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 Zen concept of “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 undergoing chronic pain management who developed coexisting disorders, including addiction, but they were unaware of this happening. 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.

This denial or self-sabotage mechanism is only one of several roadblocks to effective chronic pain management.  To learn more about overcoming these problems check out my article Overcoming Obstacles for Effective Chronic Pain Management that you can download for free on our Article page.

If you’d like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I’m very excited to announce we are presenting my Addiction-Free Pain Management® Certification Training in Sacramento on August 5-7, 2010. To learn more about this 3 day 20 hour training and my 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 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.

Modern pain management systematically approaches the treatment of pain at all three levels (bio-psycho-social) simultaneously.  This means using physical treatments to reduce the intensity of physical pain.  It also means using psychological treatments to identify and change the thoughts, feelings, and behaviors that are making the pain more intense and replacing them with positive thinking, as well as feeling and behavior management skills that can reduce the intensity of the pain. 

Finally, effective pain management must involve not only the pain patient, but also the significant people in their life who can help them to develop a social and cultural context in which to experience their pain in a way that will reduce suffering.

Biological pain is a signal that something is going wrong with the body.  The biological, or physical, pain sensations are critical to human survival. Without pain we would have no way of knowing that something was wrong with our body. So without pain we would be unable to take action to correct the problem or deal with the situation that is causing our pain.

Psychological Pain results from the meaning that the brain assigns to the pain signal.  The psychological symptoms include both cognitive (thinking changes) and emotional (uncomfortable feelings) that lead to suffering. Most people are not able to differentiate between the physical and psychological. All they know is “I hurt.” For effective pain management you need to learn all you can about your pain.

Social and Cultural Pain, results from the social and cultural meaning assigned by other people to the pain experience, and whether or not the pain is recognized as being severe enough to warrant a socially approved sick role.  These three components determine whether the signal from the body to the brain is interpreted as pain or suffering. 

Imagine the following vignette:  Bob is his college’s star football player.  In last week’s homecoming game Bob scored the winning touchdown but broke his arm in the process.  This week Bob is sitting on the bench with a cast on his arm that everyone has signed.  This cast and how he earned it are seen as an honorable reason for him to be sitting on the bench.  In that same game Karl, a big hulking lineman, “tweaked” his back and was also sitting on the bench this week.  Unlike Bob, Karl doesn’t have an observable injury and people were asking him why he wasn’t out on the field helping his team.  Karl is much more apt than Bob to experience shame/guilt, which will probably amplify his pain symptoms.

To learn more about effective treatment for chronic pain management—especially when other coexisting disorders are present—please check out my article The Need for Multidisciplinary Chronic Pain Management that you can download for free on our Article page.

If you’d like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I’m very excited to announce we are presenting my Addiction-Free Pain Management® Certification Training in Sacramento on August 5-7, 2010. To learn more about this and my other upcoming trainings you can check out our Calendar page.

You can learn 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.

Many people undergoing chronic pain management need to be on pain medications in order to be able to function and have a better quality of life.  Most people are able to take their medication as prescribed and never experience any problems.  Unfortunately, between ten to fifteen percent of people on medication for chronic pain management will experience problems.

For some people it starts taking more medication to get the relief they want—this is called tolerance.  This is expected for many of the opiates and may not be a big problem for some people while becoming a major concern for others.  As the dose of medication increases so do the side effects and risks, including substance abuse or even addiction.

Other people start taking other medications without their doctor’s knowing.  Sometimes it may be over-the-counter medications; which they mistakenly believe should be safe.  One example I’ve seen in one patient I saw a few years ago concerned Tylenol (acetometaphine).  She was on Vicodin (which is a combination of hydrocodone and acetometaphine).  I was doing a medication review with her and she stated she was taking ten to fifteen Tylenol per day. 

I was very concerned and had her call her doctor immediately for a liver function test and she found out she had liver damage from all the acetometaphine.  Luckily for her we caught it before the damage was irreversible.  Others have not been so lucky.

Another major problem is when people drink alcohol while on pain medication.  This can also lead to serious liver and other health problems including addiction.  What I help my patients and their support team do is frequently go through a “Red Flags Checklist” to make sure they are on track with their medication management.  Below I’m posting ten of the numerous warning signs that people might be heading towards a problem with their pain medication.

Ten Red Flags of Possible Medication Problems

1. You use other pain medication including alcohol or other drugs without your doctor’s knowledge.

2. You start having urges or cravings for your medication in between scheduled times.

3. You are unable to take your medication exactly as prescribed.

4. You are experiencing problems with your thinking, feelings and/or behavior.

5. Your quality of life and/or relationships are being impacted by your use of medication.

6. You use medications in physically dangerous situations, i.e., driving a car, operating power tools, providing childcare to young children, etc.

7. You find yourself not informing one healthcare provider what medication another provider is prescribing for you.

8. You start using your medication to cope with psychological/emotional type pain or to cope with stressful or uncomfortable situations.

9. Family members or friends report concerns about your use of medication.

10. You find yourself needing early refills and may rationalize this by coming up with unusual excuses: I lost it, someone else took it, it fell in the water, etc.

To learn more about potential medication management problems check out my article Addressing the Problem of Perscription Drug Abuse/Addiction that you can download for free on our Article page.

If you’d like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I’m very excited to announce we are presenting my Addiction-Free Pain Management® Certification Training in Sacramento on August 5-7, 2010. To learn more about this 3 day 20 hour training and my other upcoming trainings you can check out our Calendar page.

For an addition resource regarding medication management please go to our Publications page and check out my Addiction-Free Pain Management® Module Four: A Guide for Managing Pain Medication in Recovery that was co-authored by Shelia Thares, RN, MS, APNP. 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.

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.