Chronic Pain & Opioid Use: What you Need to Know

Chronic pain can significantly impact sleep and movement, emotional well-being, relationships and overall quality of life. 

For some people, opioid medications may be prescribed as part of a pain management strategy. While opioids can provide meaningful relief for certain patients, prolonged use may lead to physical dependence, opioid use disorder, opioid-induced hyperalgesia or challenges with medication management.

When chronic pain and opioid dependence happen together, both conditions often need to be treated at the same time. Understanding the connection can help patients and their health care providers find safer, more effective treatment options.

Dependence vs. Opioid Use Disorder

Physical dependence and opioid use disorder are not the same.

Physical dependence happens when the body adjusts to a medication. If the medication is stopped suddenly, the person may experience withdrawal symptoms. A patient can become physically dependent even when taking an opioid exactly as prescribed.

Opioid use disorder is a medical condition characterized by the compulsive use of opioids despite adverse consequences. A person may develop physical dependence while using medication exactly as prescribed and not meet the criteria for opioid use disorder.

Recognizing the difference helps providers create a treatment plan based on each patient’s needs.

When Opioids Increase Pain

Opioid-induced hyperalgesia occurs when prolonged opioid use increases sensitivity to pain rather than reducing it. In some cases, pain may spread beyond the original area and become more widespread.

When to Seek Help

People may begin taking opioids after surgery, injury or treatment for chronic pain and later have difficulty reducing or stopping the medication. Others may have a history of opioid use disorder along with an ongoing pain condition.

Talk with a health care provider if you or a loved one:

• Takes medication more often or in larger amounts than directed
• Experiences withdrawal symptoms after missing or reducing a dose
• Has difficulty controlling opioid use
• Continues using opioids despite problems with health, work, relationships or daily activities

These signs do not always mean someone has opioid use disorder, but they may signal a need for a medical evaluation.

Seeking help for opioid dependence is not a sign of weakness. Addiction is a recognized medical condition that should be addressed with the same clinical expertise and respect afforded to any other health concern. Open communication is essential to developing safe and effective treatment strategies.

Treatment for Opioid Use Disorder

Medication-assisted treatment remains one of the most effective approaches for treating opioid use disorder. Medications such as buprenorphine can help reduce withdrawal symptoms and cravings while supporting long-term recovery.

Treatment recommendations are tailored to each patient's medical history, symptoms, substance use history and treatment goals.

A care plan may include: 

•  Medication management
• Counseling
• Behavioral health support
• Recovery services
• Referral to specialized care when needed

No single approach is right for everyone. Treatment should be personalized and adjusted as a patient’s needs change. 

Treating Pain & Dependence

People living with both chronic pain and opioid dependence often benefit from a coordinated plan that addresses both conditions.

Pain management may include medication adjustments, exercise, lifestyle changes, behavioral strategies and interventional pain management procedures when appropriate. Depending on the cause of the pain, these procedures may include injections, nerve-based therapies or other minimally invasive procedures.

Occupational therapy may also help. Techniques may include:

• Deep breathing and mindfulness
• Yoga or tai chi
• Improved sleep habits
• Nutrition education
• Strategies for managing everyday activities

Over time, these approaches may help the brain and body develop healthier responses to pain. 

Setting Meaningful Goals

An important part of successful treatment is establishing realistic goals. Successful pain treatment is not always about eliminating pain completely. It may be about helping someone return to work, sleep better, walk farther, spend time with family or take part in activities they enjoy.

Looking at daily function and quality of life, rather than pain intensity alone, can provide a more complete picture of progress. 

Find Support

Chronic pain and opioid dependence can affect every part of life, but effective treatment is available. A personalized plan can help patients manage pain, reduce opioid reliance and return to activities that matter to them.