Combined pain and addiction treatment is not only possible, but a retrospective analysis from an established treatment center clearly shows not only that treatment is possible, but is available and highly effective in an integrated treatment setting with individual treatment plans and a timetable for stabilization of both disorders.

The study is client/patients who based on require inpatient residential treatment for multiple diagnoses of chemical dependency, pain/medical disorders and psychiatric/psychological conditions.

Eighteen of the twenty clients completed the program and returned home. Two left AMA because of unresolved issues and inability to complete the full course of treatment.

Four clients had been referred to the center when seeking addiction treatment and had complaints of pain as secondary co-lateral problems. Seven clients were referred from other pain programs: nine patients were referred from other addiction centers.

The length of stay was 4 – 6 months for eight clients and 1 -2 months for the others. Eight clients had alcoholic fathers, two alcoholic grandfathers and a total of eight had underlying issues of childhood trauma.

Treatment was aimed at first stabilizing the pain condition and elements then integrating addiction free pain management and chemical dependency treatment. Addressing addiction to pain pills meant not stigmatizing treatment with addiction accusations by utilizing treatment techniques focused the physiological changes that occur with addictive medications. Patients suffered both from addiction as well as, more often, dependence on a mixture of prescribes narcotic, benzodiazepine, and tranquillizer associated with aberrant drug related behaviors. Many patients were not drug addicts, but had become dependent or addicted to drugs as a result of their illnesses.

The result is that most conventional 30 day programs cannot adequately address the complex and compounding problems of physical dependence, addictive behavior and long term chronic pain and associated medical and/or psychiatrist illness we have found state of the art treatment component including buprenorphine and immunotherapy to be indicated at times. Increasing utilization of and research about these modalities lend a further support to other effectiveness for these complex conditions.

We have found state of the art treatment components including buprenorphine and immunotherapy to be indicated of and research about these modalities lends further support to obtain effectiveness for these complex conditions.

Contrary to conventional wisdom, we find that the most successful treatment occurs in with both pain and addiction to “pain killers” compounds to a “primary” (street drug) addiction population. Once the pain enters a state of remission and/or tolerability, the patient with chronic pain fears a return of intractable suffering and therefore is more motivated and has a better prognosis than that of street addiction.

Seven clients initiated the prescription drug use after an injury or with psychiatric illness without pre-existing drug or alcohol problems, but seven of these patients have had psychological pre-existing trauma or diagnosis. Six had an average of three prior chemical dependency treatments. Two had six chemical dependency treatments, and one had 12. Six had an average of two chemical dependency treatment centers. All were active pain management clients. Six used Subutex / (Buphrenophine).

Conclusion

Combined integrated treatment for pain and addiction phase is highly effective, but requires extensive multidiscipline treatment. The initial treatment phase of 2 – 6 weeks is basically directed at pain management and medical treatment with most clients unable to address or fully engage the addiction treatment component until 2 – 6 weeks into treatment when a shift from pain control and management can be affected. At other point the full integration of pain and addiction treatment ensures.