This has become a very common scenario and patients from all around the country are calling the Coleman Institute for Addiction Medicine for help. It’s important to understand the difference between addiction and physical dependence. Addiction, at its simplest, can be defined as continued use despite adverse consequences.

Physical dependence is a physical condition caused by chronic use of a tolerance-forming drug, in which abrupt or gradual drug withdrawal causes unpleasant physical symptoms.

Long Term Pain Medication Use

A person who has been treated for an extended period of time with pain medications such as Oxycontin®, Roxicodone®, Percocet®, fentanyl, Dilaudid®, Vicodin® or any other members of the oxycodone or morphine family will almost invariably have withdrawal symptoms when they stop their medications. Similarly, people who are using illegal opioids such as heroin will experience severe withdrawal if they have used them long enough to develop a physical dependence or addiction.

The Coleman Institute for Addiction Medicine’s professionals focus on treating people with Substance Use Disorders, people who are genetically predisposed to — and succumb to — using certain substances.

Physical Dependence Does Not Mean Drug Abuser

However, a very large percentage of our patients are not drug abusers at all. They have simply developed a tolerance to their medications…and many are being told by their doctors they will no longer continue providing pain management services.

My patients have shared stories of being left with no alternatives, or given a list of possible prescribers only to find the waiting period is several months long. Others have told me of finally finding a new provider whose office suddenly and mysteriously closes with no word of explanation, no way to contact the doctor, and completely abandoning the patient, leaving them susceptible to severe withdrawal


“The bad guys are ruining it for the rest of us,” a patient told me recently. “I’ve always been compliant with my pain management regimen, and my (pain management) doctor’s office is treating me like a criminal. It’s like they think I’m going to sell my medication instead of taking it!”


Tough Calls By Pain Management Doctors

Why is this the case for patients who have never had a ‘dirty’ urine, never abused or diverted their medication, never missed a scheduled appointment, and — perhaps most importantly — have a chronic pain condition? Why are these patients being cut off from their pain medication?

Doctors who regularly prescribe controlled substances for pain management are being closely scrutinized to be certain they are following the strictest protocols. It is now commonly known that years of over-prescribing by the medical profession led to criminal diversion and selling prescription opioids, contributing hugely to the opioid epidemic that ravages our country. Prescribing controlled substances for pain management has become a huge liability for many well-meaning providers (and hopefully also for the scandalous prescriber), as well as a nightmare of complex documentation to ensure every detail meets the standards of care for treating the patient with chronic pain.

Not only that, but research continues to support the once unimaginable concept that just maybe, opioids are not the best treatment for a person with chronic or persistent pain conditions.

Life Without Pain Medication Is Possible

For the chronic pain patient who finds himself cut off by his pain management doctor, the Coleman Institute for Addiction Medicine provides an opportunity to ‘clear the playing field’ and see what the reality of No Opioids means. We do this in a safe, confidential, compassionate outpatient setting. Our patients are able to have their loved ones stay by their sides and participate every step of the way as we shepherd them through a comfortable, yet accelerated, opioid detox


After years of being on highly addictive pain medications, most of our patients are able to complete our detox program in four to eight days, depending on the amount and type of medications being taken, and medical comorbidities.

A surprisingly high percentage of patients, completely convinced they needed to be on long-term pain medication, certain they were the exception and would never be able to stop, have discovered it is just not true. They have virtually re-invented themselves.

Invariably patients find that their bodies are more than able to tolerate the physical sensations they experience post-detox. And they continue to feel better as the body is actually given the chance to create its own dopamine again. Our bodies were built to handle some degree of pain.

Being suddenly confronted with the possibility or reality of no longer having a prescriber for pain medications evokes terror, anger, and desperation. Many people are driven to compromise their integrity, procuring opioids illegally to keep from withdrawing.

There is a good alternative.

Please give us a call if you have fallen through this ‘crack’ in the medical world and would like to discuss the possibility of experiencing the freedom of never having to worry about taking pain medications again.

Joan R. Shepherd, FNP