Pain Management and Substance Use Disorder

Senior woman holding hands with young lady

According to the Cleveland Clinic, “Chronic pain is pain that is ongoing and usually lasts longer than six months.” [1] Often caused by sickness or injury, chronic pain can exist for many months or even years. It has been linked to conditions such as headaches, cancer, back pain, and fibromyalgia, to name a few which is why pain management is needed.

Over 1.5 billion people in the world experience chronic pain, and it is the leading cause of long-term disability in the U.S. [2]. The National Institue on Drug Abuse expects the number of people with chronic pain to rise as the U.S. population ages and see an increasing number of diagnoses in diabetes, cardiovascular disorders, obesity, and arthritis. [3]

These statistics are significant because a leading treatment choice for chronic pain has long been opioids, which raises serious concerns. The American Association of Family Physicians (AAFP) states, “Chronic pain management is a public health concern with significant increases in the use of opioids for pain relief.

There is a corresponding growth in the number of opioids prescribed in the U.S. and the overdose from those drugs.” [4] Many individuals begin using opioids with a prescription from a doctor, but due to the addictive nature of the substance, move to misuse and addiction.

Man holding his back and needing Pain ManagementTo address this public health concern, the AAFP has “committed to being a leader in promoting the advancement of safe pain management and opioid prescribing, and in addressing the growing burden of opioid dependence.” [5] The AAFP recommends that physicians, in the context of compassionate care for patients with chronic pain:

  • Collaborate with other healthcare providers
  • Acknowledge risk factors for opioid overdose and misuse
  • Provide access to and information about treatment for opioid addiction such as naloxone
  • Consider available evidence and guidelines on the treatment of chronic pain and opioid dependence
  • Consider obtaining a Drug Addiction Treatment Act of 2000 (DATA 2000) waiver to deliver office-based opioid treatment (OBOT)

Additionally, the AAFP calls for agencies to collaborate in education and advocacy around pain management and the risk of opioid misuse. A few highlights of the recommendations include:

  • Increasing the amount of continuing medical education (CME) around the topic of chronic pain and the risk of opioid addiction
  • Align residency program training to deliver evidence-based information on best practices in managing chronic pain and opioid dependence
  • Expand governmental and private support of research into the management of chronic pain, as well as methods to manage opioid misuse.


1. Acute Pain vs. Chronic Pain: What it is & Differences. (n.d.). Retrieved June 10, 2020, from

2. Healthline. (n.d.). What Causes Chronic Pain. Retrieved June 09, 2020, from

3. National Institute on Drug Abuse. (2014, October 01). Pain. Retrieved June 10, 2020, from

4. American Association of Family Physicians. (2016, May 14). Pain Management and Opioid Misuse. Retrieved June 10, 2020, from

5. American Association of Family Physicians. (2016, August 02). Pain Management and Opioid Misuse: A Public Health Concern (Position Paper). Retrieved June 10, 2020, from

About the Author:

Travis StewartTravis Stewart, LPC has been mentoring others since 1992 and became a Licensed Professional Counselor in 2005. His counseling approach is relational and creative, helping people understand their story while also building hope for the future. Travis has experience with a wide variety of issues which might lead people to seek out professional counseling help. This includes a special interest in helping those with compulsive and addictive behaviors such as internet and screen addiction, eating disorders, anxiety, and perfectionism. Travis’ website is

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Reviewed and Approved by Jacquelyn Ekern, MS, LPC on July 9, 2020
Published July 9, 2020, on

About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.