Written by Elizabeth Boham, MD
Navigating the Intersection of Stress, Pain, and Addiction: Seeing Hope Through the Lens of Functional Medicine

Navigating the Intersection of Stress, Pain, and Addiction: Seeing Hope Through the Lens of Functional Medicine

IFM’s Annual International Conference

 

The 2019 Annual International Conference for the Institute for Functional Medicine in San Antonio, Texas, was, as always, a wonderful time to connect with friends, colleagues, and like-minded health care providers. It was also full of great lectures that provided us with tools to help our patients who are struggling with stress, pain, and addiction.

The link between these three symptoms was highlighted as was the Functional Medicine approach to treating them. In medical school, we are unfortunately not given sufficient tools to help our patients who are struggling with pain, addiction, and stress. We spend a large percentage of our education on the pharmaceutical interventions for these symptoms. Of course, there are times when pharmaceuticals can be helpful, but many medications have significant side effects and often do not get to the root cause and truly help our patients heal.

When I went through training, we were inappropriately reassured of the risks and benefits of opioid medication. As a result, physicians contributed to the opioid epidemic that we have today. Our medical school education focused us on choosing the best pill for our patient’s symptoms and did not teach us about how to use nutrition, breathwork, lifestyle modification, and stress management as the effective treatment modalities that science has shown them to be. In addition, we were not instructed in the importance of getting to the underlying root cause of the individual patient’s symptoms, which often leads to our patients feeling inadequately treated and not heard by their healthcare provider.

I am so grateful for my education in Functional Medicine and its focus on science, individuality, root cause, and the connections between all of the systems in our body and our health. We know that naming the disease is not the same as understanding the system imbalances in someone’s body. In this blog, I wanted to highlight a few of the amazing takeaways from this life-changing conference, specifically the power of community and its impact on mental health, getting to the underlying reasons for addiction, and the importance of mindfulness for overcoming substance abuse and chronic pain.

The Power of Community

Social isolation increases your risk for cardiovascular disease just as much as smoking. Support communities are wonderful ways to improve our patient’s health when dealing with many diseases including heart disease, diabetes, and addiction. Alcoholics Anonymous has been successfully helping people with alcohol use disorder for many years. There are other support groups that can help people with addictions to opioids, stimulants, and food, too.

The famous “Rat Park” study found that the benefits of community are supported scientifically. In the study, rats were isolated in small cages and given access to cocaine and heroin when they pushed a lever. These studies showed that rats will continually push a lever multiple times for years until they overdose and die of these substances. But when the rats were in a large space where they had the opportunity to interact with other rats, they were less likely to push the lever. This highlights how important it is to get together with others in a community and participate in daily movement.

The Underlying Reasons for Addiction

Although it may seem counterintuitive, the drug is not the problem for individuals, but the solution. Each person turns to opioids or other addictive substances for a different reason, hoping that it will solve their problem. Focusing on opioids specifically, our country has been successful at lowering access to them. However, if we do not address the underlying root cause, there will be another substance that people will overuse to self-medicate, even if we fix the opioid epidemic. The underlying cause of substance overuse may be stress, lack of community, adverse childhood experiences, trauma, pain, poverty, disadvantage, inadequate coping skills, inflammation in the body, brain injury, genetic predisposition, and poor lifestyle habits.

With his story of addiction, Dr. Stephan Loyd gave us all hope. His phenomenal work in the field of addiction has been instrumental in the fight against the opioid crisis. He pointed out that certain professions, such as doctors and airline pilots, are more successful at recovery from substance abuse. This is because they have more support, longer treatment programs, and more follow-up to help them achieve sobriety. Dr. Loyd demonstrated that our healthcare system should recognize these trends to maintain sobriety through long-term treatment.

Healing with Mindfulness Practices

Dr. Eric Garland reviewed his amazing research on the MORE technique (Mindfulness-Oriented Recovery Enhancement) that is helping those struggling with addiction. The MORE technique is a group program that instructs people to do 15 minutes of mindfulness meditation daily and to breathe for 3 minutes when a craving for a substance occurs. These techniques result in a lower need for pain medication as well as other substances (such as food, alcohol, or stimulants). Dr. Garland’s research has shown that those using MORE had a 63% reduction of opioid misuse as well as a reduction of chronic pain and its interference in a patient’s life.

Participants had a better ability to self-regulate physical pain, decreasing their need for medication and helping them feel better. In addition, Dr. Garland’s research showed that MORE increased positive sensation to the natural pleasure cues in life, such as time with nature, family, and communities. Mindfulness through meditation can help people reframe a negative event into a positive time for learning and growth. Participants found an increase in self-generated joy and meaning in life through MORE.

So often when we feel pain, we layer the question “Why me?” on top of it. By becoming worried and stressed, we make the body’s response to the pain even worse. It is so easy to lose hope when becoming addicted to a substance. The importance of restructuring the thought process around pain and addiction through mindfulness cannot be overstated. Remember that pain can motivate us, feeling stress can give us insight, and connecting with community gives us strength. When difficult times are occurring in our lives, using mindfulness to change our focus to understanding the pain, stress, and addiction can be an opportunity in our lives to grow and change as human beings in our journey through healing.

Here are some of my favorite mindfulness meditation programs, CDs, and apps:

 

To your health,

Elizabeth

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