Dr. Stephen Colameco has practiced addiction medicine for over 25 years. He is certified by the American Board of Addiction Medicine, the American Board of Family Medicine and has been recognized as a Fellow by the American Society of Addiction Medicine. He currently holds medical school appointments as an Assistant Clinical Professor; Dr. Colameco lectures and writes on topics related to chronic pain, addiction, and mental health. He is author of Chronic Pain: A Way Out (2012).
Addiction, Physical Pain, and Emotional Suffering
This website is intended primarily as a resource for those seeking help for addiction or for chronic pain when complicated by addiction issues or concerns.
pain and addiction are complex disorders that are often related. In his book,
Chronic Pain: A Way Out (2012), Dr. Colameco describes
the interplay between pain and addiction; he offers
steps to help create a treatment path that includes evidence-based medical treatments, physical modalities, counseling, self-care education
and alternative approaches. This book
is intended as a resource for not only for those who suffer
with chronic pain, but also for their families and healthcare providers.
This book includes an updated version of a previously published
12-Step recovery guide. The 12-Steps are intended to help individuals
recover from the emotional suffering that so often accompanies chronic
Chronic pain and addiction are complex disorders that are often related. Research shows that addicts experience more pain than the general population. Patients treated with opioids (narcotics) for chronic pain are at risk for addiction. In both disorders, psychological, social and environmental factors dynamically interact to alter how the brain functions. Science tells us that the brain pathways involved in pain and addiction overlap. Psychological factors such as mood, beliefs, and thought processing play key roles in both disorders; many individuals suffer from anxiety, depression, PTSD and other psychiatric conditions. For all of these reasons, the best treatment for pain and addiction need a holistic, biopsychosocial approach. This is not just Dr. Colameco's opinion.
In the prestigious journal Nature (1987) Dr. Alan Leschner wrote that "Addiction is a Brain Disease, and It Matters" stating that "Scientific advances over the past 20 years have shown that drug addiction is a chronic, relapsing disease that results from the prolonged effects of drugs on the brain. As with other brain diseases, addiction has embedded behavioral and social-context aspects that are important parts of the disorder itself. Therefore, the most effective treatment approaches will include biological, behavioral, and social-context components." In the ensuing years research has conclusively affirmed Dr. Leshner's statement that addiction is a brain disorder.
In 2009, the American Pain Society stated in a medical practice guideline that "As chronic noncancer pain is a complex biopsychosocial condition, clinicians who prescribe continuous opioid treatment should routinely integrate psychotherapeutic interventions, functional restoration, interdisciplinary therapy, and other non-opioid therapies."
In his book entitled 12-Steps for those Afflicted with Chronic Chronic Pain: A Guide to Recovery from Emotional and Spiritual Suffering (2005), Dr. Colameco wrote, "Sometimes these medications do more than deaden pain; they may also numb feelings... Opiates are never the answer for depression, fear, anxiety, guilt, worry or anger. In fact, numbing our feelings is altogether wrong; it delays getting real help that might relieve our suffering..."
Newer research implicates opioids themselves as a possible cause of pain. Evidence is mounting that opioids lower the pain threshold and pain tolerance because of a condition known as opioid-induced hyperalgesia. Opioids actually makes pain worse for many patients; a number of studies have shown that many if not most patients receiving high dose opioid treatment will experience less pain once opioids are withdrawn.
Medications alone, whether they be an opioid for chronic pain or Suboxone(TM) for addiction, are rarely adequate to treat these conditions. Effective treatment requires a commitment to recovery. Often, this means a combination of counseling, medications, exercise, support group participation, and complementary (alternative) therapies.
It is Dr. Colameco's hope that you will be able to find the information you need on this website. Please feel free to contact Dr. Colameco, especially in regard to how this site can be improved.