We’ve just spent the last several days at Sierra Tucson training their clinical pain management team in Denial Management Counseling for the chronic pain population.  This is such an important process when dealing with people living with chronic pain who have other coexisting disorders such as addiction, depression, trauma, sleep etc.
 
The Sierra Tucson team was really into this training which makes my job as a trainer/teacher so much easier.  It was exciting for me to watch them practice and really get that they now will be able to intervene and help their patients at a much deeper level and move them much quicker through the treatment process.  The big hit many of the participants got was how important it is to de-pathologize denial and help normalize it and let their patients know that denial is a normal human defense mechanism and we all have it.
 
My life partner, business partner and wife, Ellen Gruber-Grinstead and I also presented a workshop for about 80-90 of Sierra Tucson’s patients on Overcoming the Inner Saboteur (AKA Denial Management) and it was exciting to see many of them really get into it.  Many of the patients shared that they had been in treatment several times before but relapsed and now they got to see how some of the 12 denial patterns started their relapse slide.

Many of the patients are using my book The Denial Management Counseling for Effective Pain Management Workbook and came up to say how much they were getting out of it once they stopped being angry about having to look at their denial.  If you want to learn more about this please click here to go to my article on this topic or go to the publications page to check out the book.

Over the past twenty five years I have seen many people become depressed and even suicidal as a result of living with an under-treated or mismanaged chronic pain condition.  There are  many reasons why this happens to be sure but one reason I’ve noticed very frequently is either the patients or their providers are afraid to utilize certain types of medication.  I remember in 2001-2002 that in many states Medicare quit allowing coverage for OxyContin—no matter what the pain condition was.

On the other hand I’ve seen many other instances where the problem was too much medication and addiction.  A common side effect of opiate addiction is moderate to severe depression and when the person also has a coexisting chronic pain condition the depression is even worse.  Fortunately, I’ve also seen many people move from despair to hope.  One of the articles on my website’s articles page From Despair to Hope: A Recovery Story, shows how Jerry moved out of his depression and hopelessness and got his life back on track.   Jerry demonstrated how to move from experiencing his pain as suffering to learning to make peace with his pain and manage it effectively.

Many people are not as fortunate as Jerry.  One big problem area that is currently a travesty is our wounded military personnel not receiving the treatment the so richly need and deserve.  We saw last year the scandal of the military hospitals and now I understand the Vets have to pay to get Veterans Administration (VA) benefits.  What’s up with that?  When I talk about this at my trainings many people say “well what can I do; I’m only one person?”  One thing I suggest is get out of that helpless space and start communicating with your elected officials that this is not right.  One person can make a big difference and as a past president once said; (John Kennedy) everyone should try! 

With so much attention to all the news about prescription drug problems one serious problem has gone unnoticed.  For example a lot has been printed about the danger of OxyContin and how it kills people—however; I have not seen one report that anyone died who was taking OxyContin as prescribed.  But there is a non-prescription medication that kills more people every year.  Acetaminophen (brand name Tylenol®) overdose causes more than 450 deaths due to acute liver failure each year in the United States and this number appears to be on the rise. In 2001, the U.S. Acute Liver Failure (ALF) Study found acetaminophen responsible for 39 percent of cases. In 2003, the number had risen to 49 percent.

In fact there are many other over-the-counter (OTC) medications that are highly abused.  One example is cold medication.  If you’ve ever looked on the cold remedy isle at any large pharmacy you’ll see there are so many choices it’s hard to make a decision.  Added to what’s on the shelves are the ubiquitous TV and radio advertisements for cold relief.  A problem that some people encounter is when they mix different cold medications.  Another problem is people taking OTCs and driving.  They don’t realize that they could be charged for driving under the influence if they have an accident.

For people living with chronic pain and taking prescription medications the OTCs can also cause problems.  This can be especially problematic when they haven’t told their healthcare providers about the OTCs; many of which have very serious drug interactions.  A case in point is someone taking Vicodin and supplementing that with OTC Tylenol (acetaminophen).  Vicodin is a combination of hydrocodone and acetaminophen and it would be very easy to go over the highest limit recommended—4 grams per day.

Please be careful if you take any OTC medication.  If you’re taking any other medication or even herbal supplements you could be putting your health, or even your life, at risk.  Let your doctor know what you take and get his/her input on what is safe and effective for you. Also, if you’re in recovery for an addictive disorder many of the OTCs could trigger a relapse.