Ex-heroin Addict: Chronic Back Pain: Asking Dr. About Methadone

Question

Asked by Susy

Ex-heroin Addict: Chronic Back Pain: Asking Dr. About Methadone

I have a chronic back pain for many years now (I'm 25 years old) and I used to be a heroin addict. I went to treatment and got treated with methadone and my back pains disappeared. I have been sober for 5 years and counting but I am afraid if I go to the doctor to ask for methadone for my chronic back pain, he will say I am a drug addict and will not believe me. What should I do? How should I go about it? I have tried massage, acupuncture, therapy and none work. thank you!

Answer

One's candidacy for opioid treatment depends on many factors which boil down to the primary question: Do the risks of opioid treatment outweigh the benefits?

Potential risks include: addiction (relapse) and loss of function, hormonal imbalance with chronic opioid use, conditioned responses leading to increased pain (hyperalgesia), and typical side effects like: constipation, nausea, dry mouth and in turn dental issues, sweating, weight gain and drowsiness.

Potential benefits must be weighed in terms of function because pain control is really not the goal for using pain medications, improved function is the primary goal for opioid use. Is the medication going to help you go back to work and/or continue working? Is the medication going to help you participate in an exercise program? Is the medication going to help you care for dependents?

If the opioid medications are going to help you become a more functional member of society, then you might be a candidate for an opioid trial.

Remember, addicts become dysfunctional. People with pain on appropriate amounts of medications become functional. Which one will you become? That is for you and your doctor to discover.

Continue to try to optimize your health and someday you might discover pain control without chemicals.

Dr. Christina Lasich, MD