Today I want to focus on what I call the chronic pain spiral. I know how dangerous this can be and actually started experiencing it this weekend. Please watch my video blow then read the remainder of this post.

People living with chronic pain can sometimes begin a downward spiral when the cascade effect of painful physical symptoms combined with uncomfortable emotion occurs. This is coupled with a negative anticipation effect. People begin to think like a victim; they experience thoughts like “why me” or “poor me” or even “this is must be my punishment.” They start feeling hopeless and helpless, which often leads to grief and depression.
It is important to remember that the cumulative biopsychosocial effects of chronic pain leads to a ever-downward pain spiral. When people try to cope with this condition using potentially addictive medications, the downward addiction spiral is intensified—although the person is so medicated they usually don’t notice the spiral. In addition, the brain is attempting to adapt by telling other parts of the body to produce additional chemicals as it tries to manage the situation.

While it is important to realize that pain communicates with the body that there is something wrong, it is part of a healthy defense system; the fact that pain can sometimes be maladaptive as well, is not always as obvious.

As with any sensory system, pain receptors and circuits can become impaired, resulting in chronic pain that cannot be attributed to any identifiable physical problem. The greatest challenge with regard to understanding the biological aspects of pain is why at times it continues even after a painful stimulus has been removed. Sometimes the pain signal gets turned on but never turns off.

When this chronic pain syndrome happens people often go from living with pain to suffering with pain. To learn more about pain and suffering please check out my book Freedom from Suffering: A Journey of Hope that you can learn more about or purchase at Freedom from Suffering Book

Today I want to discusses how people living with chronic pain face obstacles most people will never be confronted with and that it takes an integrated team to help them out of the problem and into the solution of effective chronic pain management. Some conditions severely limit the level of physical functioning; living with constant pain can also negatively impact a person’s thinking and emotional management ability. Please check out my video below then read the remainder of this post.

When an individual with chronic pain also develops an addiction problem, family and friends are negatively impacted as with any other alcohol or other drug addiction that occurs in a family system. I often refer significant others to Al-Anon or Nar-Anon (12-Step support groups for family and friends of alcoholics or addicts) as they need as much support, if not more, as the person with the addiction.

People living with chronic pain can get very frustrated when they aren’t receiving the pain relief they want and deserve. People living with severe chronic pain want the pain to stop—now! People in pain have come to expect instant relief through pharmaceutical advertising or TV commercials - they want it and they want it now. But when pain medications, which were developed for acute pain, are used for chronic conditions, people often get into trouble. While acute pain medication can give them the relief they are looking for, it can also set them up to anticipate a quick fix and potential future problems.
There is a difference between appropriate and effective use of pain medication and the beginning of abuse is sometimes difficult to determine. Even so, there are progressive stages that include: medication dependency, medication abuse, pseudo-addiction, and finally addiction. The confusion and uncertainty of this progression can be a challenge for the person in pain and their treatment provider.

It is crucial to utilize an integrated team approach for the daunting problem. The Addiction-Free Pain Management® (APM™) Treatment System requires addressing the whole person, which means treatment plans for the biological, psychological, social, and spiritual domains, as well as including family members and significant others.
It is crucial to work with patients—not on them. Healthcare providers need to teach patients how to be the Captain of their own healthcare team by including integrated multidisciplinary treatment team members. APM™ treatment starts with a multidisciplinary assessment including medical, mental health and addiction. These three disciplines are necessary to implement the three core components of the APM™ Treatment System.

These are the three major components of the Addiction-Free Pain Management® System:

(1) A medication management plan: Using safe but effective medication protocols

(2) A cognitive-behavioral treatment plan using eight Core Clinical Exercises from the Addiction-Free Pain Management® Workbook

(3) A proactive nonpharmacological pain management plan intended to help patients be active participants in their own treatment process
Most pain patients need a strategic combination of all of the above.

To learn more about Dr. Grinstead’s upcoming trainings for professionals and workshops for individuals with chronic pain and/or in recovery from an addictive disorder, please check out his website at the link below.

Addiction-Free Pain Management® Calendar Page

In my video below I’m inviting you to a new training titled “Taking the Mystery our of Relapse” that I will be conducting on March 8, 2013 at our Grinstead Treatment and Training Facility. Please watch the video below and then read the remainder of this post for more information and how to register.

Research states that the incidence of relapse is as high as 60% or more. Historically, many people who are committed to a life of recovery nevertheless exhibit significant self-defeating patterns of behavior that if left unchecked can eventually lead to relapse. Many treatment providers see clients who have been through treatment before—often many times before—who when they leave treatment stay clean and sober for a period of time but end up relapsing yet again. A return to denial is always the first stage of any relapse process that at first has nothing to do with alcohol or other drugs.

Clinicians will learn how to educate their clients about the progressive nature of relapse and more importantly how to identify and manage the warning signs, including high risk situations that can steal their sobriety. They will learn how to teach their clients to identify and stop the relapse cycle—recognizing that relapse is a process not an event. They will learn to identify and manage the different self-defeating defense patterns that lead from stable recovery to becoming dysfunctional in recovery and eventually using alcohol or other drugs. Most importantly, participants will leave this training being able to immediately help their clients develop a recovery plan designed to identify and manage future relapse episodes.

Training Location: 4200 N Freeway Blvd., Suite 3, Sacramento, CA 95834

Registration: $145 or $160 at the door. Space is limited so call to reserve your seat, then send a check or money order to Dr. Grinstead, at P.O. Box 340626, Sacramento, CA 95834-0626 with name, address, phone and email address. Pay with credit card on PayPal.

For more information call Ellen at 916-575-9961. or go to the URL blow to sign up.

Addiction-Free Pain Management® Calendar Page