If you are living with neuropathic pain like I am you know that the treatment can be frustrating and often ineffective. While acute short-term pain is usually easy to manage and many chronic pain conditions can be treated effectively, neuropathic pain can be a major treatment challenge for both patients and their healthcare providers.

In neuropathic pain the peripheral or central nervous systems are malfunctioning and become the cause of the pain. Neuropathic pain is usually perceived as a steady burning and/or “pins and needles” and/or “electric shock” sensations and/or tickling. The difference is due to the fact that “ordinary” pain stimulates only pain nerves, while a neuropathy often results in the firing of both pain and non-pain (touch, warm, cool) sensory nerves in the same area, producing signals that the spinal cord and brain do not normally expect to receive.

Neuropathic pain is produced by damage to, or pathological changes in the peripheral or central nervous systems. This type of pain is often a result of pain signals getting turned on, but not getting turned off. Unfortunately, neuropathic pain often responds poorly to standard pain treatments and occasionally the pain symptoms may get worse instead of better over time. For some people, this can lead to serious disability and a significantly decreased quality of life.

This is why early recognition and aggressive management of this type of pain is critical for successful treatment outcomes. Oftentimes, multiple treatment modalities need to be provided by a multidisciplinary pain management team.

There is a varied difference of opinions on the “right” type of medication management approaches for treating neuropathic pain conditions. Some healthcare providers think opiates are a good first line treatment approach while many others think they are not appropriate. If you are experiencing this type of pain learn as much as you can and discuss all the treatment options with your healthcare provider.

To learn about how the brain changes when lliving with constant chronic pain please check out my article Chronic Pain and the Hijacked Brain 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 once again presenting my Addiction-Free Pain Management® Certification Training in Sacramento on November 11-13, 2010 this time in our new office space. To learn more about this 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.

Many times people living with chronic pain hear negative messages from their care givers.  Messages like “it’s all in your head,” “you need to try harder,” or maybe “you’re making yourself hurt so you can get drugs.”  Another phrase I often hear from doctors and nurses, as well as substance abuse counselors, is “they’re just drug/med seeking.”  I also used to think some of my patients were “drug seeking.”  However, I have learned that what they were really looking for was relief from their pain—both physical and emotional.

These negative messages, combined with their feelings of hopelessness and helplessness, can cause these people become very confused, guarded, and defensive.  Unfortunately, mistaken beliefs about chronic pain and addiction in the healthcare system and recovery community, can discourage recovering people from connecting with appropriate support.  In fact, they often lead to life threatening suggestions.

In addition to the counterproductive messages from health care providers, this chronic pain population also receives negative messages in their self-help programs.  Some misguided, but well intentioned recovering people in AA (Alcoholics Anonymous) and/or NA (Narcotics Anonymous) tell newcomers to “never take anything—no matter what,” even though AA and NA both have conference approved literature that clearly explains that some members need to be on “appropriate” medication. 

Over the years I have seen a number of my patients with chronic pain and chemical dependency problems who have received totally inappropriate treatment from their health care providers and bad advice from their recovery program.  These situations are very frustrating because they are so unnecessary.  I am very concerned because this inappropriate treatment can easily lead to relapse, and in some cases death.

Educating these recovering people about their addictive disorder and their pain condition is critical to their recovery.  However, what is often as important is teaching healthcare providers, family members, and sponsors about effective addiction-free pain management.  It is also essential for them to become more helpful by being less judgmental, shaming, and blaming.   Hint: empathy and compassion, and understanding must come before positive strength-based challenge.

For one patient there was no understanding and compassion.  Several years ago she suffered an on the job injury and was put on pain killers.  She quickly developed a tolerance (it started taking more and more to get relief) and she started abusing her medication.  She ended up with health problems and got arrested for forging a prescription.  After getting out of jail she found that smoking heroin took her pain away better than the pain medication.

She eventually developed a high tolerance with the heroine and it was no longer relieving her pain.  She sought help and was put in a hospital detoxification program.  Unfortunately, due to the stigma of being on a street drug, she was accused of drug seeking and being histrionic.  In spite of this shaming treatment, she got through the inpatient detoxification and was planning to start an outpatient program the next day. 

That night she went home and started experiencing severe pain.  The medication she had been given did not work and she had not yet learned new ways to manage her pain.  She used.  She felt very ashamed and stopped quickly.  The next day went in and told the treatment team what happened.  They dropped her from their program. 

Over the past 27 years I have seen similar scenarios many times.  When a patient fails (relapses), the treatment professional “blames the victim.”  Treatment professionals need to realize that it is not always the addict’s fault.  Often they use again because they have not been given appropriate tools by their treatment providers.  In addition, the relapse episode itself can often be a positive turning point for many recovering people if they are aided in examining the relapse episode and learning from it. 

Fortunately this story has a happy ending.  My patient took it upon herself to reach out and get alternative help and was able to obtain and maintain sobriety.  She also learned how to effectively manage her pain without using dangerous chemicals by following an effective medication management plan.

Unfortunately, this “blame the victim” mentality is not limited to treatment providers.  I have also seen 12-Step members shame, blame, and shun others who relapse.  This is particularly true if the person had acquired long-term sobriety before the relapse.  I have heard newcomers being told to avid such people because they are “losers.”  What everyone needs to realize is that when a person in recovery from and addictive disorder returns to alcohol or other drug use they need understanding, support, and help to get back into quality recovery—THEY DO NOT NEED SHAME AND BLAME.

To read more about the type of treatment I think people deserve please check out my article The Right to Quality 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 once again presenting my Addiction-Free Pain Management® Certification Training in Sacramento on November 11-13, 2010 in our new office space. 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.

People undergoing chronic pain management pay a high price.  That price tag involves both money and human misery.  Up until very recently people in this country had no idea how expensive and wide spread the “silent” epidemic of chronic pain really was.  In 1999 I joined the International Association for the Study of Pain (IASP) to begin researching the true extent of the problem. 

In the Untied States alone it was estimated that over 83 million people were living and suffering with chronic pain.  Other interesting statistics jumped out at me.  For example the United States spent over $70 billion dollars between treatments for chronic pain and lost productivity because of it.  Other research indicated the costs to be much higher.  As we fast forward to 2005 that cost rose to over $120 billion dollars for both medical treatment and lost productivity – and that was for just four types of chronic pain:

(1) Carpal Tunnel Syndrome: Over $18 Billion

(2) Low Back Pain: Over $53 Billion

(3) Migraine: Over $14 Billion

(4) Osteoarthritis: Over $33 Billion

As future research will no doubt demonstrate, the costs continue to rise. In 2010 many people with chronic pain will not receive adequate treatment and will develop secondary coexisting problems because of mismanaged or under treated chronic pain.  The “cost” for people with chronic pain is not only measured in lost productivity in the marketplace, or in lost salaries, but it also impacts families, friends, jobs, mental health and even their lives.  People can become so depressed that they see no other alternative except suicide.  Many significant others who become primary caregivers want to be helpful, but as the pain lingers they burn out and feel frustrated, and even hopeless.

At least 10 percent of people taking mood-altering medication for chronic pain will develop substance use disorders including abuse, dependence, pseudoaddiction, and addiction.  When they go into a pain management program the focus is on the physical pain, but those programs don’t know what to do when patients act out from an addiction and often discharge them.  If a person goes into an addiction treatment program, the entire focus is on the addictive disorder and often the pain is not adequately addressed.  Collaborative multidisciplinary treatment interventions are a must for this population.

I believe that anyone with chronic pain and other disorders deserves effective and compassionate treatment.  It does not matter whether they have an addictive disorder or other psychological problems—they need and should get help.  I’ve spent more than a quarter of a century studying and working with people with chronic pain and coexisting disorders including addiction and I’m here to tell you that effective, concurrent treatment is possible.  That’s why I developed the Addiction-Free Pain Management® System, published books on the subject, and continue to train healthcare providers on effective ways to deliver a collaborative integrated pain management approach.

For a number of years the focus has been to blame the patient or the physician, as the expanding war on pain management prescription drugs attests to.  If we start demanding effective, multidisciplinary pain management for people living with chronic pain, we can begin to lower the financial and human-misery price tag.  We all know someone; a loved one, friend, colleague or an acquaintance who has had some kind of mismanaged chronic pain and suffered because of it. 

Are you willing to join me in lobbying our representatives to push for better treatment and urge them to stop the war on pain management that the DEA is currently waging?  Please write letters or make phone calls and let your voices be heard. 

To learn about the importance of developing an attitude of gratitude when facing chronic pain management challenges please check out my article Living Life to the Fullest as we Face Adversity that you can download for free on our Article page.

If you’d like to receive training for helping people with relapse prevention, I’m very excited to announce that the Gorski-CENAPS Corporation is presenting The Relapse Prevention Therapy44 Hour Certification Training in Ft. Lauderdale October 18-22, 2010. To learn more about this 5 day 44 hour training 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.