Addiction and chronic pain have much in common: neither is going away, and both worsen if not managed. For those suffering from physical pain and the emotional and spiritual trauma of addiction, recovery is likely to include a series of relapses followed by fresh starts.

Because each person’s pain and addiction disease is different, hope also comes in different forms.

A recovering addict facing the added challenge of chronic pain has to start with some personal research. Anyone who has lived with chronic pain for a long time most likely has looked into, or at least heard about, non-pharmacological treatments. But keep looking.

Below are ideas that have helped some. They are not prescriptions, but a starting point toward formulating a personal sober pain management plan. Discuss what seems promising with your healthcare team. Keep in mind that some natural supplements may cause urine drug screens to test positive. Stay away from those if this is a concern.

You might feel you have tried everything already. It is certain that you have not. Some ideas to research to start developing a personalized sober pain management plan include specific behavioral changes, like making friends with sober people who have similar pain; baking; heat therapy; ice therapy; time outdoors; improving sleep patterns; finding ways to laugh; non-pharmacologic natural supplements like glucosamine, capsaicin, turmeric, ginger root, arnica, fish oil, or seaweed; massage therapy; acupuncture; hypnosis; guided mindfulness; amd disciplines like meditation, tai chi, yoga, Pilates, or basic stretching.

Twelve-step meetings or other support groups are strongly recommended, in addition to therapy and non-traditional approaches. Recovery can’t happen in isolation.

As with pain management, one size does not fit all recovering addicts. Of course, abstinence is always the ideal ultimate goal for anyone suffering from the chronic disease of addiction.

In a perfect world, no one would take any medication for anything because none would be needed. However, in reality many people’s lives and quality of life are extended and improved by drugs for conditions like hypertension, diabetes and depression, as well as for addiction.

Some addicts don’t need medication. They are better off without it, making lifestyle changes for lasting recovery. But advocates for recovery should not pass judgment on others’ treatment.

One size does not fit all. Some recover with support and self-help. Others see a therapist and attend group counseling. Still others go to short-term rehab, and some to long-term residential treatment programs. Recovery comes quicker for some, but as long as there is life, there is hope.

Some benefit from medicine prescribed by a physician. It is worth noting that judges lack the authority to practice medicine, as affirmed by the passage of a law in September 2015 that blocks courts from ordering defendants in recovery to stop taking doctor-prescribed medications as part of their treatment. (For more information, see the website of Coalition of Medication-Assisted Treatment Providers and Advocates at www.compa-ny.org/policy).

As a therapist, I recognize that addiction medicine has helped save many lives. Likewise, non-traditional approaches to managing physical pain have brought hope and improved quality of life to millions. Also of great importance is consistent compliance with psychosocial interventions such as group and individual psychotherapy and self-help groups.

Medication alone without social supports cannot fix addiction. By themselves, pills are likely to provide only limited hope for recovery. Many who suffer from alcoholism or addiction may not need medicine. If it isn’t for you, don’t take it! Such folks will still benefit from counseling and community social supports like NA, AA, or other mutual support fellowships in order to maintain a clean and sober lifestyle.

Recovery is described as “an inside job” (meaning the changes that are required are internal), but it is next to impossible to do it without the support of a recovering community and supportive healthcare providers.

Letting go of shame and of negative moral judgments and pre-conceived solutions precede “the first step,” which is admitting the existence of a problem that one is powerless to manage alone.

[Tom Rue is a licensed mental health and addictions counselor in New York State practicing in Monticello. Contact 845‐513‐5002 or www.choicesmhc.com.]