I will be doing another round table discussion…
I will be doing another round table discussion in November in San Diego. The lecture will be ” Office-Based Treatment of -Opiod-Dependence and Buprenorphine.” For more information call 1-800-375-726
Next Lecture is….Thursday, 3/10/2011 in LA, CA.
“Managing Sleep Maintenance Insomnia: The Role of Silenor (doxepin) tablets, A Potent H1 Receptor Antagonist”
Insomnia and Chronic Pain
People that struggle with daily pain will tell you that it does not end there. Often it follows them into the nighttime. The dilemma becomes just how much medication to take and when? If the person has a legitimate pain problem the amount of medication taken throughout the day is usually enough to manage the pain to prevent suffering. Next, we face the reality that once they attempt sleep the problems are usually related to; falling asleep, staying asleep and or waking throughout the night. All of which exacerbate pain. There are a few studies to support that insomnia increases pain the next day. One European study did prove that those women that kept a journal of their pain did state that they noticed an increase in their pain the day following less sleep. These women had a diagnosis of Fibromyalgia and were in the study for a period of 30 days. One study demonstrated a fifty percent increase in pain for those people who had less sleep the night before.
Remaining open to the healthcare provider and the medication options is important for consistent treatment and recovery. It is also pertinent to know that medication is not the only treatment for insomnia. Sometimes the treatment team approach can influence your growth in a positive way as it adds to the dynamics of your recovery. Results vary for each person so be open to your healthcare provider’s suggestions. Remember the best treatment plans are formulated between you and your healthcare provider. So with that in mind be honest about everything. Tell your healthcare provider what medications you are taking for pain and sleep. How are you taking the medication? Are you undertaking them or overtaking them? The more you say the more complete the picture is for your healthcare professional. It also helps them know who they are treating and how to proceed.
Substance Abuse and Recovery
Addiction is increasingly understood as a neurobiological illness where repetitive substance abuse corrupts normal reward and adaptive behaviors causing drug-induced neurochemicals changes. Substance abusers can have a tremendously negative affect on those around them, i.e. friends, family, employers, and other extended relationships. It seems that nearly every weekend we hear in the news about fatalities due to drunken driving accidents. Those most directly affected by alcohol and drug abuse look toward researchers to continue to create the medications to help reorganize the systems that have been distressed from prolonged periods of abuse / misuse. Lately, the newer methods used to reduce alcohol and drug cravings; include vaccines, injections, and other daily or weekly type medications are extremely useful in the beginning and mid-stages of supporting abstinence but can not be the only resource. Your treatment care provider can assist you in deciding which method is best for your specific need. We repeatedly look at the many ways the medications have consistently created a positive affect at onset but later see that they are back to the old drinking and using behaviors. Remember, the goal is sustaining abstinence and the eventual maintenance of a balanced life style. Here is how to sustain and balance; if the medication that stopped your craving is working, keep it up, stay on board with your MD, psychiatrist, and other mental health care provider, if you are in an outpatient program ask your treatment team how long they think you need to keep going, if you are on your way out of inpatient follow the advice of your treatment team/ treatment plan. Be consistent after treatment and maintain a schedule of group support or 12 step meetings that may help your recovery/ treatment. If you have DUI class/ alternative sentencing or other alcohol and drug classes maintain clear and concise schedule for yourself and your class facilitator. If returning to work schedule accordingly so it will not interfere with any of the classes, meetings, medical or therapeutic sessions. Most importantly remember that the treatment plan you have is one that was you agreed to and trained professionals believe will work. If you feel that things are not working ask for help as soon as possible.
As Addiction Treatment Evolves
In light of the advancements of modern medicine it is true that there is always going to be a way to help ease the suffering of the addict. We have come to see the creation of several forms of drug treatment from the cocaine vaccine to medicinal marijuana and heroin use. Not to mention the use of nicotine lozenges and powders to prevent the need for more severe chemicals as a means to cease the dependence on the smoking of the drug. It does not mean however that there are easy cures for the remaining emotional, psychological and physical issues. The question now becomes will these drugs bolster the addicted personality up for the days, weeks and months ahead? Or will some of those that were using, if we keep in line with the idea that not everyone meets the criteria for drug or alcohol dependence but that the boost from the medication and structure of a medical team were pivotal in the changing of their life style. On the other hand the person with that needed more was able to take that monthly injection and the possible therapeutic intervention to kick the habit and then be on with a better life? What do the statistics say? Well that is interesting as they are gathering the data constantly. So perhaps it is important to maintain the tried and true along as well. Using the wonders of modern science is a plus and suffering is optional. But also begin to create a consistent and balanced plan for your life. We all know medication alone will not change those things that have been out-of-place for months, weeks or years.
Tai Chi/Exercise for Arthritis/Chronic Pain
It is true that for centuries Tai Chi has been useful in decreasing chronic pain. Now in light of several years of research and preliminary studies it is believed to hold firm in today. Let’s begin by defining Arthritis; a general term that describes pain and or stiffness. This pain and stiffness often leads to inflammation (heat and swelling) in one or more joints or muscles of the body. There are more than 100 forms of arthritis. Some of these are Rheumatoid Arthritis (related to autoimmune disorder affecting 1% of population), Osteoarthritis (related to the hips and other joints), Psoriatic Arthritis (related to psoriasis) and Still’s Disease (most common with children but has also been diagnosed in adults.) Many forms of medications and alternative therapies are being used to treat this condition. We know that the use of these medications decreases symptoms tremendously. Exercise however, is of key importance in decreasing the often debilitating pain from these forms of arthritis. Tai Chi revealed that this century old tradition is both restorative and easily supplemented into any workout routine.
The restoration can, with practice build into a form of internal meditation and quiet. Regular maintenance through restorative exercise will assist in decreased daily stress that if left unattended will tremendously impact your pain. It is important to note that keeping the body active is important when you struggle with chronic pain. Remember that staying mobile / flexible, aerobic- (taking a walk) and building muscle strength- (any form of light weights) are key in your physical, emotional and mental well-being. Bear in mind that any type of exercise program needs to be done with the approval of your healthcare professional. Also, be aware of the limits that you have set for yourself. Again, Tai Chi is said to improve arthritis suffers pain. It does this by lowering stress and providing a boost to emotional health.
About Dr. Rand
Dr. Jerry Rand, M.D., has been a physician for over thirty-seven years, building, directing, and changing hospitals, for the more successful treatment of patients. In the past two decades, Dr. Rand has successfully treated thousands of alcoholics and drug addicts, and has directed mental hospitals who treat individuals with dual diagnosis. His success has come with some adversity in the mental health community, treating patients with the apparent inability to stay sober, longer than would most physicians, but the results that he has continued to have with difficult cases, have kept him thriving at what he does best. Healing the worst of the worst, time and time again. Dr. Rand, over the past ten years, has become a leading expert in the treatment of chronic pain, chemical dependency, and other co-occurring disorders that originate from unsuccessfully managed chronic pain. Bay Recovery offers a unique blend of western and eastern medicine, social and psycho-educational modalities of treatment to help men and women address their individual problems.
