By Susan Shelly

Chronic pain is a complicated and often misunderstood medical issue. When coupled with addiction, however, it becomes increasingly difficult to deal with and treat.

Medical personnel at Caron Treatment Centers address the issues of chronic pain and addiction in a specialized pain and chemical dependency program headed by Dr. Kenneth W. Thompson, medical director.

Treating the condition of chronic pain, which affects more than 7.5 million Americans, is difficult, Thompson said, because it often involves co-occurring disorders such as depression and anxiety. When addiction is added to the mix, treatment becomes even more complex.

“This is a particularly difficult patient group,” Thompson said. “These patients typically are dealing with a lot of issues.”

The most common addictions among chronic pain patients are to alcohol and opiates, a class of drugs that includes both legal and illegal substances including heroin, morphine, codeine, OxyContin, Dilaudid, methadone and others. The National Institutes of Health estimates that about 9 percent of the general population misuses opiates – either prescribed or nonprescribed – at some point of their lives.

Often, patients who seek help through the pain and chemical dependency program at Caron’s Pennsylvania campus in South Heidelberg Township are unsure if they’re addicted to pain medications or alcohol, but they do understand that they’re suffering.

Many are unable to participate in activities they once enjoyed and have become isolated from family members and friends, who may not understand what their loved one is going through and find it difficult to be sympathetic and supportive. Also, many patients already have tried unsuccessfully to stop using medications, resulting in increased pain and despair.

“Most of these patients are afraid when they get here,” Thompson said. “They don’t know if people will believe that they have pain, and they don’t really understand what’s happening to them medically.”

Treatment at Caron begins with a comprehensive evaluation, during which experts consider the patient’s history, physical and psychological conditions and the issue of chemical dependency.

In cases of patients dealing with particularly complex issues, Caron doctors often consult with Dr. Martin Cheatle, a behavioral psychologist associated with Reading Hospital’s pain management program and the University of Pennsylvania.

If it’s determined that addiction is present, staff members will review options with the patient and family members and recommend a treatment plan that addresses both addiction and pain issues.

Important treatment components for this patient population, Thompson said, are for staff members to be affirming and to let patients know that their lives can improve.

“It’s really helpful to affirm that the patient is experiencing pain, and that their lives have become unmanageable because of that,” Thompson said. “And another element of care here is to instill hope.”

Treatment for chronic pain and addiction is not easy, Thompson said, but the majority of patients experience dramatic, long-term improvement.

Medical detoxification to get patients off addicting medications often is necessary and can be difficult.

“We know we have to take them (patients) through some difficult times, but we have a variety of adjuncts to help with that,” Thompson said.

Staff members might employ massage, a hydrotherapy tub, acupuncture, physical therapy, psychological counseling, non-opiate medication, education, supportive therapy, exercise therapy, individual and group counseling and other methods to assist patients with withdrawal and treatment.

“We use a variety of means to help patients get through the difficult work of withdrawal and address the issues of the chronic pain and addiction,” Thompson said. “The bottom-line goals, in addition to treating the addiction, are to improve pain and improve function, enabling the patient to have an improved sense of well being.”

While the majority of chronic pain and addiction patients are in their 30s and 40s, Thompson said, age groups of this patient population range from young adults to the elderly.

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