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Chronic Pain Solutions Newsletter

September 2009

Quote Of The Month
"You are everything that is, your thoughts, your life, your dreams come true. You are everything you choose to be. You are as unlimited as the endless universe." ~ Shad Helmstetter

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.

__________________________
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
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December 7-9, 2009
Sacramento, CA

Addiction-Free Pain Management®
Certification School

Presented By: Grinstead Consulting, Training & Coaching Services
in Collaboration with NCADD Sacramento

Contact: 916-575-9961
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December 14-18, 2009
Ft. Lauderdale, FL

Relapse Prevention Therapy
Certification 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.

From Our Readers
Question: I've had prostrating migraines since 1983 and have been on opiates since then. For the last two years I have been taking four Dilaudid 8mg with four Tylenol/cod #4 daily. It works fairly well and I plan to continue. What do you think?

Answer: Thank you for your comment on my migraine blog.

Well, the answer may not be what you want to hear, but it's possible that your migraines are now in part or totally due to opiate rebound. I've noted below excerpts from the News and Research section of our website (2008 Archive) titled "Some Medications Lead to Rebound Headaches," that addresses this. Hopefully the information will be helpful to you and others with migraines who are using opiates to manage them.

A new study shows that using narcotics and barbiturates to treat headaches increases the risk for the development of chronic migraine. Senior author Richard B. Lipton, MD, from the Albert Einstein College of Medicine, in Bronx, New York and his team found that baseline headache frequency was a risk factor for transformed migraine.

Using acetaminophen as the reference group, researchers found that patients who used medications containing barbiturates or opiates were at increased risk for transformed migraine. However, Triptans at baseline was not associated with the prospective risk for chronic migraine, the researchers suggest, and overall, non-steroidal anti-inflammatory drugs (NSAIDs) were not associated with chronic migraine either.

"These treatments probably should not be considered first choice to relieve pain," Dr. Lipton told Medscape Neurology & Neurosurgery. "They may offer some relief on a short-term basis, but there could be long-term negative consequences." Dr. Lipton said he expected to see an increased risk with narcotics in this study. "I was not completely surprised," he noted. "But the clear-cut dose response that we saw did make me gasp." The findings appear in the Sept. 2008 issue of Headache. The initiative is part of the American Migraine Prevalence and Prevention study.

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.

Effective Stress Techniques for Chronic Pain: In today's busy world it's very important to incorporate effective stress management tools into your daily living. We hear it all the time; phrases like "I'm stressed out" or "This stress is killing me." This is obviously true for people living with medical conditions like heart disease or diabetes. If you're living with chronic pain it's even more important because . . .


Welcome
To the September 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 please email any questions or comments and we will respond as quickly as we can.

Healthcare professionals as well as mental health and addiction treatment providers are on the front line to accurately assess, intervene upon and develop appropriate treatment plans for the impaired patient with a chronic pain condition. This can become more difficult when prescription drug abuse/addiction is present. For years the numbers of people with chronic pain and coexisting psychological disorders including addiction have been increasing significantly. In fact, 90% of people in the US receiving pain management treatment are prescribed opiate medication, according to research published in Pain Physician Journal (2006). Of that number 9-41% had opiate abuse and/or addiction problems.

Given these sobering statistics and the many requests for training opportunities, we are excited to announce a date has been set for the Addiction-Free Pain Management® Certificating School to be held in Sacramento, California on December 7-9, 2009 and that we were able to secure the beautiful Sierra Health Foundation Conference Center.

Please join Dr. Stephen Grinstead, Developer of the APM™ Treatment System, to learn the skills that are vital to working with these clients, to increase your understanding, empathy and compassion for this greatly underserved population, as well as to improve your marketability in the treatment industry.

After this training you will be eligible to complete and submit the optional Competency Certification to become a Certified Addiction-Free Pain Management® Specialist for an additional $95 portfolio review fee. For more information about the benefits of this credential, please email apmsacreg@yahoo.com.

The fee for this 20 CEU hour training is $395.00, but if you register by October 15, 2009 you pay only $375.00. Subscribers to “Chronic Pain Solutions” will receive a $25 discount off the early registration fee.

You can register at our online Registration Page to get the additional discount, with payments going through PayPal. To register by mail, complete the online Registration Form, then send it and a copy of this newsletter along with a check or money order made out to Dr. Stephen F. Grinstead, at P.O. Box 340626, Sacramento, CA 95834-0626 with name, address, phone and email.

Local lodging information will be forwarded upon request. If you have questions email Ellen at apmsacreg@yahoo.com or call 916-575-9961. Keep in mind that our space is limited so early registration will not only save you money, but will reserve your place at the training!

Relapse Prevention Coaching
Relapse Prevention Coaching is individualized coaching for anyone who is in recovery from an addiction 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. Our Coaching Program is especially helpful for individuals who have had relapse episodes, but anyone in recovery will find it useful.

The Relapse Prevention Coaching Programs can assist individuals leaving treatment and support those people who cannot or chose not to go into traditional treatment programs. They 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. They 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.

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 curriculum 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 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, approximately 40% will have short-term, low consequence relapses and rapidly return to recovery, while 60% will have long-term, high consequence relapses that require costly treatment.

It is vital to have 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. Relapse Prevention will significantly reduce the cost of treating relapse-prone patients and why Terence Gorski developed trainings that include 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® Treatment 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, call 352-596-8000 or visit the CENAPS® site.

News and Research
Proposed Percocet, Vicodin Ban: A Blessing or Curse: A Federal Drug Administration (FDA) panel voted 20 to 17 in June 2009 to recommend a ban on Percocet and Vicodin, two of the most popular prescription painkillers in the world, because of their effects on the liver. I have mixed thoughts about the efficacy of this proposed ban. On one hand, I have seen the quality of life improve for many people who received adequate pain relief from this type of medication. But I have also . . .

The Role of Interventional Pain Management: Many people undergoing chronic pain management face significant challenges in finding ways to relieve their pain. Sometimes medication is not enough which is why most of the latest chronic pain management outcome research is recommending a multidisciplinary team approach for better treatment outcomes. One treatment component that has helped many . . .

Chronic Pain Management for Postherpetic Neuralgia: Over the past few months I have spoken with many people who had a recent Shingles episodes. For those of you unfamiliar with this painful condition, Shingles is a form of Postherpetic Neuralgia (PHN) affecting the nerve fibers and skin. PHN is a complication of Shingles which is a second outbreak . . .

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

"September days have the warmth of summer in their briefer hours, but in their lengthening evenings a prophetic breath of autumn. The cricket chirps in the noontide, making the most of what remains of his brief life." ~ Rowland E. Robinson, Vermont.