My good friend sends me articles she reads that have to do with addiction. This morning she sent me a quick story from the New York Times that describes a woman’s experience of having surgery in Germany: “After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea.

She asks each of the three doctors participating in her care to, please, be sure to prescribe just a few Vicodin for the first days of her recovery. (Vicodin contains the narcotic pain medication hydrocodone.) Her gynecologist, her surgeon, and her anesthesiologist all refuse. Politely.

She paraphrases her anesthesiologist’s message:

“Pain is a part of life. We cannot eliminate it nor do we want to. The pain will guide you. You will know when to rest more; you will know when you are healing. If I give you Vicodin, you will no longer feel the pain, yes, but you will no longer know what your body is telling you. You might overexert yourself because you are no longer feeling the pain signals. All you need is rest…”

She goes on to describe how they were right, the pain really wasn’t that bad—the boredom was the worst of it. She needed to rest, she needed to spend time in bed, and that was difficult for her. But she did it. Without narcotics.

Even without a history of addiction, this author was making heroic attempts to avoid the pain she believed was inevitable. It is easy to imagine how a person who is genetically vulnerable to addiction, facing the prospect of some type of pain, and having access to pain medication could get caught up in this vicious cycle.

In Recovery: Freedom from Our Addictions (p. 32), Russell Brand provides a succinct 5-point guide to the cycle of addiction:

  1. Pain.
  2. Using an addictive agent, like alcohol, food, sex, work, dependent relationships to soothe and distract.
  3. Temporary anesthesia or distraction.
  4. Consequences.
  5. Shame and guilt, leading to pain or low self-esteem. And off we go again.

Pain can obviously come in the form a physical condition, and we have helped countless people with chronic pain conditions get off their prescribed opioid pain medications in a few short days with relative comfort. But more often, the pain we see in the people who come to us for help getting off of opioids, benzos, or alcohol stems from, or has morphed into, an emotional pain based on unquestioned beliefs--beliefs that feed on each other and corrupt the lens through which their world is experienced. Until questioned, the beliefs often drive the behavior. When an addictive substance is taken long enough, a person becomes tolerant and physically dependent.

The first step in untangling this sticky web is to stop the chemicals. This is extremely difficult, and in some cases, dangerous to do on one’s own. The Coleman Institute has specialized in safely and comfortably helping people to ease off opiates like hydrocodone or oxycodone, break off benzodiazepines like Xanax® or Valium®, and end their alcohol use. This is where our expertise resides, but knowing that it is only the beginning of our patients’ journey to recover their lives, we assist them to find the best and most fitting treatment after their detox.

We can’t over-emphasize the importance of working with a trusted therapist or finding a home in a Recovery Community, such as Alcoholics Anonymous or Narcotics Anonymous. The compulsion to continue to use drugs is unlikely to go away unless the root of the pain is understood in a compassionate, healing setting.

Please call us if we can be the first step in un-packing the burden of pain that you or a loved one carries.

Joan Shepherd, FNP