People living with chronic pain often receive negative messages from their healthcare providers.  They have been told “it’s all in your head,” “you need to try harder,” or maybe “you’re making yourself hurt so you can get drugs.”  Another phrase I have heard from doctors and nurses, as well as mental health and substance abuse counselors, is “they’re just drug/med seeking.”  Before I worked extensively with this group of people, I used to think my clients were “drug seeking” as well.  However, I have learned that what they really are looking for is relief from their pain—both physical and emotional.

These negative messages, combined with feelings of hopelessness and helplessness, can cause someone suffering with chronic pain to become confused, guarded, and defensive.  Teaching them how to effectively connect with supportive people is an important part of every recovery program that strengthens the probability of relapse prevention.  This positive support often leads to overcoming confusion and defensiveness.  Unfortunately, mistaken beliefs about chronic pain and chemical dependency in the healthcare system and the recovery community can discourage recovering people from connecting with appropriate support.  In fact, misguided advice has often led to life threatening situations for the person in pain.

I have seen patients with chronic pain and coexisting addiction problems receive completely inappropriate treatment from their healthcare providers.  These situations are very frustrating because they are so unnecessary.  I get very concerned because inappropriate treatment can easily lead to relapse, and in some cases death.

The blame the victim mentality is not limited to treatment providers.  I have also seen Twelve-Step members who shame, blame, and shun others who relapse.  This is particularly true if the person had long-term sobriety before the relapse.  I have heard newcomers being told to avoid such people because they are “losers.”  When a chemically dependent person returns to alcohol or other drug use, they need compassion, understanding, and support—not shame and blame, in order to once again experience quality recovery.

To learn more about effective chronic pain management check out my article The Right to Quality Chronic Pain Management that you can download for free on our Ariticles page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are in recovery and want to learn how to develop a plan for managing your pain and medication effectively go to our Publications page and check out my book the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.

We have a busy fall schedule for upcoming trainings that you can check out on our Calendar page.

To listen to a recent radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.

To read the September Issues of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

There is quite a bit of confusion and mislabeling of people on long-term use of pain medication.  Many patients are identified as “addicts” when they really are not.  To help clarify this issue a consensus document was developed by the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine.  They have agreed upon the following definitions for, tolerance, physical dependence, pseudo addiction and addiction:

Tolerance

Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution (lessening) of one or more of the drug’s effects over time.  To put it simply, tolerance means that it takes more medication to get the same level of pain relief.

Physical Dependence

Physical dependence is a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist (antagonist meaning blocking the usual effect of the medication).  The simple explanation is that if you stop taking some medications too quickly you will have significant withdrawal symptoms.

Pseudoaddiction

The term pseudoaddiction has developed over the past several years in an attempt to explain and understand how some chronic pain patients exhibit many red flags that look like addiction.  Pseudoaddiction is a term which has been used to describe patient behaviors that may occur when pain is under treated.  Patients with unrelieved pain may become focused on obtaining medications, may clock watch, and may otherwise seem inappropriately drug seeking.  Even such behaviors as illicit drug use and deception can occur in the patient’s efforts to obtain relief.  Pseudoaddiction can be distinguished from true addiction in that the behaviors resolve when the pain is effectively treated.

Addiction

Addiction is a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations.  It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

Over-Medicating and Under-Medicating

Learn How To Make Healthier Pain Medication Decisions

Many people in chronic pain are afraid to take their opiate pain medication because they have heard horror stories of people getting hooked on pain pills.  This leads to a decision to under-medicate and then they end up suffering as a result.  On the other hand not taking effective precautions could lead to developing an addictive disorder.  If you happen to be in recovery for alcoholism or another drug addiction the problem is even worse.  If you under-medicate it could trigger a relapse.  Of course the other side of the coin is overmedication; which could lead to rapid tolerance building and finally reactivation of an existing addictive disorder that was in remission.

To learn more go to our Publications page and check out my Addiction-Free Pain Management® Module Two: Examining Your Potential Medication Management Problems.  To purchase this module please Click Here.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com.  We have a busy fall schedule for upcoming trainings that you can check out on our Calendar page.

To listen to a recent radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.

To read the September Issues of Chronic Pain Solutions Newsletter please Click here. If you want to sign up for the newsletter, please Click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment. 

The human body is a marvelous adaptive organism.  Our brains are designed to learn from our environment and adapt.  For the most part this is a good thing.  Sometimes however, it leads to some very serious pain management situations.  We know that pain is a signal that tells us there is damage or something wrong with our system.  However, with some chronic pain conditions the system (including the brain) gets altered.  The pain system gets turned on and cannot be turned off.  I call this the “hijacked” brain or what is often referred to as Neuroplasticity (also called brain plasticity, cortical plasticity or cortical re-mapping).

Pain research presented by the American Society of Anesthesiologists has emphasized the molecular transduction of painful stimuli, the sensitization processes that occur after injury and long-term phenomena such as pain memory.  Neuroplasticity after surgery occurs at the transduction process, in the central nervous system, where central sensitization occurs. 

According to research published in Annals of the New York Academy of Sciences 933:175-184 (2001) titled “Spinal Cord Neuroplasticity following Repeated Opioid Exposure and Its Relation to Pathological Pain;” convincing evidence has accumulated that indicates there are neuroplastic changes within the spinal cord in response to repeated exposure to opioids.  Such neuroplastic changes occur at both cellular and intracellular levels.  Since so many people living with chronic pain are using opiates these neuroplastic changes need to be better understood and taken into account when treating a problematic chronic pain condition.

To learn more about the role of neuroplasticity in chronic pain management please check out my article Chronic Pain and the Hijacked Brain that you can download for free on our Ariticles page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are in recovery and want to learn how to develop a plan for managing your pain and medication effectively go to our Publications page and check out my book the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery.

To purchase this book please Click Here.

We have a busy fall schedule for upcoming trainings that you can check out on our Calendar page.

To listen to a recent radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.

To read the September Issues of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.