Hello, Andrea.
Well, typically, with this illness, people tend to stick with whatever works. Opiates are not the answer for everyone, and in my opinion, tend to have a lesser effect on Type I pain, than in Type II, or Atypical.
I am an Atypical TN patient, Type II, and when unmedicated with Opiates, suffer almost constant, severe, pain of a crushing, aching, throbbing quality V2 and V3 branch of my TN nerve and around the area of the Ganglion.
I also take an anti-convulsant and a benzodiazipine, but without opiate medications, in the fall of 2009, I literally did not know how I would make it day to day through the levels of pain I was experiencing. Due to the cocktail of medications, which does include a long-lasting opiate and one for breakthrough pain, I suffer flair-ups of pain only every once in awhile.
This was like a mini-miracle for me as before, pain was driving me to the breaking point of being an inattentive friend, an irritable mother, and non-employable. I am currently thinking of whether I want to go back to work or school, and it is thanks to my pain medication.
There is a difference between addiction and dependency. People become dependent to a variety of medications, not just Opiates. I am dependent upon them for a more pain free life. A psychological addiction to them is not present.
If there were a surgical correction for my condition, I would opt for that route. But, I have suffered with ATN symptoms since 2003. Opiates are the only thing which has ever almost taken them away. Many neurologists will argue that they do not work for "neuropathic pain", yet on the "Facial Resources" website, if one looks up Opiates, it states that many chronic facial pain sufferers claim that they would have been dead years ago without them.
However, whenever I see someone who is able to be maintained on as little medication as possible, I am always happy for them.
Stef