Welcome
To the November issue of Chronic Pain Solutions. I especially want to welcome our new subscribers that either found us on the internet or heard me speak to providers at a recent conference sponsored by Montgomery County in PA and at the Relapse Prevention Therapy Certification training held in Ft. Lauderdale, Florida.
The interaction and feedback from the participants was overwhelming positive and I thank you.
I also want to take this opportunity to thank all of our subscribers for your continued support of Chronic Pain Solutions and my work. One self care exercise that I often recommend to clients is something that I have done for years - a daily gratitude journal. Every day I write out at least 5 things I am grateful for. At the end of the month I make a list of my top 30.
Today, during the week of Thanksgiving, I would like to share my top 10 for the month of November. I am very grateful for my recovery, marriage, being virtually pain free much of the time, health, family, career, phone conversations with my mom and daughter, great walks with our dog Becka, a soothing backyard waterfall, a therapeutic hot tub, and the trainings I had the opportunity to conduct this past year.
May you all have a peaceful and healthy Thanksgiving filled with gratitude and love!
From My Private Practice
Many of us in the field, as well as those struggling with a pain condition, recognize the problems associated with chronic pain management. Well, let’s put a number on it. According to a June 2011 report by the Institute of Medicine (IOM), in America today over $635 Billion per year is spent on direct medical costs and lost productivity. The report estimates that chronic pain affects about 116 million American adults—more than the total affected by heart disease, cancer, and diabetes combined which comes to about $2,000 spent for every person living in the United States.
In addition, complications arise when people develop problems with pain medication as a result of coexisting disorders. When people are in pain, they often have a need for instant gratification (I want it and I want it now). While acute pain medication can give them the relief they are looking for, it can also lead them into looking for the quick fix.
Being able to tell the difference between appropriate and effective use of pain medication and the beginning of abuse is sometimes difficult to determine. What is important to keep in mind is that there is a progression individuals go through that includes medication dependency, medication abuse, pseudo-addiction, and finally addiction. The confusion and uncertainty of this progression can be a challenge for both patients and treatment providers.
If the person happens to be in recovery for alcoholism or another addictive disorder the problem can be even worse. If they under-medicate it could trigger a relapse. Of course the other side of the coin is if they are overmedicated, or use the wrong type of medication, it could lead to a rapid tolerance build up and finally reactivation of their addiction.
To help with this confusion, below a brief list of indicators which I developed that can signify if a person might be using pain medication in a manner that could eventually lead to serious problems or even addiction. It is helpful to be familiar with these and to seek professional help from a person who has experience, understanding, or training in pain management and addiction.
- The person still experiences a sense of euphoria after adjusting to their medication.
- The person seems to have a preoccupation with their pain medication.
- The person has urges or cravings to overuse their pain medication.
- The person decreases, or refuses to participate in, non-pharmacological pain management activities.
- The person is using non-prescribed substances including alcohol and/or other drugs i.e., marijuana, over-the-counter analgesics, methamphetamine, etc.
- The person is unable to take their pain medication as prescribed—type, quantity, and/or frequency.
- The person is experiencing problems with their thinking, feelings, and/or behaviors.
- The person’s quality of life and/or relationships are being negatively impacted by their use of pain medication.
- The person is not informing one healthcare provider what medication another provider is prescribing.
- The person is unable to fulfill major obligations with family, friends, and/or work due to their use of medication.
- The person is resistant to referrals for psychological assessment and/or treatment.
Business Developments
For the past 28 years my experience and passion, in fact the course of my life, has focused on ending the suffering of individuals who are living with chronic pain and desperately looking for a better way to manage it. For those of us who are living with ongoing chronic pain, we know what it’s like, but many have given up trying to explain it to healthcare providers or even our loved ones! Others try to seek help, but sometimes in ways that are not in their best interest. My goal is to extend empathy, understanding and compassion to my clients as they embark on their journey to a higher state of health and happiness.
Through Grinstead Treatment and Training Services I partner with people living with chronic pain as they become active participants in their healing process and improve the quality of their lives. I also collaborate with healthcare providers who are struggling to address the needs of their patients living with chronic pain and coexisting mental health problems, including addiction. My commitment to providers is to help them implement more effective interventions in order to provide better treatment outcomes to the people they serve. I do this is through my writing, consulting with treatment programs and the training of clinicians interested in making a difference in the lives of people with chronic pain.
For the last 10 years Ellen and I have been maintaining the Addiction-Free Pain Management® website that provided information, research and news addressing how to more effectively treat this special population. Our business has developed to the point where we now want to attend more specifically to the different populations visiting our site and their needs. To that end, we will be introducing a number of new websites to address these diverse requirements. I now have a personal site on Facebook (http://www.facebook.com/drstevegrinstead) where I share my own chronic pain experience through a series of video blogs that cover both my personal and professional journey with links to our other sites.
Not too long ago we sent out an announcement about our new book Freedom from Suffering: A Journey of Hope which will have its own site that highlights the process outlined in the book. The site will offer podcasts and video coaching tips for individuals who are ready to let go of their suffering and to experience a higher quality of life filled with meaning and satisfaction despite their chronic pain condition.
Our site, Grinstead Treatment and Training Services, will highlight the ways that we can partner with people living with chronic pain, addiction or other mental health problems as well as teaming up with other healthcare providers to offer our unique skill set. We will also be offering treatment solution video tips and podcasts.
More developments are in the works and we will let you know as the sites launch. We are committed to doing our part to address what the IOM calls a major public health crisis—chronic pain management. The Addiction-Free Pain Management® System already contains all of the elements that the IOM is calling for in its efforts to resolve this National crisis. On our websites you will find a road map that we hope will support you on your healing journey, as well as the professionals who are working to reduce the suffering associated with chronic pain and coexisting disorders, including addiction.
Relapse Prevention Services
Dr. 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 methodologies. Please visit our website, send us an
email or call (916) 575-9961 to discuss a mutual collaboration through phone or video-conferencing.
Relapse Prevention Coaching Services is individualized coaching for anyone who is in recovery from any addictive disorder and the use of self-defeating, self-destructive behaviors and wants to learn how to recognize and effectively manage situations that put their recovery at risk. The foundation of our Relapse Prevention Coaching Program is the evidence-based work and 40 years experience of Terence T. Gorski's Developmental Model of Recovery.
Relapse Prevention is especially helpful for individuals who have had relapse episodes, but is useful for anyone in recovery. We combine the Gorski-CENAPS® relapse prevention methodology with personal empowerment coaching strategies to create a powerful foundation for long-term stable sobriety. Clients will experience seven clinical processes to quickly identify and manage high-risk situations that cause relapse. They will receive expert guidance in setting powerful recovery goals and implementing specific actions plans to facilitate their continued recovery.
Check out our Coaching
Questionnaire
which is the first step of deciding if you or someone you know is ready for APM Relapse Prevention Coaching,
or call 916-575-9961for a confidential interview.
From Our Readers
Question:
I have severe degenerative disc disease in the lumbar with 2 failed surgeries, and in the cervical spine I also have severe degeneration on every level, I am in pain every minute of every day. I was on morphine which worked wonders and I never abused it. They treat you like you are a lousy criminal with their accusations of criminal behavior, diversion and on and on, simply because they took all my money with operations, procedures, medications, bills and more bills for over 13 years now.
I took myself off of a powerful medication with no help from these so called do no harm doctor's where it was all about money. Once they drained me, then I was the criminal. Now they say I need to have 2-4 discs in my cervical spine fused or I will end up in a wheel chair or worse no moving arms and legs. What do you do to help a person in my condition? I am on MEDICAID, BROKE and in severe pain all the time.
Desperate in New York.
Answer:
I am so glad that you are reaching out for help. First of all I would be happy to offer you a free consultation session to discuss what might be possible with your limitations. What I can tell you right now is how several other people in similar circumstances turned their lives around. However, please remember everyone is different which is why I want to talk with you personally after you have read through the information below.
This first part is from one of the free articles on our website titled Effective Chronic Pain Management is a Right and a Responsibility. In this article I mention that there is nothing wrong with wanting pain relief. However, it may be unrealistic for some people with certain types of pain conditions to ever be pain free. So my question to you is even if you had a certain level of pain, would it be all right if you never had to suffer with it again? I’m hoping you answer yes. But here is the challenge.
Effective pain management is not only a right, it is also a responsibility. So my next question is: are you willing to do the work required for effective chronic pain management and freedom from suffering?
So what does take to be free from suffering? The answer will be different for each person, but there are some general areas that are important to focus on and develop. To begin, you must identify and deal with every aspect of your pain condition and its impact on every area of your life.
To do this an effective chronic pain management treatment plan must contain three major components: (1) Effective and safe medication management; (2) A plan to manage the psychological/emotional components of the pain; and (3) A proactive practice of non-medication based activities.
It is also important to investigate all aspects of yourself: (1) physical; (2) psychological (thinking and feeling); (3) social/cultural; and (4) spiritual, which are the four areas impacted when living with chronic pain on a daily basis. It is not just the physical body. This means that if a treatment plan does not adequately address all four areas, a chronic pain management plan will not be as effective.
When people feel powerless, they give up and can sometimes sink so far into a depression that they become suicidal. One tool that I use a lot and teach my patients is the Serenity Prayer which has been made popular by AA (Alcoholics Anonymous). For some patients I reframe this as the Courage Prayer which helps them to focus on the courage to change the things they can.
“Grant me the serenity to accept the things I cannot change; the courage to change the things I can; and the wisdom to know the difference.” Reinhold Niebuhr
It is important for people with chronic pain to understand the difference between pain and suffering. When they hit a hopeless, helpless or powerless stage, I remind them that they are powerless over their physical symptoms (ascending pain signals), but suffering, which is the descending or psychological/emotional symptoms, is a choice.
You do not have to suffer if you are courageous enough make friends with your pain and are willing to do whatever it takes to more effectively manage it. It is important to realize that you have great deal of influence over your descending pain signals.
Once into acceptance, empowerment can quickly follow. When people feel empowered they are more likely to do what is needed for effective pain management and an improved quality of life. At this stage many people begin to believe that they really will be able to survive their pain condition. This is an important beginning, but there is more work yet to do in order to realize true freedom.
“Gratitude unlocks the fullness of life. It turns what we have into enough, and more.
It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend.
Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow.” ~ Melody Beattie
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