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Chronic Pain Management with Addiction: It’s a Tightrope Act (Part III)

Knowledge is Power

As you can see, the road to recovery can be a difficult one for those with both chronic pain and a coexisting addictive disorder. However, most of the chronic pain research I have reviewed over the past several decades has been very clear about treatment outcomes.

The title of this section is called Knowledge is Power, because once people understand what is really going on with their body and mind, they can – and often will – take action to effectively manage their pain. In fact, the most important shift they make is to let go of the self-defeating belief that pain is their enemy and accept it as their friend. When I suggested this to Jeanie, she had a difficult time with the idea that she could make peace with her pain and that pain could truly be her friend. For more on this topic check out my four-part article, Making Peace With Pain.

Whether or not patients believe it, I have found in the course of my work that this is, nevertheless, true. It was very important for Jeanie to let go of seeing herself as a victim of her pain condition and empower herself by developing a pain management and chemical dependency recovery program that worked for her. Fortunately, Jeanie adhered to her treatment plan and today remains clean and sober, as well as effective in managing her chronic pain.

The Relapse Intervention Plan

While “Walking the Tightrope of Pain Management and Addiction™,” it’s important to make sure patients have a safety net in place – just in case they fall. I call this the “insurance policy” or the “relapse intervention plan,” which must be developed in a collaborative manner with the patient before moving into the three-part treatment process explained earlier.

This is their insurance policy – one that requires high premiums in order to obtain the best coverage that can help prevent a future relapse. People don’t buy auto insurance because they plan to crash into other vehicles. They have it just in case.

The relapse intervention plan should be a mandatory component of a treatment plan for anyone with chronic pain and coexisting disorders, especially addiction.

I first learned about this from my mentor, Mr. Terence T. Gorski, the leading expert in relapse prevention over the past 45 years. I have adapted it for my chronic pain patients.

In its simplest form, developing a relapse intervention plan consists of writing out a specific plan by answering the following three questions:

  1. What is your healthcare provider supposed to do if you relapse, discontinue effective pain management practices, stop coming to appointments, or fail to honor your treatment or medication management contract?
  2. What are you (the patient) going to do to get back in recovery if you start inappropriately using pain medication (including alcohol) or other drugs, or other ineffective pain management so that you can stop using before you hit bottom?
  3. Who are three appropriate significant others – accountability partners – who have an investment in your recovery? What do you want each of them to do if a relapse occurs? Make sure you have their day and night phone numbers accessible and they have a copy of this plan.


Positive Treatment Outcomes

The premise here is simple – those who fail to plan, plan to fail. I believe that positive treatment outcomes are possible if people have a three-part multidisciplinary treatment plan, are committed to being active participants in their treatment process, and they develop a relapse intervention insurance policy – especially when walking the tightrope of pain management and addiction.

Let me close by adding onto the “Knowledge is Power” quote with one by John Quincy Adams: “A little knowledge that acts is worth infinitely more than much knowledge that is idle.” In other words, those of us living with chronic pain and coexisting disorders – including addiction – need to become very active participants in our own recovery and chronic pain management.

I’ll end by sharing what I ask my chronic pain patients: Now that you have a roadmap, are you ready to step up, protect your recovery and achieve true freedom from suffering?


Image Courtesy of iStock

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