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Chronic Pain Solutions Newsletter

August 2009

Quote Of The Month
"You can transcend all negativity when you realize that the only power it has over you is your belief in it. As you experience this truth about yourself, you are set free." ~ Eileen Caddy

Training Calendar
Since 1996 Dr. Grinstead has worked hard to keep the APM System up-to-date so that clinicians can more effectively serve those with pain and coexisting addictive disorders. His research based interventions and protocols have been used by multidisciplinary treatment teams throughout the USA and Canada where he has trained more than 10,000 participants.

__________________________
August 18-21, 2009
Columbus, Ohio

Keynote Presentation
Are We Managing Pain or Fueling Addiction?

and

Breakout Session—Overcoming the Inner Saboteur: Managing Resistance and Denial for More Effective Pain Management

Sponsor: Addiction Studies Institute
Contact: Garrision & Associates at 614-273-1400
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September 11, 2009
Amarillo, TX

Are We Managing Pain or Fueling Addiction?

Sponsor: Amarillo Association of Addiction Professionals

Contact: 806-352-5474
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September 28-30, 2009
Palm Beach, FL

Are We Managing Pain or Fueling Addiction?

Sponsor: Foundations Associates: The Moment of Change Conference— Intervention Approaches for Professionals

Contact: 877-345-3360
__________________________
October 17, 2009
San Jose, CA

Overcome Your Inner
Saboteur By Managing Resistance & Denial

A Day of Relapse
Prevention Planning

Sponsor: WE CARE &
Voices United

Contact: 408-235-1178
__________________________
December 14-18, 2009
San Jose, CA

Relapse Prevention Therapy
Certificating School

Sponsor: CENAPS Corp.

Contact: 352-596-8000
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Go the Calendar page for more information. For more details about specific trainings please visit our website or call (916) 575-9961 to discuss consulting, training or coaching services.

News and Research
How Nerve Growth Factor Impacts Chronic Pain Management: As the number of people in this country living with chronic pain continues to increase, so do the problems people experience as a result of the management of it. One such problem is the use of opiates for chronic pain and the serious problems that develop with long-term use. Some people will develop an addictive* disorder due to prolonged exposure, while others develop tolerance* to the medication and need ever higher doses. Still others may develop a condition known as hyperalgesia*. Another problem discovered through recent . . .

Chronic Pain Management and Depression: Last month we posted an article discussing the challenge of depression that many people with chronic pain face. It’s often misdiagnosed because a chronic pain manage-ment client does not even realize they are depressed so they don’t mention anything to their health-care providers who often aren’t looking for it. And if people who have depression and chronic pain only define their physical problems as it relates to their chronic pain condition, the . . .

Pain Medication Laws — Legal and Ethical Concerns: In 2007 I published an article titled “War on Drugs—War on Pain Management.” Not a lot has changed in the past two years. When I talk about this problem at my Addiction-Free Pain Management® trainings the common response is “sure this isn’t right, but what can we do?” For starters let’s become better educated about the problem of Law Enforcement dictating medical treatment. Talk about it with friends and colleagues, as well as writing to elected officials and letting them know that in . . .

Visit our website to see the complete postings as well as an archive of past research.

New Article
Below we've included a brief introduction from the newest article on our website. For the complete content please visit the articles page.

12 Personal Action Steps for Chronic Pain & Medication Management: First of all, I want to emphasize that the information that follows can be used by anyone who wants to avoid prescription medication abuse or addiction problems, not just those already in recovery. Nonetheless, during my work with people over the past 27, I have seen far too many relapse because of poor medication management plans. . .


What Terry Gorski has to say about this book: "Fortunately, recovery plans for addiction and depression are closely related. The things that help people stay comfortably sober can also help them manage depression and a recovery plan that meets the needs of both addiction and depression can be developed. If a person is already in recovery from addiction, this is good news. All they need to do is learn the few additional techniques that are outlined in this book."

Welcome
To the August 2009 Issue of “Chronic Pain Solutions,” our Addiction-Free Pain Management® Newsletter. Thank you for your continued interest. Each month we will keep you up-to-date on our projects, the latest news stories and research we have on our website as well as upcoming events and trainings. Your input is always appreciated. On the Contact Us page email any questions or comments and we will respond as quickly as we can.

For a number of months now Dr. Grinstead has been posting tips and news related to chronic pain management and other coexisting problems on the various blogs noted below in order to reach as many people as possible with information about Addiction-Free Pain Management®. If you visit any of them, feel free to make comments or ask for certain topics you would like to see discussed.

  • http://www.addiction-free.com/blog/
  • http://recoveryview.com/category/member-blogs/
  • http://chronicpainmanagement.blog.com/
  • http://effectivechronicpainmanagement.blogspot.com/

A December date has been set for Dr. Grinstead to join Terry Gorksi and CENAPS® at the Relapse Prevention Therapy Certification School to be held in Ft. Lauderdale, FL. We hope you will be able to join them. We are still working on dates for an Addiction-Free Pain Management® Certification Training in Florida. Keep checking back to our Calendar Page for up-to-date information.

APM Center of Excellence
Our mission is to collaborate with treatment providers who are committed to fully implementing the Addiction-Free Pain Management® and Gorski-CENAPS® Developmental Model of Recovery. Our commitment is to recognize, support and assist our APM™ Centers of Excellence (COE) partners reach as many people in need of chronic pain management and relapse prevention as possible and to provide them with Science-Based treatment protocols.

The APM Center of Excellence project is executed in three phases:

  • Phase 1: Program Assessment will consist of three days of on-site consultation to evaluate the agency’s pain program and identify weaknesses or deficiencies that would preclude the agency from receiving the Center of Excellence designation.

  • Phase 2: On-site training and consultation will be conducted by Dr. Stephen F. Grinstead for the agency’s clinical and medical staff. The first year’s training consists of the 3 Day Addiction-Free Pain Management® Certification School, the 3 Day Denial Management Counseling (DMC) for Effective Pain Management Certification School, and the Relapse Prevention Counseling (RPC) Certification School. Training needs for years two and three will be identified through the Program Assessment and ongoing consultation with the agency’s designated representative.

  • Phase 3: COE designation and ongoing renewal criteria.

We are always interested in speaking with established treatment centers that want to develop a pain management program along with their current curriculicum or new programs starting from the ground up. We have the expertise and the experience to make your pain program a success. To find out how you can become a Addiction-Free Pain Management® Center of Excellence, please call us at 916-575-9961.

Gorski-CENAPS® News
For sometime now, The Gorski-CENAPS® Corporation has been providing home study programs which allow professionals to earn ongoing CEU's by studying published books or specialty prepared course materials. Gorski Home Studies also serve as an avenue to recertify your Gorski-CENAPS® credential. Take any Gorski-CENAPS® home study course totaling 20 CEU’s, pass the post-test and you will be recertified.

Please Note: These home study courses are not a replacement for and cannot be compared to the live Certification Courses that include the optional Competency Certification Credential. If you have any questions regarding this, please contact Dr. Stephen Grinstead who is now the Director of Training & Consultation for the Gorski-CENAPS® Corporation.

There are approximately 25 courses available based on Gorski-CENAPS® materials that represents source documentation for The Gorski-CENAPS® Model of Recovery and Relapse Prevention. Gorski-CENAPS Corporation is in the process of developing additional home study CEU's courses for many of the books that are instrumental in building skills that addiction and behavioral health professionals need to stay current in their field. For more information, call 352-596-8000 or visit the CENAPS® site.

For healthcare providers who are responsible for containing the cost of addiction treatment, Relapse Prevention is a top priority. It’s easy to understand when forty seven percent of patients return to chemical use within the first year following stays at private treatment programs. Of those who relapse, about 40 percent will have short-term, low consequence relapses and rapidly return to recovery, while 60 percent will have long-term, high consequence relapses that require additional costly treatment.

A specialty relapse prevention program that lowers relapse rates and can intervene early so that the duration, severity, and consequences of relapse episodes will be diminished is vital. Relapse prevention will significantly reduce the cost of treating relapse-prone patients and why Terence Gorski developed the following trainings that include an optional competency certification credentialing.

Please join Terence T. Gorski and Dr. Stephen F. Grinstead in the upcoming Relapse Prevention Therapy Training which will gives participants an excellent opportunity to learn from the developer of these two powerful models – Terence T. Gorski, world recognized in Relapse Prevention and Dr. Stephen F. Grinstead, developer of the Addiction-Free Pain Management® System.

The Relapse Prevention Therapy Training (44 hours) teaches advanced clinical skills training for professional clinicians who want to learn powerful approaches for supporting clients to identify and manage the core personality and life-style warning signs that lead to someone becoming dysfunctional in recovery and eventually relapsing. In its eighth revision and streamlined to be administered in a limited number of sessions, this training forms a foundation for clients to deal with the chronic, physical and emotional pain that often precedes relapse. To register for the December 14-18, 2009 training in Ft. Lauderdale, Florida, contact CENAPS at (352) 596-8000.

Relapse Prevention Coaching
As anyone living with addiction knows it can be very challenging to ask for help, develop an effective recovery program and then maintain it. This becomes even more difficult when clients leave treatment to return home, or for those who found that traditional outpatient programs are not sufficient to effectively prevent a relapse from occurring, or to stop a relapse once it starts.

The purpose of our Relapse Prevention Coaching Programs is to offer 1 on 1 individualized coaching to people who want to recover from an addiction and the use of self-defeating, self-destructive behaviors. The programs are especially helpful for people who have had relapse episodes, but anyone in recovery will find it useful to improve recognizing and effectively managing situations that put their recovery at risk.

We hope you take advantage of the Relapse Prevention Coaching Programs Dr. Grintead and his team offer for individuals struggling with:

  • chronic pain and coexisting disorders including prescription drug abuse or prescription drug addiction,
  • alcohol & other drugs, and
  • eating addiction.

These programs will assist individuals leaving treatment and support those people who cannot or chose not to go into traditional treatment programs.

Our Relapse Prevention Coaching Programs are also invaluable for people who have had limited success with outpatient treatment, or who want to learn powerful relapse prevention tools to enhance the program they are already in. With the assistance of Dr. Grinstead and their Relapse Prevention Coach, clients will experience the seven powerful clinical processes that help them to quickly identify and manage high-risk situations that cause relapse. Participants will receive expert guidance in setting powerful recovery goals and implementing specific actions plans to facilitate their continued recovery.

The foundation of our Relapse Prevention Coaching Program is the evidence-based work and 35 years experience of Terence T. Gorski's Developmental Model of Recovery. As an Advanced Relapse Prevention Specialist and Director of Training and Consultation for the CENAPS® Corporation, Dr. Stephen F. Grinstead's expertise in denial, relapse prevention and co-existing disorders underlie his biopsychosocial, multidisciplinary approach utilizing an ongoing continuum of care that incorporates strategic, cognitive-behavioral skill building exercises in conjunction with powerful solution-focused and strength-based coaching methodologies.

If people knew they could participate from home using their phone and a computer, and that they could become active participants in their healing by participating in our tele-coaching program, we feel confident that their feelings of helplessness and hopelessness would disappear.

Check out our Coaching Questionnaire which is the first step of deciding if you or someone you love is ready for APM Relapse Prevention Coaching. Better yet, call us directly for a confidential interview at 916-575-9961.

From Our Readers
Question: I've been suffering with horrible back pain for 11 years and have lost my job and my wife because of it. I am now on disability and very limited in what doctors I can see for my problems. My new doctor says she is very concerned because of my depression and that I need to get help. I'm also an alcoholic and have 15 years clean and sober so I'm afraid to take the meds the doc says I need. She said the medication can also help my pain. I'm confused and very anxious because I don't want to relapse.

I am so tired of living this way. Please help.

Answer: First of all I would recommend a full biopsychosocial evaluation to determine the severity of your problem before any medications are prescribed. Your doctor’s diagnosis may be correct if she used one of the several depression assessment tools that physicians are trained to use. You may be experiencing a combination of situational depression due to the problems you mentioned and the impact of living with chronic pain. Situational depression responds best to cognitive behavioral therapy which would not need medications. Other types, i.e. bipolar, may need a medical intervention in addition to psychotherapy.

There are many different types or classifications of antidepressants available and a specialist should be consulted to determine the most effective medication for you. You didn’t mention which medication your doctor wanted to use, but I hope it was the class of newer antidepressants like the SSRIs (selective serotonin reuptake inhibitors) and SSNRIs (selective serotonin and norepenepherine reuptake inhibitors). Many pain management specialists utilize these types of medication for chronic pain treatment, particularly for people who live with constant debilitating chronic pain as their serotonin and norepenepherine system becomes depleted. This type of medication is good for both depression as well as improving pain management.

The good news is that there are many treatment options available for depression management. It is important to remember that overcoming depression takes time. Anyone living with chronic pain and depression will need to stay mentally strong and focused when faced with tough pain days. They must also learn how to reach out for support to reduce the risk of becoming isolated. One last thought: overcoming depression and implementing more effective pain management treatment is achievable with the right team and the right plan! I also want to recommend a book by my mentor Terry Gorski titled Depression and Relapse: A Guide to Recovery which you can purchase at Relapse.org.

"In August, the large masses of berries, which, when in flower, had attracted many wild bees, gradually assumed their bright velvety crimson hue, and by their weight again bent down and broke their tender limbs."

~ Henry David Thoreau