Hopefully by now, you are beginning to understand addiction more clearly. In the next chapter, we will invite you to look at your use of substances and try to make sense of how these substances have affected your pain and your behavior. So open your mind and your heart and get ready to find some answers.
Now that we have explained addiction, we would like to help you answer this question. We’ll explore, in some depth, the reluctance, perhaps even overwhelming fear, that many with chronic pain have about addiction and the term “addict.” If you don’t consider the possibility that you have addiction, you may miss the opportunity to get better. In this chapter, we will not tell you whether or not you are an addict, but we will provide you with facts so that you can make an accurate and informed assessment.
The Stigma of Addiction
Why are the words “addiction” and “addict” so problematic for so many people? Much of this difficulty can be attributed to the stigma that is assigned to them. Merriam-Webster’s Collegiate Dictionary defines stigma as “a mark of shame or discredit.”* It is often attached to social judgment and cultural norms. The stigma attached to “addiction” and “addict” makes them “dirty” words. Despite volumes of research on drug dependence and scientific evidence to the contrary, addiction is viewed by many as a moral failing or weakness. Addicts and their families are subjected to social, legal, and financial discrimination, making it difficult for them to obtain the help they need. When addicts do access help, insurance is inadequate to cover the cost of effective treatment. Family members are often the most judgmental because they have experienced the consequences of the addict’s behavior, not realizing the addict is sick, not “bad.”
Addiction is one of the few diseases that carries such a negative emotional charge and is a source of shame or embarrassment. Who would want to have a diagnosis or label that carries such a stigma? For those with chronic pain who take opioids, attempting to discuss this topic is often met with resistance and denial.
{ exercise 3.1 }
Your View of Addiction____________________
When you hear the word “addiction” or “addict, ” what is your emotional response?
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Do you believe either of these terms (addict, addiction) applies to you? Why or why not?
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Addiction is a term that often conjures up negative stereotypes. You may relate to some and not to others. Write your stereotypes about addiction. Where do these ideas come from?
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I AM AN ADDICT
For some of you, there will be no question as to whether or not you are an addict—you already know you are. If you have experienced recovery you already understand it is extremely dangerous to put opioid painkillers in your system because eventually you will likely lose control and relapse, either with opioids or with other mood-altering drugs. For you, the main issue will be coming to terms with the fact that you can’t safely take opioids for your chronic pain. You will need to find alternative treatments if you are to stay clean (drug -free) and in recovery. This also pertains to you if you identify as having other manifestations of addiction (e.g., alcohol, stimulants, sedatives, etc.), since the use of opioids will cloud your thinking and make it that much easier to compulsively drink, take drugs, gamble, overeat, and so on.
Pain recovery will work for you by complementing the program you are already working with your sponsor and by helping you realize that you can live with a certain amount of pain without taking medication.
For those of you who know or suspect you are an addict, but have never experienced recovery, this book can serve as your entry point to beginning a program and changing your life. By working a program and implementing the concepts of pain recovery, you can live without drugs and in recovery from both addiction and chronic pain.
Whether you know you have addiction, are unsure, or are convinced you are not an addict, we recommend you read this chapter. We feel strongly that the information it contains is essential to the process of pain recovery no matter what your circumstances.
FRED’S STORY
At thirty-six years old, I was in great shape. I had been clean and in recovery for twenty-six months. I was diligently working my recovery program with my sponsor. I stayed physically fit working as a furniture mover. For the first time in my life, I knew and accepted who I was. I had fully accepted that I was an addict and was reaping the benefits recovery had to offer.
One day at work, I was lifting a heavy piece of furniture and I felt something pop in my back. This began an ongoing nightmare of medical appointments and surgeries. Over the next three years, I went from being physically active and fit to not even being able to pick up or play with my stepchildren. Getting out of bed was a chore, sitting too long hurt, standing too long hurt, and in essence, doing anything hurt. My life was changed dramatically.
Even when the pain was tolerable, it was like having a constant toothache. I had to practice the principles of my program daily so I wouldn’t act out in frustration, anger, and intolerance. Being inactive and unable to work resulted in weight gain and loss of self-esteem. Finances became an issue, and all this placed a tremendous strain on my relationships. I struggled not to play the role of victim even though my addiction told me I was a victim.
Then there was the issue of taking pain medication, which
