Some pain disorders require pharmacological (prescription drug) interventions. Other conditions may respond to over-the-counter medications like aspirin or ibuprofen. Still other conditions may need a combination of both. However, some pain disorders can be effectively treated without any chemical interventions at all.

It’s important to remember that any psychoactive medication could be problematic for people with a genetic or personal history of an addictive disorder. Unfortunately, there may be times when opiate (or opioid) medication management is needed, but there are risks. I think it’s important to be aware of both the benefits and potential consequences of using opiate medications for chronic pain management.

Efficacy and Risks of Opioid Medication Management

• Opioids have been shown to effectively reduce cancer and acute pain conditions and they can also share a role in the management of chronic pain.
• Opioids may be inappropriate for patients with substance use disorders or a history of those problems. If any psychoactive medications are used, providers must take special precautions.
• Concerns about side effects, such as functional impairment and physical inactivity, as well as concerns about physical or psychological dependence, must be taken into consideration when using opioids for chronic pain management.
• Physical dependence is a physiological adaptation to a substance, defined by a growing tolerance for its effects and/or withdrawal symptoms when use is reduced or ends.
• Psychological dependence (often called addiction) is a primary, chronic, neurobiological disease with genetic, psychosocial, and environmental factors influencing its development and manifestations.
• Psychological dependence may occur with or without physical dependence and is conceptually characterized by impaired control over drug use, compulsive use, continued use despite harm, and craving for the psychic effects of the drug.
• What appears to be psychological dependence may be due to pain that is under treated. This is also known as pseudoaddiction.

To learn more about the pros and cons of prescription medication in chronic pain management check out my article titled America in Pain: Turning to Prescription Drugs - a Blessing or a Curse, 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 books; especially 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 learn about my upcoming trainings you can check out our Calendar page.

If you don’t know whether or not you have a problem, it can be extremely difficult to find a solution. Have you ever had a situation where you were very enthusiastic and excited about achieving a desirable goal and then got in your own way? I know I have.

There are many different ways of talking about that part of ourselves that both protect us and sabotages us—sometimes at the same time. Some people call this our psychological defense system. Others call it denial, while still others call it the inner saboteur. Have you ever heard the expression “the committee in your head?” For others it’s the angle or devil on your shoulder and for still others it’s the “monkey mind.”

The way you also can think about this protective dynamic is that it’s the combination of our thoughts, opinions, beliefs and conclusions that we have developed over our lifetime to either protect us our get our needs met. At times it has a very high positive payoff and we do obtain protection and get our needs met. Unfortunately, at other times it can become a blind spot that is actually hurting us more than helping us.

I’ve seen many people who were living with chronic pain who developed coexisting disorders but they were unaware of sabotaging themselves. Some of them developed depression, anxiety, or sleep disorders that they didn’t manage very well and experienced life damaging consequences. Others also started have problems with their pain medication management and developed a substance use disorder—prescription drug abuse or even addiction—and didn’t see it.

At times of high stress the brain can get emotionally overloaded. At these times the brain will activate automatic defenses, which we will call denial patterns. Each denial pattern is turned on by a specific trigger that threatens something that we value. As a severe problem causes intense stress, the brain turns on intense fear and/or anger. This activates a psychological program that starts mobilizing automatic defensive thoughts and the urge to use resistant behaviors.

A major obstacle to recognizing these self-sabotaging behaviors and achieving effective pain treatment is this denial system—that psychological defense mechanism that protects us from devastating pain and problems that is automatic and unconscious.  It is important to remember that this system of defense was developed to protect us from being overwhelmed by our painful reality.

This was the reason I wrote the Denial Management Counseling (DMC) for Effective Pain Management Workbook that might be a helpful resource for some of you reading this book. I believe that learning to identify and manage denial is a necessary first step for people living with chronic pain who want to learn how to develop and implement an effective pain management plan. 

The DMC/Pain Workbook is designed for people who have experienced significant problems related to living with chronic pain, but who honestly don’t believe—or don’t want to believe—that their decisions and behaviors are undermining what could be an effective pain management plan.

To learn more about chronic pain management and denial please check out my article From Denial to Effective Pain Management that you can download for free on our Article page.

To check out my 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 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 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 believe that the more someone knows about pain the better they will be at developing an effective chronic pain management plan. In order to understand pain management we need to understand the concept of pain.  I propose the following.  Pain is basically a signal from the body to the brain telling us that something is wrong.  There are three components of pain—biological, psychological, and social/cultural. Below I have a very brief overview of the human pain system.

Pain Receptors and Circuits

The human brain and nervous system have pain receptors, which respond to the pain where it occurs in the body.  There are also pain circuits (sometimes these circuits are called neuropathways) that transmit pain signals from the local site of the pain, to the spinal cord, and then to the brain itself.  As the pain signal moves along its primary circuit or pathway, other secondary pain neurons are activated creating a wide variety of different types of pain signals. 

Some of these signals simply report the presence of pain (I hurt or I don’t hurt).  Other signals report the intensity of the pain (it hurts a little or it hurts a lot).  Still other pain signals report the location of the pain (my stomach hurts) and whether the pain is associated with an internal or external injury (my stomach hurts deep in my gut or the skin on my stomach hurts).  Other pain signals report the type of pain (it burns or it throbs). 

All of these different pain signals are transmitted into the spinal cord through nerve pathways.  There the pathways transmit the pain signal information to other specialized pain neurons, which in turn send the information to different areas in the brain.

Certain types of pain will activate an automatic protective reflex (I suddenly pull my hand away from the hot handle of a frying pan without thinking about it).  Other types of pain burst into conscious awareness prompting the person to try and figure out what is wrong.

Anticipation of Pain Affects How Pain Is Experienced

The anticipation of an expected pain level can influence the degree to which pain is experienced.  In some cases, when the anticipatory level of pain expectation is lowered, the brain responds by influencing special neurons.  This renders the brain less responsive to an incoming pain signal.  This is the rationale for using biofeedback and meditation as chronic pain management modalities.  In any event, both ascending (pain signals coming from the point of injury to the brain) and descending nerve pathways (signals from the brain to the point of injury) will influence or modify the effects on the body.

In 2007 I published an article titled Coping with Anticipatory Pain that is on our Article Archive. In July 2009, I decided to publish a new article titled Moving Beyond Anticipatory Pain for Effective 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 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 books; especially 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 learn about my upcoming trainings you can check out our Calendar page.