Published: 09/1/2026 | Author: Eric Owens

Pain care and opioid addiction have been treated as separate problems for most of the opioid crisis by different clinicians in different appointments. A gathering of pain and addiction specialists among the military branches in August 2026 put the case for treating them together.

The National Capital Region Pain Initiative hosted the 2026 Combined Pain Care Skills Training and Substance Use Disorder Symposium for its 16th year. The event drew physicians and researchers in person and virtually. Dr. Christopher Spevak directs the region’s Opioid Safety Program and the pain management fellowship and pointed out how effective pain care ties directly to readiness and recovery for active-duty members to veterans and civilians alike.

Withdrawal Itself Feeds Opioid Addiction

The first lecture came from Dr. George Koob. He’s director of the National Institute on Alcohol Abuse and Alcoholism. Koob discussed how pain and emotional pain during withdrawal push people back toward use.

Koob focused on “the increased intensity of negative emotional/motivational symptoms” that show up during withdrawal. For folks who’ve tried to quit opioids, that framing is relevant. The physical symptoms get most of the attention. But flattened mood, irritability and an inability to feel pleasure can last well past the first week and tempt people to relapse. 

Naloxone Co-Prescribing and Medication Safety

Dr. Abigail Brooks is a clinical pharmacist practitioner at the West Palm Beach VA Healthcare System in Florida. She covered drug interactions and cardiovascular complications in pain management. Her goal is to reconcile a patient’s full medication list before starting any pain drug. If a patient has a prescription for opioids alongside other central nervous system depressants, they should receive a naloxone kit and the education to go with it.

That combination matters for overdose risk. Opioids taken with benzodiazepines, sleep medication or alcohol can make respiratory depression worse. This is what kills in an opioid overdose. Naloxone reverses that effect, so have it in any household where opioids are prescribed.

Dr. Stephanie Weiss of the National Institutes of Health addressed opioid metabolism, explaining that how a person’s body processes a drug determines what a given dose actually does. Patients react differently to identical opioid doses, so people need to be candid with any clinician when considering opioids.

Alcohol and Pain in the Same Picture

Dr. Diana Martinez from Columbia University described how chronic pain and alcohol use disorder feed each other. Long-term alcohol can shift pain thresholds. People living with chronic pain often drink to self-medicate. Both conditions need treating at the same time. She also discussed transcranial magnetic stimulation, a noninvasive procedure using focused magnetic fields to stimulate specific brain regions, now in use at Walter Reed.

Army Lt. Col. Dr. Connie Thomas of the Walter Reed Army Institute of Research covered sleep. Sleep loss is widespread in the military. Unfortunately, sleep problems and chronic pain travel together.

Dr. Mark Lumley from Wayne State University presented neuroplastic recovery therapies that help patients unlearn persistent pain. He teaches the brain to read safe body signals as non-threatening. He also covered Emotional Awareness and Expression Therapy to address avoided emotions, trauma and stress.

Unregulated Store Drugs and Overdose Risk

Dr. Arwen Podesta warned about substances sold at gas stations and convenience store counters. Products containing kratom, tianeptine and other emerging compounds are often marketed as natural or herbal supplements for pain, mood or weight loss. Podesta flagged unpredictable potency and habit-forming effects and overdose as core risks.

These products are widely assumed to be safe because they’re sold openly. Tianeptine acts on opioid receptors at high doses and has produced dependence and withdrawal that people describe as indistinguishable from opioid withdrawal.

Harm Reduction & NA for Opioid Addiction

If you or any folks you know have an opioid prescription, ask for naloxone. For those using non-prescribed opioids or any pill from an unregulated source, fentanyl test strips and not using alone lower the odds of a fatal overdose.

Medication for opioid use disorders means buprenorphine, methadone or naltrexone. They cut down on overdose mortality and work with counseling rather than compete with it.

Narcotics Anonymous meetings give people of all backgrounds a peer community that understands withdrawal and the long tail of early recovery. 

That’s where our services come in. Our directory maintains a nationwide NA directory searchable by location and meeting type.

Feel free to also dial 800-934-1582(Sponsored) to speak with an expert about options anywhere in the country.