Counselling for CRPS

Counselling for CRPS. I listened to a fascinating interview on Wednesday 7th of January 2015 about Opioid use for non-cancer based pain reduction, the question was posed about drug addiction in chronic pain patients

I was struck by similarity between people using street heroin to manage their emotional pain and people using prescribed opioids to manage their physical pain.

The interviewer was Dr Mark Porter on BBc Radio 4’s Inside Health. The interviewee was Cathy Stannard Consultant in the pain clinic at Southmead Hospital.

In the following transcript you will see clearly what I mean by inserting the word “emotional” in front the word “pain”.


“It’s difficult if a patient doesn’t want to come off them or if a patient is frightened about coming off and obviously if you’re on a high dose opioid and you’re in severe pain there is always a worry that things might be even worse.  The strategy that we’ve been using here with colleagues from the neuropsychiatry department is initially to change patients over to a different opioid and the drug that we use is methadone, which many people will be familiar with from its use in the management of opioid addiction.  It is also a painkiller and it’s a useful tool to be able to help patients get their opioid dose down.  But I think the transition from one drug to another and then reducing the dose of methadone is a small part of it and a lot of what we do here is maybe exploring with patients why they’ve ended up on high doses in the first place.  And it may well be that patients will be deriving some blunting of unpleasant thoughts, emotions or experiences by taking drugs and that is one of the drivers, we know, for persisting use and that’s borne out by the larger literature.”


“So it’s not just the pain?”



“It’s not just the pain, but opioids will distance people from unpleasant thoughts and emotions and experiences.  And actually taking that away can sometimes be quite scary for patients.  So we have to find out what those drivers are and help patients manage those unpleasant experiences in a different way.”

What strikes me as sad is that we are able to identify and support those that the establishment has inadvertently turned into addicts, in this case “patients”, yet we punish those who self-medicate with street drugs, in this case, “Junkies”.

It would be good to think that one day we will view all kinds of pain sufferers as worthy of our support.

If CRPS is impacting you or someone you love and you want to find out how the counselling I provide can help you then please get in touch with me and we can look at how good therapy can make a huge difference in the lives of sufferers of this largely, as yet, unknown and under-researched condition.