The Vicious Cycle of Pain and Substance Abuse

The Vicious Cycle of Pain and Substance Abuse

“On one hand, substance use can be a risk factor for chronic pain and may worsen pain over time. On the other hand, experiencing pain can motivate people to use substances and might make it harder to quit.”

~ Dr. Emily Zale, PhD, Assistant professor of Psychology, Binghamton University

Does pain cause addiction?

Does addiction cause pain?

According to a new meta-analysis of over 100 studies, BOTH are true.

Dilaudid – the Dangerous Forgotten OpioidResearch teams from Binghamton and Syracuse Universities have concluded that co-occurring pain and substance abuse create a self-sustaining feedback look where each problem supports and worsens the other.



How Pain Leads to Substance Abuse

When people think of pain and substance use, it’s common for opioids to come to mind. While the opioid crisis has rightfully garnered considerable attention, our research suggests that non-opioid substances, like nicotine/tobacco, alcohol, and cannabis, are also very important to consider in relation to pain.”

~ Dr. Zale

According to Columbia University researchers, people suffering moderate-to-severe physical pain are 41% more likely to develop a Substance Use Disorder involving opioid medications than people who are pain-free.

One of the most surprising discoveries coming from the meta-analysis is how people in chronic pain will look for relief from other substances in addition to the expected opioid painkillers.

But looked at another way, perhaps it’s NOT so surprising.  All substances of abuse trigger a release of “feel-good” chemicals that promote a sense of euphoric well-being. They also can relieve much of the accompanying anxiety that can make pain seem even worse than it is.

There is a problem with this remedy, however.  Regular use of addictive substances changes the person’s brain to the point that they become dependent, the first stage of addiction.  Over time, they develop a tolerance and must continually increase their consumption to feel the same affects.

Eventually, their brain becomes so accustomed to the presence of the drug or alcohol that they become unable to function when they are not drinking or using.  And when they try to cut back or quit, they experience the painful symptoms of withdrawal.

How Substance Abuse Leads to Pain

“We have evidence that pain may get worse when people go into withdrawal; clinicians treating addiction should be prepared to help their patients manage pain during withdrawal.”

~ Dr. Zale

If a substance-dependent person is already in chronic pain because of disease or injury and they try to quit, withdrawal creates a rebound effect that magnifies their pain.  This is why people in recovery must be taught sober pain management techniques that don’t rely on habit-forming drugs.

This is even more important than you might think, for a couple of reasons.

FIRST, recent research suggests that in some cases, opioids can make pain worse, a negative side effect that can persist for months.

SECOND, there is an established link between long-term opioid use and depression, which, again, can make pain seem worse than it really is.

Why Is This Important to San Diego Residents?

As it is elsewhere in the country, opioid abuse in San Diego County and the rest of Southern California is a real problem.  In fact, according to five years’ worth of coroner records, In the counties San Diego, Orange, Ventura, and of Los Angeles, opioid abuse was the sole or contributing cause of death in 47% of all drug-related deaths.

In other words, any information that helps reduce the unnecessary use of dangerous opioid painkillers and addresses the ongoing and worsening drug epidemic is critically important.

If you are struggling with both chronic pain and problematic substance use, your best Southern California resource is Lasting Recovery.  As the leading addiction recovery and sober pain management program in San Diego, Lasting Recovery helps safely return to a productive life free from both pain and addiction.

To get immediately, contact Lasting Recovery TODAY.

Lasting Recovery—“Where Wellness Begins…”