When Opioid Use Hits Home

Many of my patients deal with chronic pain and opioid use. My role is to help them with their blood glucose control while dealing with managing severe pain and discomfort and other concerns they have. I have always tried to be empathetic to other’s pain and the way they deal with it. However, when I broke my foot and needed to deal with unmanageable physical and emotional pain, I realized how complex pain management and opiate use has become.

Millions of people suffer from chronic pain that has lead to the opioid epidemic. At the same time, the goal is to reduce the misuse of the opioid prescription in order to reduce its dangerous side effects.

How do we deal with chronic pain management? How can we go to work in pain, eat right while in pain, sleep well in pain, exercise in pain, and do all of the other needed daily activities that can lead to possibly reduce the pain.

Here are my top three approaches to pain management.

  1. Focus on pain management strategies instead of grieving the loss of health. Using pain scales such as the Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), or Visual Analogue Scale (VAS) helps with pain intensity assessments. These scales can help to distinguish between pain, unpleasantness and emotions that are associated with the way we experience and feel pain. When I broke my foot, I was focusing on not just the pain but the fact that I cannot move, cannot go to work and was stuck in the house doing nothing but grieving the health I lost for weeks. At that time, it did not matter that broken bones always heal and things will get better, what mattered that I was in pain and simple tasks like brushing teeth seemed like an impossible 30 minute task. The pain of being in pain and the emotions associated with it can often skew the intensity of actual pain.
  2. We cannot always control the pain but can control how we respond to it. There are several psychological approaches to pain management like cognitive behavioral therapy, mindfulness and biofeedback therapies that have shown to be effective in reducing the psychological distress that is associated with long-term pain. There are multiple layers of complex abstract thoughts and feelings we go through in response to pain which culminates how much pain we actually feel and how we deal with pain. Teaching our emotions how to respond to pain can help on a daily basis.
  3. We do not need to have it all figured out in the beginning. The goal is to talk to pain specialist clinicians who are able to explore various pain management options available. Talk to other people who have experienced pain and hear their perspective. Also talking out loud about your pain and sharing it with someone else, helps to clarify what is going on, puts things in perspective, releases tension, and might help with solutions.

My own broken foot story has a happy ending but with long recovery spectrum. I am still recovering, years after. Most recently, I was able to run my first 5 K, a task that seemed impossible just few months prior. Now, I am training for 10K and have a long-term goal to run a marathon. The experience with dealing with chronic pain was a good lesson of perseverance and prepared me to try things that might seem impossible at the time. It also taught me more compassion to myself and others that means not only feeling pain but also being able to try to help in relieving it.


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