Chronic Pain Management

Chronic pain management can be an extremely complex and frustrating experience for both the patient as well as their healthcare provider. Managing a pain condition is often very challenging, and it becomes even more so when a coexisting problem is also present. In fact, one of the most difficult problems is not identifying coexisting prescription drug abuse or addiction problem. There is a significant risk of prescription abuse/addiction problems because as many as 90 percent of people undergoing chronic pain management are prescribed opiates—about 10 percent of people on chronic opiate maintenance will develop a substance use disorder abuse or dependence.

Freedom from Suffering through Effective Chronic Pain Management

Dr. Stephen F. Grinstead, LMFT, ACRPS, CADC-II

Stop Living in the Problem

Addictive Disorders

Historically chronic pain management and addictive disorder treatment have been provided by completely different healthcare professionals. Pain clinics have had great success in treating chronic pain conditions. Addiction treatment programs have had success in treating addictive disorders. However, the effectiveness the pain clinics or addiction treatment programs often fail when the person is suffering with both chronic pain and an addictive disorder developed while undergoing chronic pain management.

Within addiction treatment centers, specific issues need to be addressed in order to obtain positive treatment outcomes for that problem. The same holds true for pain clinics when striving for effective chronic pain management. But for people who are dealing with both conditions, finding appropriate treatment can be difficult for them and their healthcare providers—unless their unique treatment needs are adequately addressed.

Some People are Blinded by Denial

What often happens for a patient undergoing chronic pain management through their primary care provider, or even at a pain clinic, is medication management becomes a problem. Sometimes nobody sees this problem until it has become quite serious. One reason for this is the person goes into denial about their pain medication because after all “I have a real injury and my doctor is prescribing me the medication.” Now in many cases this is true. Unfortunately, many people develop prescription drug abuse or even addiction and no one saw it coming.

Isolation can Lead to Depression

Many people undergoing chronic pain management can start isolating because their lives have become so problematic. This process starts when their thinking and emotions begin to shift to a painful reality perspective and they start feeling hopeless and helpless. Some people start mistakenly believing that they can handle life without any help, or they may become increasingly dependent on others to take care of them. Either style can eventually lead to depression. This caretaking by others may be enabling the depressed patient to continue ineffective chronic pain management and maintaining his or her role as a victim. Some people may need to be professionally assessed and treated for depression. An effective depression management treatment plan includes cognitive behavioral therapy and possibly antidepressant medication.

Working Towards Freedom from Suffering

The important thing to remember is that people undergoing chronic pain management who also experience coexisting addictive disorders need to be able to recognize and admit they have a problem before they can work on finding a solution. Typically they need help—a support network for instance—to work through any denial or depression issues in order to develop an effective recovery and pain management program. In acute cases, and due to the nature of coexisting disorders, they also need a multidisciplinary team to effectively assess, diagnose and provide treatment. In any case, a major task for the individual or a treatment team is education regarding the diagnosis and how to effectively participate in a treatment plan.

Knowledge Is Power—The More you Know the More you Grow

The research on people undergoing chronic pain management is very clear; the people who learn to effectively manage their pain are those who become actively involved in their own treatment. Their chances of success go up as they continue learning everything they can about their pain and effective pain management strategies—they become active participants, not passive recipients of treatment.

Once people understand what is really going on with their body and mind, they can take action to effectively manage their pain and move into recovery from the addictive disorder. In fact, the most successful people are those who stop believing pain is their enemy and begin to embrace it as their friend. Many of the people I work with have a difficult time with the idea of making peace with their pain and accepting that pain is their friend. They tell themselves, and me, they can’t buy it, but nevertheless it is true.

It’s Essential for Patients to Make Peace with their Pain

Pain sensations are essential for human survival. Without pain people would have no way of knowing that something was wrong with their body. So without pain they would be unable to take action to correct the problem or situation that is causing the condition. However, with chronic pain management it is crucial that people take action by finding the safest medication plan they can, and implementing non-medication interventions directed toward the specific type of pain condition they are trying to manage. If they only use one type of intervention, they may not be adequately addressing the entire problem because pain is a biological, psychological and social condition, which could lead to addiction or other psychological disorders.

Fortunately, people can learn how to change their anticipatory response to pain. They can decrease their perception of pain by changing what they believe and what they think will happen when they start to hurt. They can change their thinking—their self-talk—and learn how to better manage their emotions. They can learn new ways of responding to old situations that cause or intensify pain. As they come to believe that they really can do things that will make their pain sensations bearable and manageable, the brain responds by influencing special neurons that reduce the intensity of the pain. The brain becomes less responsive to an incoming pain signal.

Finding Freedom with the Addiction-Free Pain Management® System

Pain is a total biopsychosocial experience. It’s extremely important for a person with chronic pain and a coexisting addictive disorder to avail themselves of a multidisciplinary team to help them effectively develop a biopsychosocial chronic pain management treatment plan. Successful pain management systematically approaches the treatment of pain at all three levels simultaneously. This means using physical treatments—including appropriate and safe medication management—to reduce the intensity of the physical pain. Then the psychological and social interventions can be implemented to further lead the patient to freedom from suffering.

The Addiction Free Pain Management® (APM) System provides such a way to deal with the problem of chronic pain and co-existing addictive disorders and succeed in providing people with effective chronic pain management so they can lead a higher quality of life. The APM™ system is a treatment approach that is based in part on the GORSKI-CENAPS® Biopsychosocial Developmental Model of Recovery. It also integrates the most advanced pain management methods, developed at the nation’s leading pain management programs with the most effective treatment methods for addiction developed at the nation’s leading addiction treatment programs.

The result is a unique integration of treatment methods that combine proper medication management and cognitive behavioral interventions along with nonpharmacological (non-medication based) modalities. The APM™ approach leads to patients obtaining pain relief, while lowering or eliminating their risk of addiction or relapse as well as reducing or eliminating problems from other mismanaged coexisting disorders. To learn more please visit my listing on for freedom from Addiction and Chronic Pain Management.