when medicated? Be aware if this person is suddenly seeing new doctors or visiting multiple pharmacies and finally, is this person needing refills way before the prescription is up? On the other hand, if you believe someone in recovery is not getting adequate pain relief from a chronic or acute medical condition, do some investigating. Observe if he or she is becoming hopeless, helpless, depressed, and isolative, not participating in his recovery program, and most importantly, are they becoming suicidal? Look for the signs and symptoms and perhaps you can be an advocate for him or her in receiving the proper medical care and pain management they need. With proper systems in place and effective pain management, there are many options for the individual in recovery.
Sherry Gaba, LCSW, is a psychotherapist and life coach in Agoura Hills, CA. She specializes in addictions, depression, anxiety, trauma, PTSD, and other mental health issues, as well as helping her clients find their life purpose. She is a contributing author of the “Conscious Entrepreneur” and in September 2010 for Recovery Month her book “The Law of Sobriety” will be out. She is the Life Coach and Psychotherapist on Celebrity Rehab with Dr. Drew Pinsky on VH1 and has been on CNN, Inside Edition, Fox and KTLA News, as well as a contributor to the Huffington Post, E-Online, Cosmopolitan, and the New York Daily News. She can be reached at firstname.lastname@example.org or www.sgabatherapy.com. Follow me on twitter: http://twitter.com/SherryGaba