Chronic Pain and Addiction Treatment in Los Angeles

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

When someone also has a substance use disorder, chronic pain is usually treated through one plan that covers both conditions, with the clinicians involved agreeing on medicines, therapy and follow-up. In Los Angeles, listings for Suboxone clinics and methadone clinics show where opioid use disorder medicines are offered.

For opioid use disorder, the main medicines are buprenorphine and methadone. Buprenorphine also relieves pain. Pain plans may also include non-opioid medicines, physical therapy, cognitive behavioral therapy and other psychological approaches. Decisions about which options fit belong to the person and their clinicians.

Physical dependence on a prescribed opioid is not the same as a use disorder. A care team should assess each one separately. Reducing a long-term opioid prescription suddenly, or without a plan, carries real risk, so any taper is best worked out with the prescriber.

Raising pain and addiction at the same appointment helps, and so does having the prescriber send records to the addiction program, letting both clinicians work from one plan. Medi-Cal covers addiction treatment through county-contracted providers, and private plans fall under federal parity rules, so insurers can explain how each service is covered.

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

Stopping or sharply cutting a long-term opioid or benzodiazepine prescription without a plan can be dangerous. Any taper should be planned with the prescriber. Bring up pain and substance use together at the same appointment. Ask the prescriber to share notes with the addiction program so the two clinicians are not working against each other.

Naloxone nasal spray is sold over the counter in California. In Los Angeles County, the contracted Engagement and Overdose Prevention Hubs and the Department of Health Services’ Overdose Education and Naloxone Distribution program also hand out naloxone. In a crisis, call or text 988, or call the county Department of Mental Health 24/7 Help Line at (800) 854-7771.

How do I find and pay for pain and addiction care in Los Angeles?

The county Department of Public Health’s Substance Abuse Prevention and Control bureau, known as SAPC, runs public substance use treatment in Los Angeles. Its Substance Abuse Service Helpline is 1.844.804.7500. SAPC also has a Service & Bed Availability Tool that shows open beds. Medi-Cal covers substance use treatment through county-contracted Drug Medi-Cal providers. Local Medi-Cal plans include L.A. Care Health Plan, Health Net Community Solutions and Kaiser Permanente. People without coverage can ask about state-funded treatment in Los Angeles, which the California Department of Health Care Services funds. Private plans fall under federal parity rules for substance use care, so ask the insurer how pain and addiction services are covered. People in a court case can ask about the Adult Drug Court that works with the Los Angeles Superior Court.

Program locations in Los Angeles are spread out. About 88 percent of pain and addiction listings sit within 25 miles of a river, most often the Los Angeles River. Hollywood Burbank Airport is the most common nearest airport, at a median of 8.3 miles. Metro bus and rail reach most areas, though many trips combine rail with a bus. Some people use telehealth in Los Angeles for some sessions. The statewide referral line, (800) 879-2772, and the national treatment referral line are also free places to start.

Questions to ask a program before starting

Ask intake staff whether the program treats pain and substance use together rather than one at a time. Ask whether it can continue or start medication for opioid use disorder, and whether it will coordinate with your current pain prescriber. Listings also note levels of care, payment types, insurers, accreditation, languages and populations served. For the wider picture, read about pain and addiction, compare pain and addiction programs across California, or return to the Los Angeles treatment page.