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Chronic Pain Solutions Newsletter

Summer 2010

Quote Of The Month
“That beautiful season — Summer! Filled was the air with a dreamy and magical light; and the landscape lay as if newly created in all the freshness of childhood.” ~ Henry Wadsworth Longfellow

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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August 5-7, 2010
Sacramento, California

Addiction-Free Pain Management
Certification Skills Training

Sponsor: Grinstead Consulting

Contact: Ellen (916) 575-9961
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August 23-27 2010
New Orleans, Louisiana

Relapse Prevention Therapy
Certification Training (44 ceus)

Sponsor: Bridge House

To Register call: 504-522-4475 __________________________

October 18-22 2010
Ft. Lauderdale, FL

Relapse Prevention Therapy
Certification Training (44 ceus)

Sponsor: CENAPS Corp.

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 RPT Workbook
Terry Gorski, Steve Grinstead and CENAPS® have recently published a revision to the Relapse Prevention Therapy Workbook which has been updated and simplified. It is designed for people in recovery from alcohol or other drug addiction who have a history of relapse, or are currently afraid they might relapse. 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.

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 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 call the CENAPS® office at (352) 596-8000. Because specialty relapse prevention programs can lower relapse rates and, relapse prevention will significantly reduce the cost of treating relapse-prone patients.

RPT Training
To learn how to implement the powerful Gorski-CENAPS® relapse prevention model that includes optional competency credentialing, please join Terry and Steve in Ft. Lauderdale, Florida on October 18-22, 2010 for The 44 Hour Relapse Prevention Therapy Training.

Together they will teach this advanced clinical skills training for professionals who want to learn powerful approaches for supporting clients to identify and manage the core personality and life-style warning signs that lead to dysfunction in recovery and an eventual relapse. The training will use the newly streamlined RPT Workbook.

To register for the October 18-22, 2010 training please visit the CENAPS website or call (352) 596-8000.

News and Research
Laser Therapy for Chronic Pain Management: One common request we get is what can be done for Fibromyalgia. Many people have been taking opiates for this condition and they either don’t like the side effects or are afraid of becoming dependent or even addicted. A fairly new option for Fibromyalgia and other chronic pain conditions may be of interest—Infrared Laser Therapy. One source I often explore for new information on chronic pain management is the online website. . .

Neuropathic Chronic Pain Management: If you are living with neuropathic pain like I am you know that the treatment can be frustrating and often ineffective. While acute short-term pain is usually easy to manage and many chronic pain conditions can be treated effectively, neuropathic pain is often a major treatment challenge for both patients and their health care providers. In neuropathic pain the peripheral or central nervous systems are malfunctioning and become. . .

Chronic Pain Management Using Mindfulness Meditation: What does meditation have to do with chronic pain management? I often get this question when my patients see this on a list I give them of potential non-medication based intervention suggestions. One popular misconception is that it is a way to make the mind go blank so that someone can escape from what they are feeling. However, Dr. Kabat-Zinn maintains that “meditation is an invitation to wake up, experience the fullness of life, and transform a person’s relationship with problems, fears, and any pain and stress in life so that they don’t wind up being controlled and eroding the quality of their life. It is not about running away or manipulating mental states.”

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

Welcome
to the Summer 2010 Issue of Chronic Pain Solutions, our Addiction-Free Pain Management® Newsletter. With summer vacation mode in full swing, we decided to combine issues. We hope you are all enjoying your time outside or traveling with family and friends.

There are still some spaces available for the August 5-7, 2010 Addiction-Free Pain Management Certification Training to be held at the Hilton Homewood Suites Hotel. As mentioned in previous issues, Chronic Pain Solutions subscribers can receive special pricing - you are still eligible to attend the training for the early registration rate of $395.

Training Overview: 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 experiencing chronic pain and coexisting psychological disorders, especially addiction, have been increasing significantly.

After this training, you will have the option of earning the APM Competency Certification through the CENAPS® Corporation. To receive this credential, you must complete the training and then submit an APM Certification Portfolio Package with an additional $95 portfolio review fee. Details will be covered at the end of the training. We look forwarding to seeing you in Sacramento!

Here is what one participant had to say about the APM™ training.

"The APM Certification School went beyond my expectations. The skills learned were immediately useable due to Dr. Grinstead's teaching skills and his ability to impart practical ways to use this new knowledge.

He took the integration of theory and practice to a new level through the collaborative, client-therapist process of identifying high risk situations, uncovering the core beliefs, thoughts, feelings, and behaviors that lead to relapse and gave concrete, practical skills to challenge those beliefs.

Counselors and therapists will find the assignments serve as useful assessment tools with many opportunities for intervention in a subtle, empathic manner. Clients will appreciate the structured process that includes easily identifiable goals presented in an encouraging down-to-earth manner. This training is invaluable for anyone working with clients suffering from chronic pain--with or without co-morbid addiction issues."

Jill Westley, LPN - Valley Forge Medical Center & Hospital

Please join Dr. Stephen Grinstead to learn 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.

We hope to see you in Sacramento!

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.

It is especially helpful for individuals who have had relapse episodes, but anyone in recovery will find it useful. We combine the Gorski-CENAPS® relapse prevention methodology with personal empowerment coaching strategies to create a powerful foundation for long-term stable sobriety. With the assistance of Dr. Grinstead and the support of a Certified Coach, clients will experience the seven 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.

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.

APM Center of Excellence
Our mission is to collaborate with treatment providers who are committed to fully implementing the Addiction-Free Pain Management® System 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 as possible who need chronic pain management and relapse prevention tools and to provide them with Science-Based treatment protocols.

This month we want to introduce you to Valley Forge Medical Center & Hospital who has fully implemented the Addiction-Free Pain Management® model and is our APM Center of Excellence on the East Coast. We will also share with you one of the many successes they have had with their "Breakthrough" - Chronic Pain Management Services (CPM) Program.

Since 1973, Valley Forge Medical Center & Hospital (VFMC) has provided comprehensive treatment to adults with substance abuse and associated physical, social, and psychological disorders. They have an 86 bed facility that is located in East Norristown, Montgomery County, Pennsylvania on a spacious, serene, wooded campus. They are a licensed, general hospital approved by the Pennsylvania Department of Health, Bureau of Drug and Alcohol Programs and accredited by the Joint Commission on Accreditation for Healthcare Organizations (JCAHO).

Addiction to pain medication is a common diagnosis and focus of treatment at VFMC. Physical pain, if not well managed, often acts as a primary trigger for addictive processes. The interdependence of pain management and addiction requires a high level of medical expertise to generate consistently successful outcomes. VFMC utilizes various proven therapeutic modalities, including the Addiction-Free Pain Management® System, to target the causes of pain. Thus, the patient receives the most comprehensive treatment available. Treatment seeks to use the fewest medications possible, and abstinence is always preferred. If medication is required, non-addictive medications with fewer side effects are considered first, and if opiates are indicated, an effective individualized medication management plan is developed.

Julie K's Story: Julie (name and some information changed to protect confidentiality), a 48 year old woman, arrived at VFMC after a suicide attempt in March of 2010. After an assessment with her social worker and workman's comp case manager they recognized that her efforts to end her life were based on mismanaged chronic pain. Julie experienced a career ending injury in 1999 when she jumped out of a dump truck and sprained her knee. She has been unable to work for the past 11yrs and became increasingly depressed. With a history of addiction and Bipolar disorder, Julie deteriorated biologically and psychologically. After her initial injury she was prescribed narcotic medication; soon she began drinking and drugging to manage her physical and psychological pain. Here is the rest of Julie's story.

From Our Readers
Question: I’ve recently been diagnosed with fibromyalgia and I’m so confused. I had an auto accident four years ago and was diagnosed with whiplash and had a lot of cuts and bruises. First I went to my chiropractor, but after six months the pain was getting worse so I went to my medical doctor who gave me Vicodin. At first it helped, but over three years later I was on OxyContin and Vicodin for "breakthrough pain" as my doctor called it. It seemed like no matter how much I took it really wasn’t helping that much, so my doctor sent me to a pain specialist who diagnosed me with fibromyalgia. She is now recommending that I get off the OxyContin and Vicodin; she would then set up a new treatment plan for me. I’m scared to stop my pain meds because I’ve heard horror stories and I’m not sure if my new pain doctor can really help me. What should I do?

Answer: I’m not surprised that you’re confused and afraid to stop your pain medication; many people we work with have the same concerns and fears. I agree with your pain doctor that the first step would be to get off the two opiate medications. Opiates are not really that effective for fibromyalgia. In addition, using opiates for over three and a half years may be causing a condition called hyperalgesia or pain rebound—this is where the medication can actually cause the pain symptoms you're having.

One option for coming off the opiates is to ask for a referral to a doctor who uses Suboxone (Buprenorphine) to help you get off of the OxyContin and Vicodin. This medication has been a great transitional tool to support people with chronic pain withdraw from opiates. Also talk with your pain doctor about what her plans are for your fibromyalgia treatment. In my research and work with patients, I found that a combination of medication management that addresses the neuropathic (nerve) pain, which is what most fibromyalgia pain symptoms are, along with stretching, exercise, and possibly Yoga can really make a difference.

If you visit my Research Page, you will see an post listed toward the end of the page called New Fibromyalgia Research that may be helpful for you. There is also one called Cymbalta Approved for Fibromyalgia that discusses FDA approval of this SSNRI (Selective Serotonin and Norepinephrine Reuptake Inhibitor) for the neuropathic symptoms of fibromyalgia.

I would also suggest that you investigate the psychological and emotional components of your pain which you can read about in my article The Psychological Components of Pain. Like most chronic pain conditions, fibromyalgia responds best to a multi-faceted treatment approach to address an individual’s biological, psychological, social, and spiritual areas life. Treating just the symptoms is not enough.

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.

Living Life to the Fullest as We Face Adversity: I believe that life is meant to be lived to the fullest. The phrase "living life to fullest" has changed a lot for me over the past three decades. Before my injury, about 28 years ago, my definition of living life to the fullest was to push my body as far as I could. My dream was to open my own Karate Dojo and teach other people what I had learned to love with a great passion. I was in my 30s and anything was possible. . .

Understanding, and action proceeding from that understanding and guided by it, is the one weapon against the world’s bombardment, the one medicine, the one instrument by which liberty, health, and joy may be shaped or shaped toward, in the individual, and in the human race. ~ James Agee (1909-1955)