Fighting Opioid Misuse and Chronic Pain

Guest Post by Amanda Merchant, Ph.D., Lisa Willner, Ph.D. and Jonathon Cole, Ph.D.

Psychologists who treat those with chronic pain are well aware that living with daily pain for months or years on end can take a significant toll.

Being limited in daily activities due to pain can lead to loss of job and livelihood, reduced ability to care for and interact with others, loss of leisure-time activities, depression, irritability, anger, loss of concentration and sleep disruption.

Whether the pain comes from the wear and tear of hard work, from an injury or from a disease, people have to adjust and change their lives dramatically.

People being treated for chronic pain have felt stuck in the middle of the pain-pill and heroin epidemic in our state. Regulations have helped to shut down “pill mills” where people paid cash for their treatment, consisting almost entirely of high doses of opioid medications.

These offices never intended to help people with pain, but intended to make money for themselves. Many people with drug addiction used these offices as a source of opioids for their addiction or to sell. As the pill mills closed, patients with chronic pain have seen the addicts who used to go to these places flood their physicians’ offices.

They have seen how their physicians have been forced to sort through those who need help with their pain and those who need drugs for their addiction. The caution and care needed to safely prescribe opioid medication became clear. Many individuals with pain who had been treated by their family physician are now referred to a physician specializing in pain management.

Psychologists are increasingly being asked by these pain-management physicians to assist them in determining whether the patient has chronic pain, addiction or both. This identification of risk factors for opioid addiction provided by psychologists after interviewing and testing has proven to be very helpful to the prescribing physicians.

The standard treatment for chronic pain has never been only opioid medication. Just as a pill does not stop heart disease or diabetes, it does not stop chronic pain.

The most effective treatment for chronic pain focuses on improving daily function through targeted procedures or injections, physical therapy, medications and cognitive behavioral therapy. Psychologists are part of the treatment team to help those in pain reduce the depression and anxiety that understandably come from adjusting to limitations.

They help people learn strategies to manage pain, function despite pain, improve sleep and quality of life.

As the Department of Justice designated this week as National Heroin and Opioid Awareness Week, psychologists are acutely aware of those struggling with addiction, as well as their family members, friends and neighbors whose lives have been affected.

We will continue to focus on ways to prevent more individuals from becoming addicted while compassionately treating those who suffer chronic pain.

This op-ed column was published in the Lexington Herald-Leader and the Louisville Courier-Journal. It is reprinted here with the permission of the authors. Amanda Merchant is a past president of the Kentucky Psychological Association; Lisa Willner is the former executive director of the association. Jonathon Cole is president of the Kentucky Pain Society.

Thanks to my colleagues Drs. Merchant, Willner, and Cole for their insightful article! Also, please consider subscribing to my blog and feel free to follow me on X (formerly Twitter), “like” my Facebook page, or connect on LinkedIn. Thanks!