Answer:
Addiction-Free Pain Management® is a system that uses three different types of components to treat the synergistic symptoms of people who have chronic pain and a coexisting addictive disorder such as prescription drug abuse or prescription drug addiction or even pseudoaddiction. The first treatment component includes eight Core Clinical Exercises using cognitive behavioral and rational emotive approaches, which are the foundation of the Addiction-Free Pain Management® Workbook. Second are the Medication Management Components, and third are the Nonpharmacological Treatment Processes. These three components are covered in-depth in Dr. Grinstead's book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System.

Answer:
To help clarify this question a consensus document was developed by the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine in 2004. They have agreed upon the following definitions for addiction, physical dependence, tolerance, and pseudoaddiction. For a more in-depth explanation you can go to Chapter One in Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System.

• Addiction
  Addiction is a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.
  
• Physical Dependence
  Physical dependence is a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.
  
• Tolerance
  Tolerance is a state of adaptation where exposure to a drug induces changes resulting in a diminution (lessening) of one or more of the drug's effects over time.
  
• Pseudoaddiction
  The term pseudoaddiction has developed over the past several years in an attempt to explain and understand how some chronic pain patients exhibit many red flags that look like addiction. Pseudoaddiction is a term which has been used to describe patient behaviors that may occur when pain is under treated. Patients with unrelieved pain may become focused on obtaining medications, may clock watch, and may otherwise seem inappropriately drug seeking. Even such behaviors as illicit drug use and deception can occur in the patient's efforts to obtain relief. Pseudoaddiction can be distinguished from true addiction in that the behaviors resolve when the pain is effectively treated.

Answer:
There has been a lot of confusion about what the best relapse prevention treatment plan is for someone in recovery with a chronic pain condition, who also requires psychoactive prescription medication. I propose that effective chronic pain treatment requires a three part approach that includes a combination of the following components utilizing a multidisciplinary integrated pain management strategy: (1) A medication management plan; (2) A cognitive-behavioral treatment plan; and (3) A nonpharmacological pain management plan.

Quality recovery, effective pain management and relapse prevention is possible if treatment providers are willing to work together to develop a collaborative multi-disciplinary treatment team, and the patient is willing to do the footwork and follow their APM™ treatment plan. With an appropriate plan in place and positive support, these patients can obtain successful chronic pain management without relapsing into prescription drug addiction or self-defeating behaviors and treatment providers can increase successful treatment outcomes for their agency. Patients will become proactive participants in their healing process instead of passive recipients (i.e., a victim to their pain). This shift empowers them to work toward and experience a much higher quality of life in recovery.

Dr. Grinstead's latest publication the Addiction-Free Pain Management® Module Four: A Guide for Managing Pain Medication in Recovery is now available to help people in recovery avoid a potential relapse episode when they need to be on appropriate pain medication.

Answer:
The psychological meaning that the individual assigns to the physical pain signal will determine whether they simply feel pain (Ouch, this hurts!) or experience suffering (Because I hurt, something awful or terrible is happening!). Although pain and suffering are often used interchangeably, there is an important distinction that needs to be made when dealing with chronic pain. Pain is an unpleasant signal telling people that something is wrong with their body. Suffering results from the meaning or interpretation the brain assigns to the pain signal. I like to tell my patients that pain is inevitable but suffering is optional--and it is!

Answer:
Sometimes all they have to do is to start thinking about doing that thing. Click here to read the full article on Coping with Anticipatory Pain. Or read Chapter One in Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To learn more about this book or to obtain it click here.

Answer:
We have developed a list of “Red Flags” or indicators that can help you determine if someone is using their pain medication in a manner that could eventually lead to problems or even addiction. It can be found in the Appendix of Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. Or you can go to the Contact Us page and request a copy by email. It would also be helpful to read the article Avoiding the Prescription Drug Trap.

Dr. Grinstead's Addiction-Free Pain Management® Module Two: Examining Your Potential Medication Management Problems is now available to help people taking pain medication determin if they might be experiencing problems and need help.