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Treating Co-Occurring Chronic Pain and Opioid Use Disorder: Finding Balance in Recovery

Kate L.

April 7, 2025

Dealing with chronic pain is an exhausting and often isolating reality. For those who turn to opioids for relief, the temporary comfort can quickly spiral into dependency or addiction, creating a dual struggle: managing unrelenting pain while battling the grip of opioid use disorder (OUD). This intertwined challenge is both physical and psychological, leaving individuals trapped in a painful cycle that feels impossible to escape.

The crisis of co-occurring chronic pain and opioid misuse has become more prevalent in the wake of the opioid epidemic, as millions were prescribed opioids with little regard for their addictive potential. While opioids can mask pain for a short period, they often cause more harm than good in the long run, leading to dependency, higher pain sensitivity, and significant emotional struggles.

In this article, we’ll address the complexities of treating chronic pain alongside opioid addiction. We’ll explore integrative, evidence-based approaches to help sufferers reclaim control over their pain and addiction. New Dawn Treatment Centers, located in Sacramento, CA, and Reno, NV, is a leading organization in providing customized and compassionate care for individuals facing these dual challenges. To bring the journey to life, we’ll include the inspiring story of one patient who overcame the odds and found hope.

What Are Co-Occurring Chronic Pain and Opioid Use Disorder?

Chronic Pain: The Silent Challenge

Chronic pain affects more than 50 million Americans and is defined as persistent pain lasting longer than three months. Unlike acute pain, which signals an underlying injury and serves a protective purpose, chronic pain may continue even after the original cause has resolved. It can stem from various sources, including:

• Arthritis or joint issues
• Back injuries or spinal degeneration
• Fibromyalgia: Widespread muscle and joint pain accompanied by fatigue.
• Neuropathy: Nerve pain often caused by conditions like diabetes or chemotherapy.
• Migraines: Intense, recurrent headaches that interfere with daily life.
• Post-surgical pain or cancer-related pain

Chronic pain changes the way the brain and nervous system process pain signals, making the discomfort feel more intense and harder to relieve. What’s worse, the constant battle with pain often triggers feelings of depression, anxiety, and hopelessness—a vicious cycle that feeds itself.

How Opioid Use Disorder Develops

For decades, opioids were seen as the solution to chronic pain. Drugs like oxycodone, fentanyl, and hydrocodone were widely prescribed without consideration for their addictiveness. Over time, many patients who used opioids for legitimate pain relief became dependent—or even addicted.

Here’s how it often happens:

1. Tolerance develops: Over weeks or months, the same dose of opioids becomes less effective, prompting a need for higher doses.
2. Dependence builds: The body adapts to opioids, requiring them to function normally. Without them, painful withdrawal symptoms emerge.
3. Addiction takes hold: The brain’s reward system is hijacked, leading to compulsive use despite negative consequences.

Those battling OUD often find it difficult to distinguish between unmanaged pain and cravings for opioids, making the condition especially complex to treat.

Challenges in Treating Co-Occurring Chronic Pain and OUD

The intertwining nature of chronic pain and opioid addiction presents unique challenges for treatment providers. Addressing one condition without the other often results in failed outcomes. To understand why, consider these challenges:

1. The Double-Edged Sword of Opioids

For individuals dealing with pain, especially severe conditions like nerve pain or post-surgical pain, opioids were often the only solution offered. However, these medications not only lose their effectiveness over time but can also heighten pain in the long run—a phenomenon called opioid-induced hyperalgesia.

The delicate balance of managing adequate pain relief while weaning a person off opioids is a challenge that requires expertise and careful planning.

2. The Emotional Toll

Chronic pain doesn’t just take a toll on the body—it weighs heavily on the mind. When addiction is added to the equation, feelings of shame, guilt, and isolation add another layer of emotional pain. People with co-occurring chronic pain and OUD may withdraw from social connections, lose jobs, or struggle to maintain family relationships, compounding the problem.

3. Stigma and Misunderstanding

Unfortunately, those suffering from chronic pain and opioid addiction often face stigma, both personally and socially. They may be labeled as “drug seekers” or dismissed by healthcare providers who misunderstand their condition. This stigma can delay treatment and discourage individuals from seeking help altogether.

4. The Complexity of Withdrawal

Withdrawal from opioids is a grueling process that includes symptoms like severe muscle and joint pain, anxiety, nausea, insomnia, and even heightened pain sensitivity. For those with chronic pain, these symptoms may be particularly intense, requiring compassionate medical care to overcome.

Innovative Approaches to Treatment

Treating co-occurring chronic pain and OUD involves addressing the root causes and breaking the cycle of pain and addiction. Below are some cutting-edge approaches to managing this dual condition effectively.

1. Medication-Assisted Treatment (MAT)

Medication-assisted treatment is one of the most effective ways to manage OUD while providing relief for chronic pain. These FDA-approved medications include:

• Buprenorphine (Suboxone): Reduces cravings without producing a euphoric high. It also has mild pain relief properties.
• Methadone: A long-standing approach to both severe addiction and pain management, especially for individuals needing higher levels of care.
• Naltrexone (Vivitrol): Blocks the effects of opioids entirely, but requires complete detox before use.

MAT reduces opioid cravings, stabilizes withdrawal symptoms, and helps individuals function more effectively, paving the way for sustainable recovery.

2. Non-Opioid Pain Relief

When opioids are no longer the answer, non-opioid strategies become essential. These include:

• Anti-inflammatory medications like ibuprofen and acetaminophen.
• Nerve pain medications, including gabapentin or pregabalin.
• Physical therapy to target muscle imbalances and improve function.
• Holistic therapies like acupuncture, yoga, mindfulness, or massage therapy, which can reduce tension and alter the brain’s perception of pain.

Some individuals benefit from minimally invasive procedures, such as nerve blocks or cortisone injections, which provide localized relief without the risks of systemic medications.

3. Behavioral Therapies

Cognitive-behavioral therapy (CBT) is a cornerstone of treatment for chronic pain and opioid addiction. CBT teaches individuals to:

• Reframe negative thought patterns surrounding pain and addiction.
• Develop healthy coping mechanisms to manage stress or discomfort.
• Reduce the psychological intensity of pain by changing how it is perceived.

Group therapy and family counseling are equally vital, offering emotional support and targeting relational dynamics often strained by addiction.

The Role of New Dawn Treatment Centers

A Leading Solution in Sacramento and Reno

When chronic pain and addiction become overwhelming, New Dawn Treatment Centers provide a lifeline. With multiple locations in both Sacramento area, CA, and Reno, NV, these facilities offer state-of-the-art, compassionate addiction rehab tailored to the needs of individuals with dual diagnoses.

Services Offered

At New Dawn, recovery is about treating the whole person. Their specialized programs include:

• Inpatient detoxification: A safe and comfortable environment to manage withdrawal symptoms.
• Medication-assisted treatment (MAT): Customized for chronic pain patients.
• Outpatient options: For individuals seeking flexible yet effective treatment.
• Therapy services: Including CBT, trauma-informed care, and family counseling.
• Relapse prevention programs: Building long-term resilience against triggers.

Why Choose New Dawn?

New Dawn Treatment Centers focus on addressing the root causes of both pain and addiction. Their multidisciplinary teams include medical doctors, licensed therapists, physical therapy specialists, and peers in recovery who collaborate to create individualized care plans.

A Success Story: Sarah’s Journey

Sarah, a 42-year-old elementary school teacher from Sacramento, had been living with debilitating back pain after a car accident. Initially prescribed opioids to manage her pain, Sarah found herself increasing her dose as the medication became less effective. Over time, her dependency spiraled into addiction, and she began using more than prescribed just to feel “normal.”

“I was in so much pain—physical and emotional. Every day felt like a battle, and I was losing,” Sarah recalls.

After an overdose scare, Sarah sought help at New Dawn Treatment Centers. There, she entered their residential detox program, where doctors carefully transitioned her to buprenorphine to manage both her withdrawal symptoms and pain. She attended CBT sessions to understand the psychological toll of her pain and addiction, learning mindfulness techniques to manage her discomfort differently.

Through outpatient care in Reno, she continued her recovery journey, discovering non-opioid alternatives like acupuncture and physical therapy. Today, Sarah is teaching again, living an active life, and serving as a mentor to others in recovery.

“My pain isn’t gone, but I have the tools to manage it now—without opioids controlling me,” Sarah says with a smile.

Conclusion

Treating co-occurring chronic pain and opioid use disorder is a delicate but achievable process requiring comprehensive care and compassion. By addressing both conditions through integrative strategies like medication-assisted treatment, behavioral therapy, and non-opioid pain management, individuals can regain control over their lives.

New Dawn Treatment Centers, with locations in Sacramento and Reno, provide expert support for people navigating this dual challenge. Through their tailored programs and dedicated staff, they’ve helped countless people like Sarah transform their lives.

If you or someone you love is struggling with chronic pain and addiction, know that help is available—and recovery is possible.

Frequently Asked Questions

1. Can I manage chronic pain without opioids?

Yes, many alternative therapies, including physical therapy, NSAIDs, acupuncture, and mindfulness practices, can effectively manage pain without the risks of opioids.

2. What’s unique about New Dawn Treatment Centers?

New Dawn provides customized, evidence-based care for individuals with co-occurring chronic pain and OUD. Their multidisciplinary approach and emphasis on whole-person wellness set them apart.

3. Will I ever be pain-free after addiction recovery?

While complete pain relief isn’t guaranteed, most individuals achieve significant improvements in quality of life and emotional well-being through integrative treatments.

4. Does New Dawn offer outpatient services?

Yes, New Dawn provides outpatient programs in both Sacramento and Reno, offering flexibility for those unable to commit to residential care.

5. How do I get started at New Dawn Treatment Centers?

Contact New Dawn Treatment Centers directly through their Sacramento or Reno locations. They offer consultations to determine the best program for your needs.