Abstinence is key to recovery. But for many people with an opiate addiction, issues with chronic pain can be a real challenge to long-term sobriety. That makes finding effective non-opiate painkiller options a driving concern in recovery. Fortunately, there are safe and effective solutions for chronic pain that won’t interfere with your recovery….
How Slow Relapse Is Possible “Following Doctors’ Orders”
One very important component of successful recovery from opiate addiction is staying healthy, by following doctors’ orders and addressing medical issues as they arise. For problems with chronic or severe pain, however, simply following a doctor’s orders may not necessarily be good for recovery, especially if the doctor has prescribed a narcotic painkiller. In this case, even a strong commitment to avoid opiates may not be enough to prevent slipping into a slow relapse trajectory.
That is one more reason to know the options regarding non-narcotic, non-opiate painkillers. Afterall, no one who has worked hard to achieve recovery wants to backslide into addiction for any reason— especially not because of a doctor-prescribed medication.
What a ‘Narcotic’ Is and Why People in Recovery Avoid It
The term “narcotic,” also known as “opioids,” refers to substances that dull the senses and relieve pain, according to the U.S. Drug Enforcement Administration. “Narcotics” include illicit drugs like heroin and synthetic opiates, such as fentanyl and carfentanil; they also include prescription opiates, often prescribed to those with debilitating chronic pain or post-operative pain.
These drugs can be highly addictive, even for first-time users. This risk is much higher, though, for those in recovery from these drugs. It’s therefore common wisdom that anyone in recovery from an opiate addiction should avoid these drugs entirely.
What Do Narcotics Have to Do With Addiction?
An addiction to a narcotic, (opiate) drug is a medical condition like other substance addictions, meaning it typically requires treatment. After a narcotic addiction has developed or a person has relapsed on opiates, professional detox and therapies are often the only way to stop the addiction cycle.
Are There Non-Narcotic Options for People in Recovery?
After becoming abstinent and no longer physically dependent on narcotic painkillers, the last thing someone in recovery wants to do is revert to using opiates. Still, if chronic pain persists, the body’s inability to tolerate unceasing pain may prompt a return to the use of prescription or illicit narcotics as the only known way to stop the agony. There are, however, non-narcotic options for people in recovery that can help ensure they remain abstinent while simultaneously addressing pain relief.
What are some of these non-narcotic painkiller options, including the strongest non-narcotic painkiller? Let’s take a look.
List of Non-Narcotic Painkiller Options
Several therapies are proven to alleviate pain, reduce the need for reliance on narcotic painkillers, and help with adherence to strategic plans and goals in recovery. These non-narcotic painkiller options are also equally useful in treating all kinds of addiction, as well as mental health disorders such as anxiety and depression that so often accompany addiction.
- Mindfulness Training
- Cognitive-Behavioral Therapy (CBT) – CBT uses practical techniques that change physical activity and lessen distress and the tendency to catastrophize, while increasing social engagement and functioning. Coping strategies, relaxation techniques, exposure to activities that are feared, and those that divert the individual’s attention to pain are some elements of CBT.
- Stress Management
Complementary Non-Narcotic Painkiller Options
Many individuals in recovery from substance abuse who also suffer from chronic pain choose to take part in complementary nonnarcotic painkiller options. The American College of Physicians recommends acupuncture and massage for the non-narcotic treatment of chronic low back pain.
Other options include:
- Guided Imagery
- Music Therapy
- Heat Therapy
- Physical Therapy
- Transcranial Magnetic Stimulation (TMS) – For chronic pain that is resistant to other pharmacological treatments, some studies report that individuals with spinal cord injury pain experience some improvement with transcranial magnetic stimulation (TMS) and other forms of neural stimulation techniques.
- Epidural Analgesia or Intrathecal Treatment – These interventional approaches may help reduce the uncontrolled pain associated with cancer.
- High-Frequency Spinal Cord Stimulation and Stimulation of Dorsal-Root Ganglia – This is a new but not yet rigorously tested interventional approach for pain.
List of Non-Narcotic Pain Pills
Since opiates fall under the classification of narcotic pain relievers, and most are highly addictive, searching for a safe and effective non-opiate painkiller to relieve chronic pain is a worthwhile endeavor.
An article in the New England Journal of Medicine, discussing non-narcotic pain management methods, recommends non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and acetaminophen, as safe and well-known, analgesic, over-the-counter drugs. They’re best for slight-to-moderate pain, including pain from migraine, post-operative pain, joint and muscle pain, toothache, menstrual pain, and tension headache.
Other non-narcotic and non-opiate analgesic agents include antidepressants such as tricyclic antidepressants and serotonin-norepinephrine reuptake inhibitors (SNRIs), and anti-epileptic medications, including gabapentin and pregabalin. Findings from a study in The Lancet, Neurology led to a strong recommendation for the use of the proposal of SSRIs, gabapentin, and pregabalin in the treatment of neuropathic pain. Some topicals can be used externally to manage pain, such as a lidocaine patch that is FDA-approved for postherpetic neuralgia, and a capsaicin patch that desensitizes and temporarily reduces the number of pain fibers in the skin.
Strongest Non-Narcotic Painkiller
Among the non-opiate painkiller options that may may qualify as the strongest are duloxetine, gabapentin, and pregabalin. Another study published in The BMJ pointed out that 75 percent of clinical practice guidelines endorse the use of duloxetine, a SNRI, for low back pain and osteoarthritis. All three are first-line therapy for treating neuropathic pain, while duloxetine is also for fibromyalgia and chronic musculoskeletal pain.
What is AA’s Stance on Painkiller Use?
AA has long encouraged an abstinence from drugs and alcohol. However, AA also recognizes that alcoholics have medical conditions like heart disease and epilepsy, mental and other conditions, and that some of these conditions are serious and require prescription medication. The AA stance is that it’s wrong to deprive individuals of required medications, including painkillers, that can control their conditions or alleviate their pain.
What if You Have Relapsed on Painkillers – Next Steps
Relapse is often a part of recovery and is nothing to fear or be ashamed of. Indeed, relapse is considered a common, although not inevitable, phase of the recovery process. As such, for those who have relapsed on prescription opiate painkillers and want to resume the progress they’ve already made in recovery, here are some effective and evidence-based next steps to take.
- Remember that relapse is not a failure. It is a part of the recovery process and it is possible to get past this episode.
- Step up participation in 12-step groups. Being with like-minded people, each intent on helping others with their sobriety, can reduce the risks of relapse and boost recovery.
- Go back to rehab, starting with opioid addiction detoxification that’s medically monitored, followed by treatment.
- Engage in continuing care or aftercare treatment, if available.
- Continue counseling. Professional psychological help can help in sorting out the obstacles and blockages that may be preventing total commitment to sobriety.
- Enlist the support of a strong network of loved ones, family members, and friends to help with accountability and staying on track toward sobriety.
- Explore the possibility of taking non-narcotic and non-opiate painkillers to help with pain management.
- Take advantage of complementary, non-narcotic painkiller options such as yoga, meditation, guided imagery, and more.
- Maintain a hopeful, positive attitude and commit to resuming a healthier lifestyle complete with effective coping strategies.
- Keep a list of what works and refer to it often when unexpected or anticipated hurdles and challenges arise that could otherwise derail sobriety and thwart the return to recovery.
- Be gentle with yourself. This is a journey, not a race, and progress takes time to achieve. After all, you have your whole life to live. This is a step along the way, one that’s vitally important, to be sure, but not an end of the path by any means.
Stuck and need help? Contact us at FHE Health for a confidential discussion of the options. We can help you figure out what you need and get back on track to recovery.