SOME REHAB PATIENTS USE ILLICIT DRUGS TO EASE PAIN

NEW YORK (Reuters Health) - At least one in four people enrolled in
substance abuse treatment programs may experience chronic severe pain, and
many use illicit drugs to get relief, researchers reported Tuesday.

In the study, 37 percent of participants in methadone maintenance treatment
programs and 24 percent of inpatients in short-term, residential
drug-treatment programs said they had suffered chronic severe pain.

And among these, half of inpatients and one-third of those on methadone
maintenance said they self-medicated with illicit drugs and alcohol.

"Because patients are treated for addiction does not imply that their pain
is being treated," study author Dr. Andrew Rosenblum of the New York-based
National Development and Research Institutes, Inc. (NDRI) told Reuters
Health.

He noted that the study participants' pain was not related to withdrawal
symptoms or any other aspects of their addiction.

"They may have two disorders," Rosenblum said, "addiction and chronic pain,
although each can complicate the other."

In general, the prevalence of chronic pain among people with chemical
dependency is "likely to be at least as high" as in the general population,
the report indicates. Surveys have suggested that more than 70 million
adults in the U.S. have chronic pain.

"Pain is extremely common ... and it's devastating to an individual's
quality of life," study co-author Dr. Russell K. Portenoy, of Beth Israel
Medical Center in New York, told Reuters Health. "This is true also in
people with addiction."

Yet among the study participants -- who were most commonly receiving
treatment for heroin, alcohol or cocaine use -- nearly half of inpatients
and a third of those in the methadone maintenance programs were not
receiving prescription medications for pain.

The findings are published in the May 14th issue of the Journal of the
American Medical Association.

Most study participants said the chronic, severe pain interfered with their
sleep, and many said it disrupted their work, mood and general activity.

This indicates how "devastating the experience of chronic pain is for this
population," Portenoy said.

Patients in substance abuse treatment programs "are struggling to have pain
adequately treated, just as others in our society are struggling to have
pain treated appropriately," the researcher said.

"It is likely," he added, "that their ability to access care is going to be
more difficult than the general population because of their disease of
addiction."

Among inpatients with chronic severe pain, 35 percent said they had used
alcohol to treat the pain, while 29 percent had used cocaine and 26 percent
each had used opioids or marijuana. Thirty percent of those on methadone
maintenance with chronic pain had used opioids for pain relief.

The study included 390 participants in two New York methadone maintenance
programs and 531 inpatients in short-term, residential treatment programs,
also in New York. Up to 80 percent of patients in both groups said they had
had some type of pain during the previous week.

The study was funded by the Center for Drug Use and HIV Research and the
National Institute on Drug Abuse.