I’ve had reinforced again this week the importance of stress management for people experiencing any type of medical condition after receiving a frantic call for help from a former patient of mine. Stress management is even more important when someone also has other coexisting disorders. People with chronic pain and coexisting disorders including addiction have three major reasons to learn effective stress management: (1) to lower the intensity of their pain; (2) to help them avoid a relapse back to inappropriate medication including alcohol or other drugs; and (3) better manage any pscychological or mood disorders.

Stress is a blessing and a curse. We need stress to motivate us and help us deal with life on life’s terms. Stress also gives us energy and fuels the fight, flight, or freeze phenomenon. On the other hand stress can be a curse for someone in early recovery for an addictive disorder. Stress is a major trigger for protracted or post acute withdrawal (PAW), and often leads to increased urges and cravings to use alcohol or other drugs. The stress response is a combination of biological psychological and behavioral factors.

In response to stress the body mobilizes an extensive array of physiological and behavioral changes in a process of continual adaptation. This is an important part of the body’s defenses with the goal of maintaining homeostasis and coping with stress. The body reacts to stress by secreting two types of chemical messengers – hormones in the blood and neurotransmitters in the brain.

Hormones alter the metabolism of food for fuel and energy for the fight-flight response. In the brain neurotransmitters trigger emotions, such as aggression or anxiety that prompt a person to engage in fight-flight or freeze response to stress. This leads to self-defeating behaviors.

One of the first steps in effective stress management is to learn how to identify and challenge irrational thinking that leads to uncomfortable emotions and anticipatory pain.  For example if you’re under high stress the thought might be “I can’t stand this… I need a pill.”  This in turn could lead to, fear, anger, anxiety, or even euphoric recall—anticipatory excitement.

The next step is to be aware of and learn how to manage those uncomfortable feelings before they lead to self-defeating urges. Developing recovery-prone feeling management skills is very important. Learning to share with trustworthy people is one way to deal with uncomfortable emotions. If the feelings are too intense or overwhelming, counseling or therapy may be necessary.

If those negative urges do surface, it is important to learn how to make healthier decisions before indulging in self-destructive behaviors. There is a decision point between the urge and the behavior that is almost non-existent when people first get into recovery. If people keep reacting to their impulses instead of thinking and responding they very well could relapse. That is why learning impulse control and delayed gratification is so important.

The final part of stress management is to learn relaxation and stress reduction techniques.  For some people this includes options such as meditation, yoga, Tai Chi, breathing exercises, etc. Other people like to use soothing music to relax. These relaxation interventions need to be coupled with developing an effective diet and exercise program.

Yes stress is a blessing or a curse, and if you want to stay serene and reduce your pain learning to identify and manage your stress is very important. Relapse prevention is an inside job, but that doesn’t mean you have to do it all alone. Help is out there if you’re willing to reach out.

To learn about two skill trainings coming up in Sacramento California designed to teach treatment strategies for people living with chronic pain and coexisting disorders including disorders including addiction please Click Here.

To learn more about other obstacles for effective chronic pain management, please read my article Overcoming Obstacles for Effective 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 living with chronic pain, especially if you’re in recovery or believe you may have a medication problem and want to learn how to develop a plan for managing your pain and medication effectively, please 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.

To listen to a 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 latest issue 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.

Over the years I have been very outspoken about the need for people in recovery, who have an addictive disorder, to stop smoking.  About six years ago I was working with a doctor at a pain clinic who had done extensive research on the effects smoking has on pain management.  Recently I ran across a study that demonstrated that people who were living with neuropathic pain and continued to smoke were actually amplifying their level of pain. This was published in 2005 by the Journal of Spinal Cord Medicine Volume 28(4): 330-332.  I’m going to insert a portion of that report below.

The first subject rated his pain as 4/10 when not smoking and 7/10 when smoking. The pain subsided 30 minutes after smoking was discontinued. He noted an immediate increase in neuropathic pain when smoking. The second subject quit smoking for 1 month and immediately noted that the pain disappeared, rating it 0/10. After he resumed smoking, his radicular pain was 8.5/10 in the morning and 5/10 in afternoon.

This particular study focused on people with spinal cord injuries (SCI) and neuropathic pain, but the findings could translate to any type of neuropathic pain, whatever the trigger or pain generator was.  I have seen many patients quit smoking over the years and almost all that stopped reported an improvement in their pain levels.  Many of them did not have SCI or neuropathic pain, but even so they reported improvement in their pain management.

To learn more about my views about smoking, recovery and chronic pain management please check out my article Smoking and Recovery Just Don’t Mix that you can download for free on our Article page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people in chronic pain or are living with chronic pain and have any resistance or denial and want to learn how to develop a plan for helping to identify and manage denial please go to our Publications page and check out my book the Denial Management Counseling for Effective Pain Management Workbook. To purchase this book please Click Here.

To listen to a 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 latest issue 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.

If you watched any amount of TV the past few years you may have noticed a significant increase in commercials hyping prescription medication.  At the same time research is showing that prescription drug abuse and addiction is on the rise, especially among adolescents.  In fact some research reports that prescription dug use is now exceeding other previous drugs of choice with 16-24 year olds. 

According to researched published in Pain Physician Journal as recently as 2006, 90 percent of people in the US receiving treatment for pain management were prescribed opiate medication. Of that number 9 percent to 41 percent had opiate abuse/addiction problems. The research also stated that 16 percent of pain management patients experienced illicit drug use along with their prescribed medication, and as high as 34 percent in other research they reviewed. These numbers give a picture of the overall problem of chronic pain abuse/addiction problems in the general population. What is harder to quantify is the extent of this problem in the recovering community.  

Should we blame TV for this increase?  Well I don’t think there’s a direct cause and effect, but it sure does support a quick fix mentality that is all too apparent in our culture.  After all if you have a problem all you need to do is pop a pill.

My medical colleagues have complained to me that many of their patients are demanding specific medications that they saw on TV—if it’s advertised on TV it much be safe; for example the commercials advertising Lunesta, a sleep medication.  After all how can such a cute butterfly be dangerous? 

A 2008 Johns Hopkins Health Alert that emphasized that it’s not so black and white of an issue as you can see by a portion of that report below.

A study, carried out by researchers at Massachusetts General Hospital, Harvard University, and the marketing research firm Harris Interactive Inc., found that 72% of the physicians surveyed believed that advertising had increased their patients’ understanding of possible drug treatment.

Another interesting finding: One in four doctor visits spurred by DTC advertising resulted in a new diagnosis. This suggests that advertising may help some people to recognize that they have a treatable health problem.

However, DTC advertising can also cause confusion. In the Harvard-Harris survey, many physicians said that ads often left their patients with a lopsided view of the risks and benefits of medications, with a bias toward potential benefits. The FDA survey, too, concluded that people tended to view drugs they learned about through these ads as more effective than they actually were.

For a look at this complete Health Alert please Click Here; then search for Direct To Consumer Drug Ads.

The next time you’re watching TV pay attention to the pharmaceutical commercials and decide for yourself.

To learn about two skill trainings coming up in Sacramento California designed to teach treatment strategies for people living with chronic pain and coexisting disorders including disorders including addiction please Click Here.

To learn more about my thoughts on prescription drug problems, please read my article Addressing the Problem of Prescription Drug Abuse/Addiction 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 living with chronic pain, especially if you’re in recovery or believe you may have a medication problem and want to learn how to develop a plan for managing your pain and medication effectively, please 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.

To listen to a 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 latest issue 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.