Understanding Addiction and the Brain

According to the National Institute on Drug Abuse, addiction is a chronic, often relapsing, brain disease that causes compulsive drug seeking and abuse over time, causing brain changes over time that challenge an addicted individual’s self-control. The impulses and feelings of euphoria hamper the individual’s ability to resist overwhelming impulses to abuse drugs. Long-term abuse causes changes in brain chemical systems and circuits, as well as, compensation to changes in the reward center of the brain (National Institute on Drug Abuse. 2012). This creates the compulsion to need and abuse drugs. The changes in the brain can be seen on MRI and often affect learning areas, judgment, decision making, memory, behavior, and self control areas of the brain (National Institute on Drug Abuse. Revised 2012).

There are treatments to successfully manage drug addiction, as with any other relapsing condition. However, it is all to common for a person to relapse and begin abusing drugs again. Relapse indicates that adjustment or alternative treatment is needed to help individuals recover and regain control. The risk factors vary and include, not using medication used for pain management as prescribed; at the correct dosages and scheduled times, family history of abuse, previous addiction, and underlying mental health issues not previously detected (National Institute on Drug Abuse. Revised 2012).

It is important to seek medical advice from a physician trained in pain management for unmanaged pain. The idea behind pain management therapy is to reduce risk factors of addiction, as the reward center in the brain is less likely to be in flux; the thought is pain will be reduced as the medication attach to pain receptors in the brain (National Institute on Drug Abuse. Revised 2012).

Only your physician can determine the correct medication and dosage to manage your pain. Remember, pain management specialists are also trained in alternative pain management therapies separate from or in conjunction with medications. Such therapies include radio frequency ablation, spinal cord stimulator implants, acupuncture, massage, physical therapy, aquatic therapy, exercise physiology, Yoga, Pilates, and other alternative therapies and procedures.

Tips for talking to your doctor about pain management, are things such as keeping a journal of pain levels from 1-10, and usage of medication and effectiveness. Don’t be afraid to ask questions, such as, “Are there alternatives to this treatment plan, and what are the risk and benefits to each plan?” Educate yourself, ask your doctor for resources for additional educational material. There are always search engines, but be aware that there are websites out there that look professional and legitimate, but are not maintained by medical professionals, and may have exaggerations, or inaccuracies. Ask your doctor about distraction techniques that can help manage pain, such as counting, coloring, and meditation.

Be sure to call the doctor when pain is too much and unmanageable, don’t sit in pain for hours agonizing, or worse, days. And never take more medication than you are prescribed without first talking to your doctor. Talk to your doctor about having a breakthrough medication and alternative therapy plan such as patches, Epsom salt soaks, and TENS unit therapy. Keep all scheduled appointments and adhere to any contract that may be in place such as patch for patch, counting tablets left, and not seeing any other doctors for pain management unless your doctor is notified of them. Remember that some prescription pain medications are combined with over the counter pain medications, so check with your doctor before you add over the counter pain medications.

Communicate effectively about your pain to your care team, they are there to oversee your optimal health and manage conditions including pain. Do not take any un-prescribed medication, if you have unresolved pain seek help at your local health facility/urgent care, emergency room, or pain management specialist/family practitioner’s office. There are also crisis helplines in your area at the front of your phone book, or on a search engine online under addiction crisis hotline.

It is okay to take your medication for pain when its prescribed or over the counter if recommended by your doctor. Its okay to need help. Seek professional medical advice before stopping or starting any medication. You do not have to feel guilty about needing help with pain management, it is not taboo. You should not feel shame talking about your pain. Make sure you seek a physician that understands your condition, and need for proper pain management. It is also important to feel comfortable talking to your doctor about pain medication side effects, and quality of life.

Tell them your expectations for pain levels and quality of life. It may not be possible to have zero pain and be able to stay awake. You know the old saying, “you can’t have your cake, and eat it too.” Be clear about what you expect your level of function should be.

Recently pain management has become the black sheep in medicine, yet it is one of the most common reasons people seek medical attention. Don’t let pain run your life, get help. Just be sure to keep an open line of communication with your doctor about your pain to minimize your risk of addiction. Never be ashamed of having to ask for help, whether it is for pain management, or addiction, you deserve help. Remember, you are WORTH IT!

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  1. National Institute on Drug Abuse. Revised 2012. Understanding Drug Abuse and Addiction Retrieved from https://www.drugabuse.gov/publications/drugfacts/understaning-drug-abuse-addiction on March 23, 2016

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