From Despair to Hope: A Recovery Story

Posted on Friday, December the 28th at 7:46pm

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

Living with chronic pain is very difficult. If a person also has a coexisting addiction, it makes it even harder. Many people who have chronic pain and addiction become very depressed and begin to feel hopeless. They have often lost their self-esteem and the support of significant others, who may be feeling burned out by trying to be overly helpful. Healthcare providers often become confused and frustrated when none of their treatment interventions seem to work. Sometimes it’s helpful to put a face on this painful situation, so let me introduce you to Jerry.

Jerry is thirty-four years old, married man with a wife and three teen-age children. He was injured in a construction accident three years ago and has been unable to work since two months after his injury. At first Jerry was very hopeful that he would be able to return to work in a short period of time and believed that everything would be fine. Unfortunately, that’s not what happened.

Although his injury was very painful and he had great difficulty even walking, his treating physician determined—without appropriate diagnostic testing—that Jerry was "only" suffering from severe muscle strain and prescribed analgesic narcotics and antispasmodic (muscle relaxing) medication. Jerry attempted to return to his job on limited duty and tried his best to cope with his increasing pain symptoms, but found it harder and harder to keep going. After two months Jerry sought legal counsel and discovered that he had the right to seek another doctor. Thus began a three-year journey of confusion and frustration.

The new doctor he chose ordered diagnostic testing, including MRI and CT Scan procedures, which determined that he had three damaged disks in his lower back. The doctor immediately referred Jerry to an orthopedic surgeon to discuss treatment alternatives. Jerry was very frightened, but at the time refused to let anyone know how terrified he really was.

After a brief physical examination and review of Jerry’s diagnostic test results, the surgeon recommended an extensive surgical procedure. The doctor told Jerry that without the surgery he could end up being paralyzed, or at best, continue to live in excruciating pain. The consultation session was very brief and Jerry got the impression that the doctor wasn’t really listening to his concerns and was rushed, but because he had so much distress around his pain he reluctantly agreed to the surgery.

In less than three years Jerry had four surgeries. By the time I started working with him Jerry’s pain had became worse instead of better. The surgeries didn’t work, and in fact made his situation much worse. His surgeon finally discharged him, saying the surgeries were "successful" and there was nothing more that he could do to help, so he referred Jerry to a pain clinic.

After an extensive assessment procedure at the pain clinic, it was determined that Jerry could be helped, but it would take some hard work and the implementation of a multidisciplinary treatment plan. The pain clinic referred Jerry to me in order to assess his physiological and psychological/ emotional pain symptoms, his medication management, and to recommend a treatment protocol. I discovered that Jerry was experiencing both physiological and psychological/emotional pain symptoms with the psychological/emotional being significantly more predominant—a good prognosis for Jerry’s eventual recovery. I also determined at our first session that Jerry had become addicted to his pain medication and was experiencing significant negative consequences as a result.

Jerry had a difficult time accepting that he had become addicted. After all, he did have a serious chronic pain condition and doctors had prescribed the medication. I listened to Jerry and validated his concerns. Eventually he began to trust me enough to begin looking at the emotional pain he was experiencing around the trauma of the past three years, and how he was using his pain medication to escape those emotions. We worked together with his doctor at the pain clinic to come up with a more effective medication management plan that included epidural and trigger point injections coupled with non-pharmacological treatments like hydrotherapy and massage therapy. At the same time Jerry and I started working on his psychological and emotional pain management as well as developing a recovery plan for his addiction using the Addiction-Free Pain Management (APM) Recovery Guide and the APM Workbook.

It hasn’t been easy for Jerry. There were many days when he wanted to give up and he even considered suicide. Jerry had developed severe clinical depression due to his injury, the multiple surgeries and his significantly decreased quality of life. Jerry’s depression needed to be addressed immediately. I asked his doctor to consider antidepressant medication while I worked with Jerry using cognitive behavioral therapy interventions. After four or five weeks Jerry’s depression symptoms had significantly improved. This was a real turning point in his recovery and pain management process.

After three years Jerry finally began moving from despair to hope. He was learning that although he may need to live with chronic pain, he no longer needed to suffer with it. He even learned to communicate his feelings more effectively and started reconnecting with his family in a much healthier way. If he continues with his recovery and pain management plan, Jerry will once again experience a more positive quality of life.