I flew to Kansas City today to conduct Managing Pain and Coexisting Disorders for ReDiscover and the Shirley Fearon Training Institute.  This training institute is a tribute to the founding director of ReDiscover in 1968 in response to a lack of services for mentally ill persons in South Jackson County Missouri. I am honored to be asked to present at their Fifteenth Annual Shirley Fearon Training Institute as they recognized the importance of delivering education to help providers deliver effective chronic pain management to their patients.

This presentation that is based on the Addiction-Free Pain Management® System  will demonstrate how effective implementation of a multidisciplinary and integrated chronic pain management approach can increase positive treatment outcomes by addressing the synergistic effect of pain and addictive disorder issues. Participants will learn about the three types of components necessary to treat the synergistic symptoms of the Addiction-Pain Syndrome™, which include:

(a) Medication Chronic Pain Management

(b) Emotional/ Psychological Chronic Pain Management

(c) Nonpharmacological Chronic Pain Management

Healthcare and treatment providers are on the front line to accurately assess, intervene upon and develop appropriate treatment plans for the impaired patient undergoing chronic pain management. This can become more difficult when prescription drug abuse/addiction present; often because of a mismanaged chronic pain condition that may be either under treated and over treated.

We know from the research on people using pain medications for chronic pain management that about 1.5 to 20%, depending on the study used, will have substance use disorders (i.e., abuse or addiction). Using a conservative 10% estimate, over 10 million chronic pain sufferers will experience substance use disorders.

Therefore, an important goal of this training will be to focus on identification and effective intervention and treatment of prescription drug abuse for chronic pain management patients. This will be accomplished in part by discussing how to identify the most common red flags of prescription drug abuse, and the denial patterns patients use to avoid recognizing and/or dealing with their prescription drug abuse/addiction, as well as becoming familiar with common pain management drugs of abuse.

Since chronic pain includes both physiological and psychological pain symptoms, the participants of this presentation will learn how to differentiate between the two types of symptoms; how effective implementation of a multidisciplinary and integrated pain management approach can increase positive treatment outcomes by addressing the synergistic effect of pain and chemical dependency issues; and what components are necessary to treat the synergistic symptoms of pain and addiction, which include medication management, emotional/ psychological management, and non-pharmacological pain management.

We have two APM™ Certification Trainings scheduled this Spring—one in Sacramento California on May 18-19 and the one at Valley Forge Medical Center and Hospital on June 10-12. It’s not to late for people to sign up and in fact by mentioning this Blog I will make sure you get a $20 discount for either training. To get this discount you must call Ellen at (916) 575-9961 and ask her for the discount.

To learn more about multidisciplinary treatment for chronic pain management and coexisting disorders including addiction please check out my article The Need for Multidisciplinary 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 working with people udergoing chronic pain management and want to learn how to develop a plan for managing their chronic pain and coexisting psychological disorders including addiction effectively please go to our Publications page and check out my book the Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

For other upcoming trainings you can check out our Calendar page.

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.

I have spent the past three days in prison—literally.  Fortunately, I was there to work not serve time.  Earlier this year I was asked to be part of an innovative pilot program by Options Recovery’s Tom Gorham.  Mr. Gorham is also the President Elect of CAADAC (California Association of Alcohol and Drug Addiction Counselors) tasked to deliver a 270 hour alcohol/drug counselor training program.  This project is committed to helping a group of 51 inmates at Solano State Prison in Vacaville California to become certified addiction counselors through CAADAC.

Many people in prison today—it could be as many as 60-80 percent—are in prison due to alcohol or other drug related legal problems.  One of the main reasons recidivism is so high is also alcohol and other drug related.  Even people who get into recovery behind the bars are at high risk for relapse upon release do to the stressful change of environment and other obstacles placed in their way.

The group I’m working with is in a special unit that the men fondly call the “House of Solace.”  It is being spearheaded by Sol Irving.  I’m going to send a copy of this blog to Mr. Irving and see if he would be willing to write a posting for me to put up in the next few days.  My hope is that he will explain the history and reasoning that is behind this project and how he sees it impacting the institution.

I wrote last month that I spent several days teaching these men the Denial Management Counseling process and now this week we completed a 20 hour Relapse Prevention Counseling process.  We had several groups visit us during this training including the director and several members of the California Prison Board of Parole Hearings as well as State Substance Abuse Professional Regional Managers.

I am once again awed by the dedication and hard work these 51 individuals exhibited during our three days together.  One important part of the Relapse Prevention Counseling process is to go through a 17 point High Risk Situation List that highlights the common high risk situations that have led people to relapse.  Unfortunately, this list does not really apply to a prison environment but not to worry as these men developed their own list.

The men are already in groups of 4-6 per table and I gave each table two of the original high risk situations to modify to make them prison-environment-specific.  The last table was tasked to develop three new high risk situations that were prison-specific.  They did an awesome job.  They can be proud to take this new instrument and start using it during their practicum with other inmates that need addiction services at the prison.  These men will be true instruments of change.

Many of these men are serving life-sentences and will never be released but now they will have purpose and help others who are going back out.  They will be responsible for significantly reducing the recidivism rate by helping their peers get and stay clean and sober.  One of the biggest reasons for parole failure and re-offending is alcohol and other drug related, so this could have major impact if it starts spreading to other prison populations.

The staff is already starting to plan for a second group and my hope is that this program will be re-created in many other settings as soon as possible.  In addition, they are planning to bring Alcoholics Anonymous and Narcotics Anonymous meetings back into the prison and this group of men will be instrumental in helping make these meetings successful.  I also suggested that they have Al-Anon meetings for this group of men as they will be working with alcoholics and addicts and will need to have this type of support to help keep them emotionally sober.

In additon to Relapse Prevention and Denial Management, I’m teaching these men about the Gorski-CENAPS® Developmental Model of Recovery. I also include a motivational and hamr reduction approach in the begining with the goal being total abstinence. You can learn more about my views on harm reduction in my article Harm Reduction versus Abstinence for Addiction Recovery that you can download for free on our Ariticles page.

We have two Addiction-Free Pain Management®Trainings scheduled this Spring — one in Sacramento California in May and the one at Valley Forge Medical Center and Hospital in June. It’s not to late for people to sign up and in fact by mentioning this Blog I will make sure you get a $20 discount for either training. To get this discount you must call Ellen at (916) 575-9961 and ask her for the discount. Also, for these and other upcoming trainings you can check out our Calendar 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 or other mental health 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.

One of the primary goals of the Addiction-Free Pain Management® (APM) System is to provide concurrent treatment for someone undergoing chronic pain management that is also experiencing coexisting disorders including addiction. The APM™ System requires a multidisciplinary collaborative teamwork approach where the patient is the team Captain.

There are three core components of APM™. All three parts are equally important but let me start with the Clinical Components. The first component – the Core Clinical Process – uses the APM™ Workbook exercises which apply cognitive behavioral and affective therapy interventions while implementing a manualized treatment approach. The next component – Medication Management – uses safe and effective medical approaches. The third component – Non-Pharmacological approaches – uses proactive pain management interventions.

The Core Clinical Processes use a strategic set of treatment protocols. One of the first tasks is to asses the physical versus psychological components of pain. This is followed by patients identifying their self-defeating medication use or other ineffective pain management strategies. A motivational approach is used to help patients make better pain management decisions. Once patients are willing and they sign a medication management agreement, they need tools to cope with both cravings and pain flare ups. These cravings are usually triggered by high risk situations; so it is crucial to teach patients to identify and learn to manage high risk situations.  The final protocol helps patients to develop a recovery plan designed to more effectively manage their pain and learn relapse prevention tools for their addictive disorder.

The next component – Medication Management – involves collaboration with addiction medicine specialists to implement effective medication management. The specialists’ first task is to asses for risk or level of an addictive disorder and screen for identifiable red flags of problematic medication use. Once this has been done the correct type, dose and delivery system must be determined.

The medical professional is also a part of the collaborative medication management team discussed in the core clinical components. Finally the medical professional will determine if there is a need for any other medical procedures such as epidural injections, trigger point injections or other interventional procedures.

The third component – Nonpharmacological Approaches – are often the most important interventions that help patients develop proactive pain management strategies such as relaxation response training which teaches patients how to reduce their stress levels and their pain symptoms. Other patients benefit from acupuncture or acupressure while others respond to chiropractic; either low impact or the activator method.

Physical therapy and hydrotherapy are often recommended for many pain conditions. Some patients with a spiritual or religious background could benefit from prayer and meditation. The major point I want to make here is the only limitation for the nonpharmacological approaches is your imagination and that of your patients.

We have two Addiction-Free Pain Management®Trainings scheduled this Spring — one in Sacramento California in May and the one at Valley Forge Medical Center and Hospital in June. It’s not to late for people to sign up and in fact by mentioning this Blog I will make sure you get a $20 discount for either training. To get this discount you must call Ellen at (916) 575-9961 and ask her for the discount. Also, for these and other upcoming trainings you can check out our Calendar page.

To learn about ways to improve a chronic pain management plan in the area of anticipatory pain please check out my article Coping with Anticipatory Pain 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 or a loved one is undergoing chronic pain management, especially if you’re in recovery or believe you may have a medication or other mental health problem and you want to learn more effective chronic pain management tools, 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 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.

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.