Demystifying Psychiatry

A resource for patients and families

Opiate Medications: Pain Management Versus Addiction

Although powerful medications such as opiates are often necessary to treat acute and chronic pain, opiates are highly addictive. Physicians may be inadvertently contributing to the increasing problem of opiate addiction through efforts to keep their patients pain free. What can be done about this? Read More

Chronic pain

As a licensed psychotherapist who treats chronic pain, this series is so helpful. Thank you!

TalkTherapyChannel on YouTube - Managing Chronic Pain

First Do No Harm

I am grateful that you've taken on the subject of Rx pain medication, as sadly I have seen too much evidence to suggest a denial of ethics (vs awareness) by prescribers. I worked in managed care for nearly 12 years, 3 of which were in a hospital in Florida where Rx abuse is widespread. I saw individuals prescribed addictive opiates for minor bumps and bruises or fibromyalgia (and the opiates seemed to increase symptoms of depression, thus worsen their physical pain; vicious cycle). Once an individual is dependent on a particular medication they often require hospitalization to safely detox. If they had pre-existing mental health conditions, like depression, they are also at greater risk for suicide after detoxing from pain medications. (or even benzodiazapines)
This is where I wish medical doctors, psychiatrysts and mental health practioners would come together and (leave their egos at home) really learn from one another...listen to each other and try and think like one another. More and more we are moving to models of integrative health...I truly believe this will result in best practice and outcomes for individuals...mind and body being equally considered.

Rapid Detox From Opiates

There are other alternative methods that can be used to avoid opiates addiction.I don't see opiate treatment as a perfect method for everyone. It may result to dramatic and dangerous withdrawal.

In Arizona, 31% of the population are involved in illegal or illicit drugs. One popular and effective drug medication method used by the people who undergo therapy is the Sauna Detoxification. Sauna detox is the process of placing the patient inside the sauna so that he or she will be able to flush out all the toxins and chemicals inside his or her bloodstream. Rehabilitation is also done after a patient undergoes detox to teach the patient how to manage the pain caused by withdrawals.

Alternative Opiate Treatment for long term pain.


Apologies for my lack of knowledge in your respective field but when asking my GP I was basically given an answer stating "I have no idea" (Slightly concerning)

As a breif background I 3 years ago was diagnosed with CRPS after a nasty arm fracture along with nerve damage to bothe the median and ulner nerves. I was prescribed Gabapentin (Now Pregablin), anti inflammatories and most concerningly Oxycontin.

I guess my question is Im aware of opiate withrawal medication such as Suboxone? However i believe this is literally for weaning patients off opiates and not used as a painrelief medication, are there any other opiates that can be used for long term treatment of pain minus the side effects and addictive qualities.

Once more apologies for my lack of knowledge and if this question makes no sense once again sorry but just wondered if there was any information i could take to my GP to discuss to see if there was any alternatives.

Many Thanks in advance.

Alan (Scotland, United Kingdom)

As a person who suffers, I disagree with your hypothesis

As briefly as possibly, I have suffered from a number of pain syndromes, currently a failed back injury from degenerative disk disease between L4-L5 as well as fibromyalgia. The fibro is believed to most likely have been brought on chronic, severely painful monthly cycles that began when I was 12 that were later diagnosed as endrometreosis. I was given pain killers monthly for a couple of years, to deal with the pain as I passed (THIS IS GRAPHIC) chunks of endrometrial lining at a time. I finally got used to this and was able to handle it on my own. The pain started with ovulation and finally ended once my periods ended, which were 7-10 days long. I has 7-10 days a month that I was not in pain. I finally had a full hysterectomy in 1999.

Two years later, my back went out, which is when they realized I had degenerative disk disease. I was put on Vicodin, then eventually Oxycontin, 20mg. I waited as long as I could, 4+ years before having surgery. Although it was a success in some areas, it wasn't completely successful and got worse as time passed. My Dr now had me on Percocet to help out the pain that the Oxycontin wasn't helping, up to 4 a day. Eventually, I had to stop working.

When I stopped working, my Dr. increased my Oxy to 40 mg, 2/day and my Percocet is still 7.5/325, up to 4/day. That was Feb. 2011. I don't take the maximum of either. I actually forget to take them, even when I'm in pain.

Not everyone becomes addicted, especially those who are taking opiates for continual, non-stop pain.

Maybe that should be your next paper. Once a person who is in chronic pain, finds that dosage that fits their pain level that's all they need and they don't become addicts.

Thanks for 'listening'
Be well,

I don't agree with this

I don't agree with this article either. I have ben on opiates for over year now. I take 30mg of morphine er 3 times a day and up to 4 10mg of hydrocodone. I have gastric cancer that is now terminal. I am also schizophrenic. So I'm not supposed to treat my pain because you think I'm more apt to become addicted?

Post new comment

The content of this field is kept private and will not be shown publicly.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Allowed HTML tags: <a> <em> <strong> <cite> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Lines and paragraphs break automatically.
  • You may quote other posts using [quote] tags.

More information about formatting options

Eugene Rubin, M.D., Ph.D., is Professor and Vice-Chair for Education in the Department of Psychiatry at Washington University in St. Louis - School of Medicine.


Subscribe to Demystifying Psychiatry

Current Issue

Let It Go!

It can take a radical reboot to get past old hurts and injustices.