Multidimensional Treatment: Pain, Addiction and Psychological Comorbidity (1 CME)
(1 CME) In this conference recording from the 2018 Pain & Addiction: Common Threads Course, you will learn how to treat psychological dimensions of your patient's pain. Pain is a primal and essential warning system that has a complex interrelationship with mood and substance use disorders. People with pain, addiction, and mental health issues benefit from an integrated bio-psycho-social-spiritual approach for effective treatment. In this session, treatment challenges will be reviewed, including opioid-induced hyperalgesia, withdrawal-associated injury site pain and autonomic hyper-arousal with pain, addiction, and anxiety states. This talk will outline a range of treatments for these complex patients through case examples and literature review. Pharmacological and non-pharmacological therapies will be reviewed including the following: Pain medications (e.g. NSAIDs, TCAs, SNRIs, neuromodulators, opioids, cannabinoids); sleep medications (e.g. TCAs, antipsychotics, melatonin, prazosin); modalities (e.g. acupuncture, massage, physiotherapy, prolotherapy); behavioural therapies (e.g. CBT, pain education, Seeking Safety); and popularized offshoots of spiritual traditions such as mindfulness meditation and 12-step for pain. Building rapport with patients to engage in an office based practice , or a multidisciplinary clinic will be addressed. Finally , the importance of practitioner self-care will be emphasized.
- List common goals when treating people with pain, addiction and mood disorders
- Evaluate the contribution of pain sensitivity induced by substance use and withdrawal to the overall presentation of pain, anxiety and addictive behavior
- Describe to your patients with addiction and mood issues a range of pharmacologic and non-pharmacological treatment options for pain
Launette Marie Rieb
MD, MSc, CCFP, FCFP, DABAM, FASAM
Dr. Launette Rieb is a Clinical Associate Professor in the Department of Family Practice at the University of British Columbia (UBC), Canada. She is a Family Physician and diplomat of The American Board of Addiction Medicine. She did her graduate work in the area of pain physiology. She completed a postgraduate UBC Clinical Scholar's Program in 2015 and a NIDA sponsored Canadian Addiction Medicine Research Fellowship in 2016 resulting in publication on a newly described opioid pain phenomenon - withdrawal-associated injury-site pain (WISP). She has also published on fentanyl and heroin overdose deaths in BC, as well as on addiction in a variety of marginalized populations. Dr. Rieb is the Medical Director of a multidisciplinary team at OrionHealth (Vancouver Pain Clinic), and works as a consultant for the Rapid Access Addictions Clinic at St. Paul’s Hospital in Vancouver. In addition, she does addiction medicine consultations for The Orchard Recovery Centre, on Bowen Island. Dr. Rieb has taught addiction medicine in the undergraduate and postgraduate medical programs at UBC, and at national and international conferences for 24 years. Dr. Rieb was the co-creator and initial Physician Director of the St. Paul’s Hospital Goldcorp Addiction Medicine Fellowship (now the BC Centre on Substance Use Addiction Medicine Fellowship). She is a member of the Canadian Society of Addiction Medicine’s Education Committee and the College of Family Physician of Canada's Competency Creation Working Group for the Certificate of Added Competency in Addiction Medicine. Dr. Rieb is the past recipient of a UBC Faculty of Medicine Post Graduate Teaching Award.
Mel Pohl, MD, DFASAM is a Board Certified Family Practitioner. He is the Medical Director of Las Vegas Recovery Center (LVRC). Dr. Pohl was a major force in developing LVRCs Chronic Pain Recovery Program. He is certified by the American Board of Addiction Medicine (ABAM), and a Fellow of the American Society of Addiction Medicine (ASAM). Dr. Pohl is a Clinical Assistant Professor in the Department of Psychiatry and Behavioral Sciences at the University of Nevada School of Medicine. He is a nationally known public speaker and co-author of Pain Recovery: How to Find Balance and Reduce Suffering from Chronic Pain (Central Recovery Press, 2009); Pain Recovery for Families: How to Find Balance When Someone Elses Chronic Pain Becomes Your Problem Too (Central Recovery Press, 2010). Dr. Pohl is the author of A Day without Pain (Central Recovery Press, 2008), which won a silver medal from Independent Publisher Book Award in May 2009. His new book writtten with Kathy Ketcham is The Pain Antidote: The Proven Program to Help You Stop Suffering From Chronic Pain, Avoid Addiction to Painkillers - and Reclaim Your Life (DeCapo). Las Vegas Recovery Center- Salary- Medical Director
ACCME Accreditation Statement
The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA Credit Designation Statement
The American Society of Addiction Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.