Managing chronic physical pain during addiction recovery is a challenge many doctors are rue to accept in the age of the opioid crisis. 

That’s why it’s so important for someone with chronic pain to know how to handle their pain outside of a hospital or rehab environment. Opioids aren’t always the antidote for pain!

Many of the people who abuse drugs were initially prescribed opioids by a doctor. A patient walks in searching for a resolution to his pain and walks out with addictive pharmaceuticals like Vicodin and Hydrocodone. According to the U.S. Department of Health and Human Services, over 80% of current heroin addicts report that they first started using opiates with prescription painkillers. Yes, the meds can take away the pain, but unless the patient is properly prepared for the physical and psychological effects of opioids – these fast-acting meds can cause long-term destruction.
 
Prescribing Addiction

Some patients take their medications as prescribed. Others burn for more. Both quickly notice that a few hours without a dose brings a return to both the original pain (amplified by a factor of ten) AND the painful ignition of opioid withdrawal. Time is no friend to these patients. The longer they take opioids, the less relief they will derive. The longer they take opioids, the more dependence develops until they became physically and mentally addicted.

The solution to reducing the physical pain? Take more pills. Digging the proverbial hole of physical dependence deeper and deeper. In order to get off the pain medication, many patients will turn to opiate detox centers for help. These programs can help patients overcome the physical and mental withdrawals associated with prescription opioid dependence. Once the patient is no longer physically hooked, one huge unresolved issue remains: how to function with chronic pain while dealing with physical and emotional toll of sobriety?

Pain management in recovery is vital to sobriety. When chronic pain again rears its tireless head, users are at high risk of relapsing. Learning how to safely and naturally manage pain and sobriety minus narcotic painkillers is essential to a healthier, happier life.

Non-Opiate Medications

There are numerous non-narcotic medications out there to treat physical pain that don’t risk physical addiction. These non-opioid medications may assist with the management of acute and chronic pain: Gabapentin, Duloxetine, Tricyclic, Naproxen, Acetaminophen, Amitriptyline, Norpramin, DexPak and Prelone are some of the most commonly prescribed. Each medication has different and highly-specific label and off-label uses. Patients should only take these medications as prescribed by a physician who is informed of the substance abuse difficulties. (Note: If YOU are that patient, then it is YOUR responsibility to inform the physician BEFORE any prescriptions are written.)

Manage Physical Pain in Sobriety

A common myth in our society is that only drugs can cure pain. Some organizations including The American College of Physicians, the U.S. Department of Veterans Affairs and the Centers for Disease Control and Prevention recommend drug-free treatments as the first course of action for chronic pain.

Taking charge of yourself and doing activities like exercise, physical therapy, yoga, acupuncture, distraction therapy, biofeedback, deep breathing, meditation and mindfulness training can do wonders. Work with your doctor to develop a flare-up protocol to follow whenever you feel a flare up spark.

Alternatives to Prescription Opiates

Millions upon millions of Americans suffer from chronic pain and addiction troubles. Some suffer from chronic headaches, others back pain. Some are recovering from surgery or have been sidelined by fibromyalgia. Every year hundreds of millions of opioid medications are dispensed to patients to help them cope with physical pain. Too many of these people will find themselves physically addicted to these pills or harmful street drugs. If you or a loved one are struggling with physical pain, investigate natural options before turning to narcotic pain pills as a solution.

For more information and resources regarding substance abuse help, visit Opiates.net the Life Skills Village Resource Links Page.

If you suffer with chronic pain and live in southeast Michigan, Life Skills Village offers a Pain Self-Management Program that teaches people how to manage their own pain.

​Our physical, spiritual and mental lives are all connected to the brain. Since the brain is the “CPU” of our bodies, it is through the brain we experience every aspect of life. At Life Skills Village, we promote a holistic approach to traumatic brain injury rehabilitation. We believe keeping your brain healthy is vital – especially during neuro rehab. That’s why the upcoming series of blog posts focus on diet, exercise and sleep.

Folate (also known as vitamin B9 and folic acid depending on where it's found - folate is in food, folic acid is in supplements) is critical to healthy brain and body function. After being digested and absorbed it becomes methylfolate, which is essential for the brain's production of DNA and neurotransmitters. 

Folate is also crucial for women attempting to get pregnant or who are already pregnant. During pregnancy: 400 micrograms per day are recommended. During lactation, 500 micrograms per day. This is especially important one month before trying to get pregnant and within 21 days of conception. Refer to our sources for more complete information. The National institute of Health has a list of recommended folate intake.

Good food sources of Folate:

Vitamin D is synthesized in our skin when it comes into contact with sunlight. However, because of our lack of contact with sunlight during winter, Americans are often Vitamin D deficient. Symptoms of this deficiency include bone pain, muscle weakness, seasonal depression and a study in the UK found evidence of impaired cognition. If a physician diagnoses a deficiency, it is important you take the active forms of Vitamin D: Calcitriol or Vitamin D3. While it is found in many foods, 10-20 minutes of direct sunlight will produce more Vitamin D in our bodies than a day’s worth of food. As we age your body is less efficient at producing the vitamin, so it is important to include in your diet and daily supplements.

Tips for supplementation: magnesium helps increase effectiveness of absorption. A safe amount of Vitamin D to include in your diet is 400 IUs for infants, 600 IUs for adults and 800 IUs for seniors.

Good sources of Vitamin D:

Various antioxidants can be found in these foods:

​Good sources of healthy fats: 

Sugar, syrups and simple carbs cause obesity, metabolic syndrome and an assortment of other disorders and diseases that arise from those conditions. Studies have shown that high fructose corn syrup, a cheap sugar alternative, hampers cognitive ability, slowing down memory and learning. It is believed that this is because the test subjects (rats) developed insulin resistance which inhibited insulin's ability to regulate stored sugar for brain function. 

Foods to avoid with High Sugars:

Brain Games are a recent upload to the modern digital milieu. Most are made for mobile.  Some are surprisingly enjoyable. All of these apps endeavor to improve cognition, lower your mental age or improve focus by playing a variety of short games. Users are scored according to performance in each game and receive alerts intended to encourage consistency.

It's only natural that brain games have become a useful treatment tool, nowhere more-so than in field of Neurorehabilitation. When a person experiences a brain injury, they inevitably suffer cognitive deficits. But they can still recapture some of their former attention, memory and focus through hard work on multiple fronts. 

The process of neuroplasticity; which is the ability of the brain to change throughout the duration of a lifetime; allows for damaged areas of the brain to pass along their responsibilities to other parts of the brain. This is why some patients recover parts or all of their pre-concussed abilities. By playing certain brain games on a very regular basis, the neurons will go on the hunt - seeking a way around the obstructing injury. Repetition over time can mean some semblance of recovery.

There are many applications that are useful to a person with a TBI and can be used as an extension of your mind, for example reminder systems and note taking apps. Brainline.org compiled a large list of apps that can prove to be life changing for TBI Survivors including some of the apps on this list. You can read their list here. Our list focuses on just brain games that could prove useful in rehabilitation.

Lumosity
A very usable app with lots of variety, reminders, statistic tracking and pleasing, minimalist interface. When you first boot up the app you immediately notice that the interface is all about much options and self-motivation. The makers of Lumosity are very transparent about wanting you to upgrade to their paid "premium" version. This is one brain game that keeps some of your stats under wrap. Or, at least behind a pay wall. The interface displays your current cognition scores for speed, memory, attention, flexibility, problem solving and math ability.

On the other hand, the games themselves are quite easy to understand and usually fun. An article from Businessinsider.com takes an in-depth look at exactly how beneficial these games really are, noting that "specific populations [of people]... have shown some improvements in memory and executive function after Lumosity-like brain training." They are referring to differently abled individuals. This is in contrast to non-concussed people, who would improve in their ability to perform a specific task, yet not show improvement in their general cognition.

This one is subscription based. More available games than any other app on this list. Also, it is the most expensive.
​Compatible with Android, and iOS.

Elevate
Very similar to Lumosity in that it uses brain games, reminders and score features, but  presented differently. Of the apps on this list, I find the games most stimulating visually and conceptually, and give the added bonus of being informational. These games practice skills that are relevant to daily activities like quickly calculating percentages, estimating price, and reinforcing correct spelling and grammar. Similarly the stats it collects are presented less as attributes of cognition and more of practical ability. This means it gives you writing, listening, speaking, reading and math scores and graphs them for you to see your progress.

This app guides you through the process of selecting and participating in activities. You will receive reminders that regularly track your progress. However, some of these games may prove frustrating or too difficult for some clients.

​Paying their subscription fee allows you to play more games, and unlocks more performance statistics. Elevate is cheaper than Lumosity, and offers a more polished experience. The drawback is that Elevate doesn't have as many activities. Of this group I'd be most likely to pay for this one and you still get a lot for free.

Compatible with Android, and iOS.

Happify
Unique concept that takes its tenets and encourages users to internalize them and "practice" away from your phone. Happify's purpose (and mantra) revolve around positivity, happiness, and mindfulness. At Life Skills Village we use these same concepts in our TBI day program. Using Happify feels like meditation and helps to reframe your thinking; Happify is worth checking out. It's a refreshing mix of in-app mini-games, self-reflection techniques and real-life applications that makes for an interesting experience. ​This app helps you track your goals and progress - it even and asks you questions about your actions! Happify offers periodic checks-ins and a happiness assessment (so you know how happy you really are).

For all the positive vibes you get on this app, it can feel gimmicky at times. That said I am quite optimistic about positive outcomes and can't recommend this app enough. However, take note: the free version is restrictive and slow. 

The subscription fee is the same as Lumosity's. and the app itself does not use any ads.
Download: iOS, Android

Fit Brains Trainer
Polished product with a decent variety of games available in the free version. Games can be somewhat derivative from other products (in some cases the only difference is color), but at least these are available in groups of five per day rather than the three that is standard from the big names. The product is no cheaper than others and the statistics offered aren't very in depth and are almost exactly the same as Lumosity's. I would have said that this one offers the most activities for free, but after five sessions the game locks up and you cannot continue training for free.  Lumosity is probably a better option.

Download Here: iOS, Android

Skillz:
This is the first of the group that does not request you pay a subscription, instead it has one time charges for optional features, like removing ads, or their brain currency that makes the app easier. It is most likely entirely funded by ads, which are ubiquitous in the app. The lower your game score, the more ads you see. Skillz has a minimum viewing time as well. The upside is that you are not limited by how many games you want to play per day and can retry each game as much as you like. The games are somewhat low visual quality and unforgiving; however it's completely free and still offers the cognitive training desired. The app even tries to have a sense of humor and, for what it's worth, it helps you get through the games.

Downloads: iOS, Android

Smart:
This app has both ads (a one time charge for removing ads) and add in-game currency (though at three dollars it's one of the cheapest on the list). The free version is not as restrictive as Elevate, Lumosity or Brain Fit. It's a happy medium that has many of the same games as other apps but doesn't lock them behind a pay wall, but rather a progression wall.  So to play other games you have to play games! Smart offers no progress metrics and makes no specific claims about brain training. It just offers the same type of games as other well known brain training apps, and lets you play as much as you'd like. Its layout and transaction scheme is similar to the Skillz app, though a bit more polished. 

Download Here: Android, iOS

Brain it on!:
The most unique entry in this list, Brain it on! is a series of puzzles that you solve by drawing shapes. It's a relatively simple concept and all of it sticks to the basic principles, but they extrapolate these ideas and keep adding and adding until the game becomes very difficult.  Thankfully they offer hints (behind ad videos). The free version also has you unlock levels by playing other levels kind of like an early Mario game. The app does not offer progress metrics, but does award pleasing little stars and shows you how many you've earned. People with limited hand dexterity may find this outside their abilities, but it offers enough engaging content that I'd recommend it to people who wish to improve their hand-eye coordination.

The premium version is a one-time fee of $3, and removes all ads, unlocks all hints, and unlocks all levels.  
Download Here: Android, iOSThe Ideal Brain Game for Brain InjuryThis list was written to give a brief rundown of the most popular brain games currently on the market.  Each app has its merits - be they functional or economical. My personal favorite has been Elevate, but I am biased because I had used it before, and opted in to the "pro" free trial. 

The ideal brain game app would have vast scaling potential and variability. It would track a TBI survivor's cognition and offer a tracking system to show how the user has improved over time. Statistics like these are useful to the subject because they provide a sense of pride and accomplishment, but can be useful to a provider who might integrate this information into their treatment.

What do you think about brain games? What's your favorite?
0 Comments Even Celebrities Get Brain Injuries - Here's What a Few Shared About Their Experiences1/9/2018
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With the NFL "Concussion" scandal beginning to fade from public consciousness, it's easy to forget that traumatic brain injuries are still a serious problem. A traumatic or acquired brain injury can change your life in an instant - whether you're playing pro football, fall off a ladder or get injured on the job.  People with brain injuries know first-hand - life is different post-injury. 

In the interest of raising awareness, we're using this blog to highlight celebrities who have survived traumatic brain injuries and what they've taken from the experience.  If you have survived a TBI, we encourage you to share your story - and what you've taken from the experience - at the end of this post.

Gary Busey suffered a TBI in 1998.  Best known for his roles in Lethal Weapon, Point Break and Predator 2, he crashed his motorcycle while not wearing a helmet. Busey fractured his skull and spent two months in the hospital. In an interview one year after the accident on The Tonight Show with David Lettermen he discusses how the accident changed his personal life, shifted his perspective on the world and informed his philanthropic endeavors. He has worked to raise $400,000 for muscular dystrophy and advocated for a skill tests that could result in required helmet use on motorcycles. Busey readily admits that his TBI caused him to act impulsively and has significantly lowered his "mental filters." Letterman even jokes "you're funnier now."

Busey has remained active professionally, maintained a populated filmography and capitalized on his well-known, unique demeanor. Despite his TBI, he was able to continue his acting career, raise a son and even become a major proponent for Brain Injury Awareness. He won $40,000 on the Celebrity Apprentice in 2011 and donated all of it to the Center of Head Injury Services in Missouri.

Steve Young was the San Francisco 49er's quarterback from 1987 to 1999. He suffered a minimum of 6 concussions over the course of his career. He retired early after a tackle by Aeneas Williams left him unconscious on the field for several minutes. Since then he's been an advocate for concussion awareness, prevention and protection. Young even created a collaborative infotainment page on YouTube discussing the prevalence of concussive risk for every player in every sport, the symptoms of a concussion, the risks of returning to the field while concussed, the effect age has on concussion recovery and severity, and what to do if you've been concussed. The mantra of the video is "When in doubt, sit it out."


On June 7th, 2014, A Wal-Mart semi-truck crashed into six cars, putting Tracy Morgan in a coma for eight days and killing his long-time friend James McNair. His recovery was long and arduous.  Months later he still required a wheelchair for taking more than "some steps." In September 2015 he made a surprise appearance at the Emmy's, where he shared his first-hand TBI experiences. Using comedy and emotion, he told us that he was starting to feel like himself again.  Backstage he shared that he "couldn't walk" and had to relearn "how to stand up and sit down again." Unfortunately, despite improving by leaps and bounds, "Tracy will never fully be himself again" and his therapy has no end date. 

Tracy has since returned to showbiz.  He's been welcomed back by Saturday Night Live,  appeared in three films and has released a new standup special, "Tracy Morgan: Staying Alive." He is an active philanthropist supporting causes like Drug Abuse, HIV/AIDS and disaster relief. 


Gabrielle Giffords, Arizona House Representative from 2007 to 2012, suffered a Traumatic Brain Injury from an attempt on her life at a public speaking event at a Safeway near Tucson.  The gunman shot her in the head at point blank range and then opened fire on the crowd. Thirteen people were injured and six people were killed including Federal Judge John Roll, and nine-year-old girl Christina-Taylor Green. Here is the NBC report from the day of the incident.

A year into recovery, Giffords resigned from her seat in the house of representatives to dedicate herself to rehabilitation. Here is her resignation letter. In the years following, she championed gun control, founded "American's for Responsible Solutions," which is now known as Giffords. They campaign in congress and have worked to pass legislation that takes guns out of the hands of high-risk individuals.

Mark Kelly, Gabrielle's husband, put it best when he addressed the would-be assassin: "Mr. Loughner, you may have put a bullet through her head but you have not put a dent in her spirit and her ability to do good."

In 2017 she became the third living woman to see have a Navy Warship named in her honor. She fights the good fight and in spite of her injury she is an American hero.


A helmet saved Kevin Pearce's life, but the incident still left him with a Traumatic Brain Injury. He was a professional snowboarder and had his accident while practicing a maneuver called the "cab double cork" on a half pipe.  He was preparing to compete against Shaun White for a spot on the US Olympic Snowboarding team. His injury was very severe and cost him his independence, his voice, career and ability to walk.

Pearce's rehabilitation was extensive and he had the support of his family and friends, but he attributes his successful and ongoing recovery to his competitive nature. He will never compete again, but has been able to safely return to recreational snowboarding. He also co-founded a non-profit called Love Your Brain dedicated to raising awareness and improving the quality of life for people with brain injuries and those with Down Syndrome people.

Kevin is very active in the world of brain injury and works very hard to educate and inspire people. Here he is leading a TED talk about TBIs, and this is his website if you'd like to know more about him and his causes.


Kevin Pearce said it best in his TEDx Talk, "a brain injury is like a fingerprint, no two are the same." Evidenced here through these wonderful stories is the fact that TBIs are the hardest thing a person can experience, but that also, to an extent, many of these injuries can be overcome. Their accomplishments are inspiring, and are proof that a new best self can be reached.

Do you have a personal story of surviving a brain injury? We welcome you to share those stories with us below.