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Chronic Pain Solutions Newsletter

November 2010

Quote Of The Month
“There is not a more pleasing exercise of the mind than gratitude. It is accompanied with such an inward satisfaction that the duty is sufficiently rewarded by the performance. ”
~ Joseph Addison (1672 –1719)

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 15,000 participants.

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January 31-February 5, 2011
Colorado Springs, CO

Walking the Tightrope of Pain Management & Addiction, and
Relapse Prevention Counseling

Sponsor: Psychotherapy Associates, P.C.
37th Anual Advanced International Winter Symposium

To Register call: (719) 594-9304
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February 24-26, 2011
Sacramento, Ca

Addiction-Free Pain Management
Certification Training (20 CE)

Sponsor: Grinstead Treatment & Training Services

To Register call: Ellen
(916) 575-9961
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March 28 - April 1, 2011
Sacramento, CA

Relapse Prevention Therapy
Certification Training (44 ceus)

Sponsor: CENAPS Corp. & Grinstead Treatment & Training Services

To Register call: Tresa Watson
(352) 596-8000
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May 16 - 20, 2011
Sacramento, CA

Relapse Prevention Therapy
Certification Training (44 ceus)

Sponsor: CENAPS Corp. & Grinstead Treatment & Training Services

To Register call: Tresa Watson
(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.

New Article
Here is a brief introduction from the newest article on our website. For the complete content please visit the articles page.

Identifying and Managing Stuck Points that Interfere with Effective Chronic Pain Management: When confronted with issues that get in the way of effective chronic pain manage-ment, it is important to not linger too long in any phase of the healing continuum. Over the years I’ve seen many of my patients stop making progress and not transition through the following five phases.

  1. Hopeless to Hopeful
  2. Demoralized to Revitalized
  3. Victim to Victorious
  4. Powerless to Empowered
  5. Surviving to Thriving
In the sections below you will see the problem side of each transi-tion point and the importance of moving through to a solution. Some of you may see where you have been or are currently stuck and need to move forward! A point to remember is that. . . . . .

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.

We are always excited to speak 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 more about the benefits of becoming an APM Center of Excellence, please call us at 916-575-9961.

Welcome
To this issue of Chronic Pain Solutions. Because November is Gratitude Month, I want to share my Attitude of Gratitude story with you. For the past 29 years the word gratitude has taken on a different meaning than it had for me before then. In my healing and recovery process I learned that an attitude of gratitude could help shift my feelings of anger, fear, guilt, shame, loneliness, hopelessness or any other uncomfortable emotional state, into one of hope and excitement.

Since 1981 I have considered November as Gratitude Month, the week of Thanksgiving as Gratitude Week, and Thanksgiving Day as GRATITUDE DAY. So, during this past Week I once again sat down and made a long list of everything I’m grateful for in my life. This took a while as I have so much to be thankful for.

What I am most grateful for today is my recovery of almost 30 years and my relationship with Ellen, my wife and partner of almost 23 years. I make it a point to tell her everyday how grateful I am for her. Many times she laughingly asks: what are you grateful for? Last year when she asked me that, I put together my "short list" of 25 reasons I am grateful for her and gave it to her. I say short list because there are not enough words to express how grateful I am that Ellen is in my life.

I also wanted to share a story that my Karate Sensei (Teacher) Richard Kim would tell us when we seemed upset or down. He said that when something bad happens, say "Thank you adversity for yet another test. If you break a toe, be grateful it wasn’t your foot. If you break your foot, be grateful that it wasn’t your leg. If you break your leg, be grateful you didn’t die. And if you die, be grateful that you don’t have to finish the rest of this grueling class with me."

So today when life happens, I try to remember to say thank you for yet another test and then learn from it. One of the most challenging life events for me was a bit over three years ago (September 29, 2007) when my father died. As I came out of the shock/denial of his death, I had a difficult time finding anything to be grateful for around his passing. Fortunately, I have many recovery support people in my life and I made an effort to express all the gratitude I felt for the time I had with my father; especially the last seven years of his life when we became so much closer. Then I decided to read through all my gratitude lists for that year and before I was half way through my attitude shifted. Many of my early gratitude’s were about different things I was grateful for in my relationship with Dad. That’s when I sat down and updated Bob’s Story and posted it on my articles page as a testimonial to this wonderful father of mine. Feel free to check it out on our Articles page.

I want to wish you all a Happy Gratitude Month and Week and that you had a warm and heartfelt Thanksgiving Day. I hope you find many things and people to be grateful for. No matter what you are experiencing, making an effort to acknowledge what you are grateful for can turn a dismal day into the best day of your life.

It is impossible to be grateful and suffer at the same time — the choice is yours!

Onward and Upward, Steve

News From Gorski-CENAPS®
The Gorski-CENAPS® Corporation has been at the forefront of developing and training clinicians in Mr. Terence Gorski’s evidence-based relapse prevention protocols. Because specialty relapse prevention programs can lower relapse rates, relapse prevention will significantly reduce the cost of treating relapse-prone patients.

For the first time in years, The 44 Hour Relapse Prevention Therapy Training will be offered on the West Coast in Sacramento, CA in March and May of 2011 and will be co-sponsored with Grinstead Treatment and Training Services in their new Private Practice and Training Office. Dr. Grinstead will teach this advanced clinical skills training for professionals who want to learn powerful approaches to support clients as they identify and manage core personality and life-style warning signs that lead them to become dysfunctional in recovery and eventually relapse. The training will use the newly revised eighth edition of the Relapse Prevention Therapy Workbook. This training develops a foundation for clients to identify and learn how to manage the repetitive self-defeating thinking, feeling, social and behavioral warning signs that often precedes a relapse.

To learn how to implement the powerful Gorski-CENAPS® relapse prevention model that includes optional competency certification credentialing, please join Dr. Stephen F. Grinstead in Sacramento, CA on March 28-April 1, 2011 or May 16-20, 2011. Training Fee is $695. To register please contact CENAPS at (352) 596-8000.

For several years, Gorski and Grinstead have been co-teaching, modifying the process, and field testing all of the exercises contained in this newly revised version of Relapse Prevention Therapy. If a person is willing to be open and honest, as well as to actively complete each of the fourteen developmental exercises in this workbook, they may never have to experience the pain of relapse again. You can order the $15 workbook directly from Herald House Publishing or speak to Tresa Watson at the CENAPS® office at (352) 596-8000.

From Our Readers
Question: In 1983 I crushed a disc at L4/L5 and fractured L5 and S1 while weightlifting (power-lifting workout). I had 2 surgeries to clean up the mess, but lived in constant pain - sometimes crippling. I had many spinal injections over the years, but refused narcotics. In 2007 my lower back gave out totally. I have had 3 additional back surgeries including a AND stimulator implant. None were effective in even reducing the now crippling chronic pain in my low-back, left leg (sometimes right) and both feet.

After trying every neuropathic-black-magic drug, my doctors settled on methadone - now at 100mg/day, which at best cuts the pain by 25 percent. I am fortunate in that I am not an addictive person and the withdrawals of methadone are nothing compared to the pain, so I have periodically reduced my dosage to test this re-bound theory. I was told by a professional drug chemist that I have known for several years that “Suboxone” might give me a break from the methadone for a while. Please advise! I would trade 5 years of life for a week of no pain.

Answer: Many of my patients and my colleague’s patients have indeed significantly improved their quality of life and their chronic pain manage-ment with Suboxone as a transitional medication. According to research posted in the American Journal of Therapy in 2005, patients who failed to achieve lasting analgesia with long-term opioid therapy have achieved benefit using sublingual buprenorphine, a partial mu agonist. The drug was investigated in an open-label study with 95 consecutive patients who were referred by local pain clinics for detoxification from long-term opiate analgesic therapy (mean 8.8 years) due to increasing pain levels, worsening function and in 8 percent of the patient’s, opiate addiction.

This study showed that after abstaining from all opiate analgesics for a minimum of 12 hours, patients received low doses of sublingual buprenorphine or Suboxone (buprenorphine/naloxone). The daily sublingual buprenorphine dose ranged from 4 to 16 mg (mean, 8 mg) for an average duration of 8.8 months. 86% of patients experienced moderate-to-substantial pain relief, improved mood and functioning.

However, it is important to remember that medication is only one part of a multidisciplinary treatment plan for chronic pain management to be truly effective. It is crucial to also develop non-medication based interventions, as well as treating the psychological/emotional components of pain. A multidisciplinary approach always gives the best treatment outcomes.

If you haven't already done so, please take some time to visit our News and Research section of past research on Suboxone. I've also published books on Addiction-Free Pain Management that you can review on our Publication Page and purchase from our publisher at reasonable prices.

If you don't live in the Sacramento area, and want to use the Addiction-Free Pain Management Treatment System, we offer phone or video-conference coaching for people all over the US and Canada. Check out our Coaching Page or call us at 916-575-9961 for an interview.

Relapse Prevention Coaching
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.

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.

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.