Managing Pain in Recovery Without Opioid Painkillers

Can recovering addicts use pain medication? Opioid painkillers in particular – such as codeine, hydrocodone, and morphine – pose a serious risk for triggering relapse.

Whether you’ve recovered from addiction to prescription medication, heroin or some other drug, every former addict needs to be especially careful when it comes to pain medication, and seek out alternatives for managing pain.

Pain Meds Are a Threat to Sobriety, But So Is Pain

Injuries happen. Surgeries are necessary. There are many legitimate reasons why a person in recovery might need pain medication, including:

  • Healing after surgery
  • Recovering from a car accident
  • Broken bones
  • Chronic back pain
  • Migraines
  • Painful health disorders, etc.

If you’re committed to maintaining your sobriety, you may think that it’s a good idea to not even consider taking pain medication. However, it’s important to be aware that untreated pain also poses a threat to your sobriety.

Pain takes its toll emotionally and physically. It can wear down your resolve and lead you to seek out relief – wherever you can get it – when the pain finally becomes too much to bear.

So don’t wait until you’re desperate. Take a proactive approach to managing your pain.

Pain-Management Alternatives

There are many non-addictive pain medications, therapies and alternative practices that can help you manage pain safely, without the use of opioids. Talk to your doctor about using one, or a combination, of these alternatives:

Over-the-Counter (OTC) Pain Relievers

These include aspirin, acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). Although not habit-forming, you should still talk to your doctor about using for these medications for chronic pain, since long-term use can have other side effects, such as liver and kidney damage.

Topical Pain Relievers

Medications that you can rub onto the skin for quick relief on contact, such as lidocaine and capsaicin cream, can be purchased over the counter or prescribed by a doctor in a higher strength.

Physical Therapy

PT can help you regain strength and flexibility in your body that in turn helps relieve pain, especially back and neck pain and when recovering from surgery or injury.

Massage Therapy

Massage stimulates the production of endorphins, which can help counteract pain. It also loosens tightness in the body that can contribute to pain.

Ice and Heat

Applying ice packs or heat packs when appropriate can provide immediate relief as well as lessen swelling, bleeding and stiffness, helping the body to recover faster.


This technique helps you learn to exercise some control over bodily functions that are controlled automatically by your involuntary nervous system. It can be used to help treat conditions such as migraines and chronic pain.


This type of therapy uses water to relieve stress on the body that contributes to a variety of illnesses and conditions such as headaches, arthritis, muscle aches, depression and sleep disorders. There are many different techniques that involve baths, tubs with water jets, showers, etc. that strategically use hot and cold water, water pressure and mineral baths.

Mindfulness and Meditation

There are various forms of this practice, such as guided meditation, deep breathing exercises, visualization, progressive relaxation, etc. Prayer also fits into this category. The ultimate goal of these practices is to calm and destress the body, enabling faster healing and reducing pain-related anxiety.


This ancient practice is less strenuous than aerobic exercise, yet provides significant benefits in terms of strength, flexibility and good posture. This is especially helpful in relieving muscle and joint pain.

Acupressure and Acupuncture

Acupuncture involves inserting hair-thin needles at various strategic points on the body, called acupoints. It is nearly painless when done correctly by an experienced practitioner. Acupressure works the same way, except it uses massage to stimulate the acupoints.

These alternative methods are typically used to treat chronic muscle and joint pain that is not alleviated by other methods – such as anti-inflammatory medication, ice/heat treatment and physical therapy. It is considered by some doctors to have fewer adverse effects than taking medication. 


This alternative treatment method is based on the idea that the practitioner can channel his or her energy into the patient in order to stimulate the body’s natural healing abilities and to reduce tension, pain and fatigue. It is generally used in conjunction with other pain-management techniques.

Opioid medications should only be used as a last resort if these other methods aren’t effective at controlling the pain.

If You Must Use an Opioid Medication

In some cases, the pain may be severe enough that your doctor chooses to prescribe you an opioid medication for a short time. If that happens, follow these guidelines:

  • Get Drug-Free For Life With Elevate Addiction ServicesFollow the prescription’s instructions exactly, especially in terms of dosage amount and frequency.
  • Tell the people who support you in your sobriety – such as your spouse or close, sober friends – about your treatment. Do NOT hide the fact that you are taking this medication.
  • Put someone else in charge of handing out your pills, like a spouse or trusted friend who won’t allow you to do something that’s not in your best interests. Some doctors may dole out your doses for you. Certainly expect your doctor to keep close track of your medication, because they understand the risks and are looking out for your safety.
  • When you’re healed, dispose of any unused medication. Don’t keep it around for future use: Remove the temptation immediately.
  • Ask your doctor for extended-release opioids instead of immediate-release opioids, so you get pain relief over time without a high.

Taking your medication as prescribed means you not only avoid taking too much, you also avoid taking too little. When the time for your next dose comes around, you may not be in serious pain yet, but that doesn’t mean you shouldn’t take your dose on time, because it will take time for the new dose to kick in.

Some people try to “tough it out” and see if they can go longer between doses. But this is not a good idea because of the delay time in which a medication wears off and takes effect. If you wait until the pain is very strong before you take your next dose, you may be in serious pain for another hour while you wait for the new dose to kick in.

Remember, the goal is to keep the pain under control so that you’re not tempted to do something you shouldn’t do, like take three pills instead of one because the pain’s gotten so bad.

Keep Your Doctor Fully Informed

Be sure to give your doctor feedback about how well a pain-management technique works, or doesn’t work. Discuss the frequency of use, the dose/intensity, and combining different methods. You can keep a pain diary to keep a record of all this data.

A pain journal should include notes on:

  • The type of pain: Sharp? Aching? Burning?
  • When it starts and ends, how long it lasts
  • Where in the body you experience it, and if it moves or stays in one spot
  • Intensity of pain on a scale of 0 to 10 (0 = no pain, 10 = worst possible pain)

Be fully transparent about your past history with substance abuse and all medical details. Never lie to your doctor. They will not judge you. (If they do, find a different doctor.)


For former addicts, opioid pain medication should only be used as a last resort after trying alternative pain-management options, and only for a short period of time. Your doctor or a trusted caregiver should be in charge of dispensing the medication precisely according to the prescribed instructions.

As much as possible, keep participating in activities that bring you joy and keep you motivated to stay sober.

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