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Rehab Doc: Rx Painkillers Make More Pain

Opioids may cause more problems than they solve, feeding into a vicious cycle of trauma, pain and addiction.

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By Hunter R. Slaton

04/24/12

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Day two of the Foundations Recovery Network’s Freedom & Recovery conference in San Diego kicked off with a tag-team talk by Dr. Mel Pohl, FASAM, medical director of Las Vegas Recovery Center (LVRC), and Claudia Black, Ph.D., senior clinical and family services advisor for the same rehab. Pohl and Black spoke on the interplay between trauma and chronic pain, both of which feed into one another to create debilitating addictions—not to mention more pain. Trauma sufferers drink or use drugs to relieve emotional and physical pain, which works for a while; but then—due to a quirk of how opioids act on the brain, as well as to the biological need for a functioning pain response—the pain comes back stronger than before, requiring more booze or higher doses of meds to suppress it, kicking off a vicious cycle.

It’s worst for those who have been through a particularly harrowing experience, such as war or sex abuse (especially during childhood): “The greater the trauma experience, the more synergistic the relationship between trauma and pain,” Black said. She added that greater trauma leads to a greater likelihood of addiction. Unfortunately, many medical doctors—influenced by the “pharmaceutical-industrial complex,” as Pohl put it—are too quick to write prescriptions, often for opioids, which can cause more problems than they relieve. As a particularly jarring PowerPoint slide illustrated, from 1999 to 2010, rising painkiller sales have corresponded with remarkably similar, steadily increasing rates of overdose and treatment admission. It’s for this and other reasons that LVRC uses the term “pain recovery.” “I got tired of calling it ‘pain management,’ said Pohl. “And I don’t like using the term ‘painkillers’—we’re not going to ‘kill’ the pain.”

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