Chronic Pain and Addiction Treatment in Alabama

How is chronic pain treated when someone also has a substance use disorder?

Chronic pain in a person with a substance use disorder is usually treated in Alabama through one shared plan, with pain and addiction clinicians working together. Coordination means agreeing on which medicines are prescribed and by whom, how they are monitored, and what happens if pain flares or a return to drug or alcohol use occurs.

Physical dependence on a long-term medicine is not the same as a use disorder, and many people on long-term opioids do not have one. A national overview is on the pain and addiction treatment page. Buprenorphine treats opioid use disorder and also relieves pain, which leads some prescribers to pick it when both problems are present.

Pain care often continues during addiction treatment, provided the pain team and the addiction team are in contact and share one plan. Outpatient care can make that easier, since someone can keep seeing the pain specialist they already have. Pain plans may also include non-opioid medicines, physical therapy and cognitive behavioral therapy.

Cutting a long-term opioid or benzodiazepine quickly without the prescriber is unsafe, and a sudden stop can bring withdrawal and rebound pain. Access also varies by county: state-funded adult treatment reaches 59 of Alabama’s 67 counties, but co-occurring programs run in only 10, so people outside regional hubs often travel.

Medication and non-drug options

Buprenorphine and methadone are both used to treat opioid use disorder. Buprenorphine also relieves pain, so some clinicians choose it with both conditions in mind. Alabama listings for Suboxone clinics and methadone clinics show where each is offered. Pain plans can also include non-opioid medicines, physical therapy, cognitive behavioral therapy and other psychological approaches. Taking opioids together with benzodiazepines or gabapentinoids adds risk to breathing, so every prescriber should see the full medication list. Decisions about the right mix rest with a person’s clinicians.

Can I keep getting pain treatment while in addiction treatment in Alabama?

Many people keep receiving pain care during addiction treatment, as long as both teams know about each other and agree on the plan. Outpatient care often makes this easiest, because a person can stay with an existing pain doctor while attending outpatient rehab in Alabama. Programs that treat substance use alongside mental health needs appear under dual diagnosis rehab in Alabama.

Access in Alabama varies by county. The Alabama Department of Mental Health reports that state-funded adult substance use treatment reaches 59 of the state’s 67 counties, but co-occurring programs operate in only 10. People outside the regional hubs often have to travel. Among programs listing pain and addiction services, about 71 percent sit within 25 miles of a river, at a median of 10 miles. The rivers named most often are the Elk River and the East Fork Choctawhatchee River. Birmingham-Shuttlesworth International is the nearest airport for about two in five of these programs, and the median distance to the closest airport is 28.2 miles.

Is it safe to stop or reduce pain medication on my own?

Stopping or sharply cutting a long-term opioid or benzodiazepine on your own is not safe, and any taper should be planned with the prescriber. A sudden stop can bring withdrawal and a rebound in pain. With benzodiazepines, withdrawal effects can be serious. Tolerance also drops after a dose change, so going back to an old dose can be more dangerous than before. Alabama’s benzo rehab listings show where help with benzodiazepine use is offered.

Naloxone can be obtained without a personal prescription in Alabama. A State Health Officer standing order lets pharmacies dispense it, and the Jefferson County Department of Health mails free kits after a short online training. Alabama’s 2015 Good Samaritan law protects a person who seeks medical help for someone else in good faith from prosecution for misdemeanor drug offenses. To qualify, the person must be the first to call, give their name and stay until help arrives.

How do I pay for pain and addiction treatment in Alabama?

Payment in Alabama usually comes through Alabama Medicaid, private insurance or state-funded treatment, and each listing shows which of these a program accepts. Alabama Medicaid is run by the Alabama Medicaid Agency. The state has not expanded Medicaid to most low-income adults, so eligibility is narrower than in expansion states. Providers certified by the Alabama Department of Mental Health bill Medicaid directly. Ask both the program and the agency whether a given medication or level of care is covered. You can also browse programs that take Medicaid.

State-funded care runs through the Alabama Department of Mental Health, the state’s single agency for substance use services. See state-funded rehab in Alabama for these programs. Pregnant women get priority admission at all certified providers. Women’s programs charge no admission fees to pregnant women or to women with dependent children. With private insurance, federal parity rules generally require substance use coverage on terms comparable to other medical care, so ask the insurer for your plan’s details.

What should I ask an Alabama program before starting?

The first question for an Alabama program is whether it treats pain and substance use together rather than one at a time. Then ask:

Can staff continue medication for opioid use disorder you already take, or start it? Will they coordinate with your pain prescriber, and how often will notes be shared? How do state prescription records and any opioid prescribing limits affect your plan? Which levels of care are offered, and which payment types does the admissions team accept?

Programs focused on opioids are also listed under opioid rehab in Alabama.

Free help is available at any hour. The ADMH 24/7 Helpline at 844-307-1760 is staffed by the peer recovery organization R.O.S.S. The national treatment referral line is 1-800-662-4357, and 988 connects anyone in a crisis.

Listings on RehabSeekers.com draw on government treatment registers, state licensing records, accreditor listings and information the providers themselves supply. Ask intake staff about current details before you go. Every program type in the state is on the Alabama locations page.