There is a growing need for effective treatment to help people undergoing chronic pain management who also develop a substance use disorder.  Some people get into trouble with their pain medications due to the potential addiction risk of opiates and the benzodiazepines. For some it is substance abuse but for others it becomes addiction.

It is important to understand what happens when someone has chronic pain and a coexisting addictive disorder. But before I get into that I want to give you some background information so you can better understand this overview. Today, there may be over 100 million people who are living with chronic pain. Current research estimates that 90% of people seeking medical treatment for chronic pain are prescribed opiates. Using a conservative 10% estimate means that there may be as many as 10 million people experiencing prescription drug abuse or addiction.

In 1996 I conducted research to begin developing the first clinical skills training in the Addiction Free Pain Management® treatment system. What I looked for was information on people undergoing chronic pain management who also experienced co-existing addiction. What I found was disturbing. There was nothing there! What I did find was a large amount of data on people with addiction and an abundance of information about people who had chronic pain. But I couldn’t find anything that addressed someone who suffered with both conditions.

During my research I surveyed addiction and pain programs to find out what happened to these people when they tried to seek help. As I continued to explore I discovered that when they went into an addiction treatment program; the entire focus was on the addictive disorder. Unfortunately, the pain condition was not adequately addressed. The addiction programs really struggled with what to do about the chronic pain. On the other hand if that same person went into a pain clinic, the focus was on the chronic pain condition, the physiological pain. Unfortunately, the pain clinics struggled with what to do when people were acting out with the addiction.I soon realized that the focus needs to be on concurrent treatment for both chronic pain management and addiction recovery.

That is why I developed the Addiction Free Pain Management® System so treatment providers can learn how to effectively deal with both conditions concurrently.  What I also uncovered during my research, was that when the person had both conditions, there was an amplification, or a synergism, of their symptoms present that I coined the Addiction Pain Syndrome™. This syndrome has three zones—the addictive disorder zone, the pain disorder zone and a third zone I’ll discuss a little later.

The addictive disorder zone contains all the symptoms, problems, or consequences people experience when living with addiction. Someone in the pain disorder zone has a different set of problems, symptoms, or consequences. When a person has both conditions a synergistic effect happens and now we have the third zone the addiction pain syndrome zone.

The problem is that if the person goes into an addiction program 1/3 of the problem is dealt with and if they go to a pain clinic a different 1/3 of the problem is covered. Many of these programs cross-refer; which is great because now we are treating 2/3 of the problem. Thus I belive that it is important to use the Addiction Free Pain Management System® to treat all three zones concurrently using a collaborative, multidisciplinary approach.

To learn more about this synergistic problem please check out my article titled Understanding the Addiction Pain Syndrome™ that you can download for free on our Article page.

If you would like to see my upcoming trainings and especially to learn about my 20 hour (three days) Addiction-Free Pain Management® Certification Training on December 7-9, 2009 in Sacramento California designed to teach treatment strategies for people living with chronic pain and coexisting disorders including disorders including addiction please Click Here and scroll down to the December 7-9, 2009 for the description and how to sign up.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people undergoing chronic pain management and want to learn how to develop a plan for managing their chronic pain and coexisting psychological disorders; including depression, addiction and other coexisting psychological disorders effectively; please consider my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. 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.

As the Clinical Director of Training and Consultation for the Gorski-CENAPS® Corporation I am very excited to announce a new Gorski-CEANPS® Relapse Prevention Center of Excellence (COE) collaboration. Earlier this year we started conversations with Pat Hammer the Founder of the brand new Brentwood Meadows; a 24 Bed Hospital licensed facility in Evansville Indiana.

This is like no other hospital facility I have seen. For example the ceilings in the patient area were 25 feet high, which gave that area a feeling of spaciousness. The furniture was not the traditional institutional grade but rather more like you would find in a high end hotel. In addition, Brentwood Meadows is located in a pleasant rural area outside of Evansville that will give their patients a sense of peace and serenity. To see photos please visit the Brentwood Meadows Website and check out their photo album of building construction and check out the rest of their website to learn more about them.

This past week I spent four days in Evansville and trained the staff in the first clinical protocol they will need in order to meet the Relapse Prevention COE criteria. This training was a combination of an overview of the Gorski-CENAPS® Developmental Model of Recovery and 20 hours of our Denial Management Counseling competency certification training.

As Brentwood’s goal is to offer true multidisciplinary treatment Mr. Hammer also arranged to have all disciplines take this intensive training including the Brentwood Meadows nursing staff. I also met for dinner meetings with the Clinical Director, Judy Unger, and the Director of Addiction, Ed Ross to help them develop the treatment schedules and how to best implement the Gorski-CENAPS Model into Brentwood Meadows.

Brentwood Meadows will also be the first Untied States program to use the new Gorski/Blampied Cognit System. Cognit is a web-based psychoeducational system that also offers online quizzes, self-awareness journaling, and outcome data tracking. Brentwood Meadows plans to start seeing patients as early as next week as they have already received JCAHO accreditation and when I left yesterday the Indiana State Licensing director was onsite to take the last steps for state licensing.

In addition to offering a training in denial management for addictive disorders, I have modified the Denial Management Counseling process for work with people living with chronic pain and coexisting disorders including addiction. 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.

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.

If you would like to see my upcoming trainings and especially to learn about my 20 hour (three days) Addiction-Free Pain Management® Certification Training on December 7-9, 2009 in Sacramento California designed to teach treatment strategies for people living with chronic pain and coexisting disorders including disorders including addiction please Click Here and scroll down to the December 7-9, 2009 for the description and how to sign up.

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.

Many people living with chronic pain and taking potentially addictive medication may be experiencing a substance use disorder (abuse, pseudoaddiction, or addiction) and may not even know it.  This is how denial works; but what is denial? If you ask a room full of people for their definition of denial you’ll get a roomful of definitions. In fact I do ask both patient groups and my clinical training groups to share their own personal definitions—not dictionary definitions—of denial. I’ll list some of the most common responses I receive below.

1.  Honest dishonesty
2. I don’t have a problem—no not me!
3. A coping tool
4. Being stuck in a problem and not knowing I’m stuck
5. Lying to myself
6. Not seeing a problem
7. Believing I don’t have a problem
8. A defense mechanism
9. Don’t even know I am lying (D.E.N.I.A.L.)
10. Clueless to danger

I could go on for a lot longer but I’m sure you get the idea. So what I want to do here is to share my working definition of denial so you’ll know what I mean when I use this term. The first part of this definition is that denial is an automatic and unconscious reaction. A person doesn’t say “I think I’ll use denial now.” It’s a reaction that has an important purpose—to protect us. Denial is a psychological defense system that we learn all through our life-span starting in early childhood. Denial protects us from what I call Painful Reality. What I mean by this is when situations seem too overwhelming and we believe we can’t handle a situation our defenses come on line to help protect us. Another general definition of denial I also find helpful is: Denial is the natural tendency to avoid the pain that is caused by recognizing the presence, severity and responsibility for dealing with serious problems.

Denial is a set of automatic and unconscious reactions

It is a psychological self-protection defense system

Its purpose is to protects us from painful reality

In fact, denial can sometimes become a very important coping tool for us. Imagine what would happen if you had to always be consciously aware of all the painful situations that you experienced throughout your life. What condition do you think you would be in? I think I’d be in a padded cell somewhere. Sometimes denial helps us cope with life.

Unfortunately, unrecognized denial can lead to severe consequences. For example the population I work with is people with chronic pain and many of them have coexisting additive disorders but are in denial about what the addiction is doing to them and those they love.

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.

If you would like to see my upcoming trainings and especially to learn about my 20 hour (three days) Addiction-Free Pain Management® Certification Training on December 7-9, 2009 in Sacramento California designed to teach treatment strategies for people living with chronic pain and coexisting disorders including disorders including addiction please Click Here and scroll down to the December 7-9, 2009 for the description and how to sign up.

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.
If you would like to see my upcoming trainings and especially to learn about my 20 hour (three days) Addiction-Free Pain Management® Certification Training on December 7-9, 2009 in Sacramento California designed to teach treatment strategies for people living with chronic pain and coexisting disorders including disorders including addiction please Click Here and scroll down to the December 7-9, 2009 for the description and how to sign up.

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.