Dear Sir or Madam,
June 26 2008
For those of you unfamiliar with The Addiction-Free Pain Management® System, it was developed by Dr. Stephen F. Grinstead in collaboration with Terence T. Gorski and the CENAPS® Corporation. Their mission is to develop an International network of APM treatment centers collaborating together to provide cutting-edge multidisciplinary treatment for chronic pain patients and their families, instilling in them a sense of optimism and hope for a better quality of life.
Whenever Dr. Grinstead talks about the Problem of chronic pain and co-existing disorders, it is always followed by a Solution. The goal of APM and their E-Newsletter is to point the way toward a Solution to the problem of mismanaged chronic pain - hence: The Chronic Pain Solutions E-Newsletter. Every month has up-to-date information about projects and the latest news stories and research regarding pain management and the coexisting disorders that accompany someone living with chronic pain. To sign up for the Chronic Pain Solutions E-Newsletter please go to http://www.addiction-free.com/contact.html and submit your name and email address. You will receive a return email that you must reply to in order to be put on the list.
Pain Management
An Interview with
Dr. Stephen F. Grinstead, LMFT, ACRPS, CADC-II
By Terence T. Gorski
Gorski: When did you first become interested in people with pain disorders and what stirred your interest?
Grinstead: When I began working with people who had chronic pain and addiction in the early 1980's it was extremely challenging. I could also identify because I had been managing my own chronic pain condition for several years so when I was able to help someone in treatment it was very fulfilling. Over the next several years I began to discover that this group had very specific needs and issues that were not being appropriately addressed through the current "addiction&#xu201D; paradigm.
Gorski: When you discovered that chronic pain was not being addressed by most addiction programs, what did you do?
Grinstead: The firs thing I did was to begin studying the work that had been done on helping people deal with chronic pain. Then I began to apply what I learned to people suffering from both chronic pain and addiction. As I began applying what I was learning to clients in my practice, I began to realizing that I was actually developing the foundation for what was to become the first Addiction Free Pain Management® (APM) protocol for clients which would quickly grow into both recovery workbooks, professional guides, clinical skills training workshops, and eventual the certification of programs as Centers of Excellence In Addiction Free pain Management®. To learn more about the APMTM Centers of Excellence people can go to www.addiction-free.com/center-of-excellence.html.
Gorski: When did your work in pain management begin and how long did it take to grow into the internationally recognized model that it is today?
Grinstead: This work begin to take the form of a specialty process in 1996. This emerged from clinical work I had done with clients with chronic pain starting in 1983. In 1986, after joining the faculty of the Relapse Prevention Certification School, I began seriously writing and developing simple yet effective exercises that could help chronic pain patients stay sober by learning effective broad-based strategies for managing their pan.
Gorski: How would you summarize what you learned about the connection between pain and addiction in both addiction programs and pain clinics?
Grinstead: I saw that addiction treatment programs cover about a third of the problem (the Addictive Disorder Zone) when dealing with a chronic pain patient. The pain clinics cover a different third of the problem (the Pain Disorder Zone). When either of the above modalities is implemented alone it misses about two thirds of the problem. Both missed a critical third zone of treatment.
Gorski: What is that critical "third zone.&#xu201D;
Grinstead: I coined this third zone the Addiction Pain Syndrome Zone. This zone is a combination of the Pain Disorder Zone the Addiction Pain Syndrome Zone. The addictive disorder leads to one set of biopsychosocial problems originating primary by an addictive brain response to a mind altering drug. The pain disorder leads to a different set of problems originating in a different set of brain responses caused by the effect of chronic pain on brain chemistry reactions.
Gorski: So why is this Addiction Pain Syndrome Zone so important to understand and deal with?
Grinstead: The Addiction Pain Syndrome Zone is so important because the combination of the addictive and chronic pain responses in the brain more than double the intensity of the pain experienced. 1 + 1 no longer equals 2, rather 1+ 1 now equals 3 or more. This is called synergism. Synergism is a condition where the combined action is greater in total effect than the sum of the individual effects. A new universe of symptoms now occurs due to the synergistic effect. To have successful treatment outcomes this phenomenon must be addressed through a specialized treatment approach-a Synergistic Treatment System.
Gorski: Does such a synergistic system that integrates the treatment of chronic pain and addiction exist today?
Grinstead: Yes it does, and over he past several years the use of this system is spreading to more and more addiction treatment programs, pain management programs, and private practice professionals. The system is called Addiction-Free Pain ManagementTM (APM). APMTM concurrently addresses TheAddictive Disorder Zone, the Pain Disorder Zone, and the Addiction Pain Syndrome Zone and teaches treatment providers how to more effectively deal with patients who have both conditions. To learn more people can go to www.addiction-free.com/articles/articles/view/understanding-the-addiction-pain-syndrome.
Gorski: Where would people find information about additional training and materials they could use with their clients on this comprehensive system of Addiction-Free Pain Management®?
Grinstead: There are three easy places to look on the Web: www.cenaps.com which contains information about upcoming training events, www.addiction-free.com which contains articles and up-to-date information on the growing system, and www.relapse.org which carries all published books and materials on APM, Pain management, and addiction treatment.
Gorski: Thank you, Dr. Grinstead, for taking this time to share you expertise on addiction and pain management.
