Chronic Pain and Addiction: How Can Your Loved One Get Help for Both?

Is it addiction or physical dependence?

Anyone who takes opioids regularly can develop tolerance, needing more for the same relief, and physical dependence, meaning withdrawal when the medicine stops.² Neither one on its own means addiction. When opioids are taken as prescribed under medical supervision, tolerance and withdrawal don’t count toward a diagnosis of opioid use disorder.³

What does point that way: running out early, cravings, trying and failing to cut back, and using despite problems. The risk goes up when opioids are prescribed for more than 90 days.³ Our guide to how dependence, tolerance and addiction differ goes further.

Should their opioids be stopped?

Not suddenly. CDC says opioids for pain shouldn’t be stopped abruptly unless there’s a life-threatening issue,¹ and its 2022 guideline doesn’t support rapid tapering or abandoning patients.² When the risks outweigh the benefits, prescribers are advised to strengthen other pain treatments and work with the patient on a gradual taper.¹

Tolerance drops during a taper, so going back to the old dose raises the risk of overdose;⁸ keep naloxone at home and know what to do in an emergency.

What if the doctor cuts them off?

Ask for two things: a slow taper and an addiction assessment. If the assessment finds opioid use disorder, CDC says clinicians should offer or arrange medication treatment, or refer to a specialist who can.⁵ Detox without medication isn’t recommended, because people are more likely to return to use afterward.⁵

Can someone with addiction still get pain treatment?

Yes. CDC says people with both pain and opioid use disorder still need ongoing pain care.⁴ Depending on the type of pain, that might mean acetaminophen, ibuprofen or naproxen, certain antidepressants and anti-seizure medicines that also ease pain, physical therapy and exercise, cognitive behavioral therapy, injections, or acupuncture and massage.⁷⁶ For some conditions these work better than opioids, with fewer risks.⁷

Living with pain can also bring on sadness and hopelessness.⁶ If depression or anxiety is part of the picture, look for care that treats mental health and addiction together.

Can buprenorphine treat both pain and addiction?

For some people, yes. CDC says buprenorphine or methadone treatment for opioid use disorder can also help with pain,⁴ and both medicines are approved to treat chronic pain on its own.⁹

Buprenorphine is a partial opioid, so its effects, including slowed breathing, are weaker than those of full opioids.¹⁰ A regular doctor’s office can prescribe it; methadone for addiction comes only from a certified opioid treatment program.⁵ Our guide to medication for opioid addiction covers both.

What about benzodiazepines and other sedatives?

CDC warns against combining opioids with alcohol, benzodiazepines, sleep aids or muscle relaxants,² and asks prescribers to be cautious about adding gabapentin or pregabalin.¹

Coming off a benzodiazepine takes care too. A 2025 joint guideline led by ASAM says someone who has taken one for longer than a month should taper gradually under a clinician’s supervision rather than stop abruptly.¹¹ Read more about benzodiazepine withdrawal and safe tapering.

How can we help?

Stay close to their care without taking it over. Ask to join appointments; the doctor can talk with you once your loved one gives written permission. Keep one list of every medicine, dose and prescriber. Prescribers are advised to check state prescription records,¹ but your list is often the only place the whole picture lives. Store opioids out of reach and take unused pills to a take-back program.² If they go into a program, tell it about every prescribed controlled medicine before admission. Our guide to the levels of addiction care explains the options.