Coming Clean by William Moyers on Creators.com

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Coming Clean

Many alcoholics and addicts suffer long-term physical consequences as a result of their use, even after they get sober. This includes chronic pain that may require the use of doctor-prescribed narcotics. So how does this affect somebody's recovery?

Dear Mr. Moyers: I used heroin for 20 years and crack for eight. In a few weeks, my family will be celebrating the 10th anniversary of my being clean. My big question is: Am I really clean? I did a lot of damage and still live with pain that only painkillers mask. I am careful not to take these meds on my own; a family member dispenses them to me. My family is aware of the situation, and they don't see it as getting high. They see it as survival because of the extreme pain and hardship I live with daily. I would like to think I truly am celebrating for good reason, so I ask you: Can I celebrate with my heart these past 10 years, or are the prescribed pain meds holding me back? — Wondering in Western New York

Dear Wondering in Western New York: Managing chronic pain in recovery is always tricky. Far too many people who stop using alcohol or other drugs can quickly become addicted to medications properly prescribed by doctors, and they rationalize that it is OK to use these mood- and mind-altering substances just because the doctor says so. The key starts with informing your doctor that you have a history of addiction. The doctor should monitor your prescriptions carefully and attempt to taper your use or find a nonaddictive substitute. I know a lot of addicts who pretend that aspirin alone won't ease their pain, so honesty is the best medicine.

If you are not taking more than what is prescribed, can't find relief in over-the-counter medications or physical therapy, and are on the up and up with your doc and your family, then you have a good reason to celebrate the past 10 years. Congratulations. You have come a long way despite the hurdles.

Doctors aren't always the best line of defense. Most medical schools still do an inadequate job of educating their students about addiction. Doctors often fail to recognize the symptoms of addiction, whether the patient is in for a regular checkup or being treated for trauma in the emergency room. The Substance Abuse and Mental Health Services Administration is rolling out screening and brief intervention programs across the country, but it will take time before medical professionals are prepared to diagnose addiction and recommend a regimen of treatment for patients.

Not long ago, I was reminded of the gulf between doctors and their patients whose underlying problem is addiction. I took a friend to his first 12-step meeting. There he met another recovering alcoholic who also happened to be his doctor. For a moment, they stared at each other in amazement. "So that's what was wrong with you back then," the doctor joked to my friend, who quickly replied, "Yes, if only I had known what you yourself knew about alcoholism, maybe I wouldn't have tried to hide it from you all the time."

William Moyers is the vice president of foundation relations for the Hazelden Foundation and the author of "Broken," his best-selling memoirs, and "A New Day, A New Life." Please send your questions to William Moyers at wmoyers@hazelden.org. To find out more about William Moyers and read his past columns, visit the Creators Syndicate Web page at www.creators.com.