The San Quentin Mental Health and Medical Departments conducted a pilot “Chronic Pain Management” workshop. The 12-week program met once a week for two hours. Participants were referred by their primary health care provider (Doctor) to mental health services.
Social Worker Ms. Cline and Dr. Combs were the facilitators of the group. A curriculum developed at Richard J. Donovan Correctional Facility was used, and the objective was to provide information and techniques for coping with chronic pain.
There are two sorts of pain: “acute pain” and “chronic pain.” Acute is anything from smashing a finger to being shot or stabbed. Chronic is defined as a pain which may or may not have a clear cause and lasts longer than three months. Chronic pain can result in or be accompanied by substance abuse, anxiety attacks, post traumatic stress disorder (PTSD) and depression and can have a very negative impact on one’s quality of life.
Those involved in the workshop were taken at their word. Whatever the type of pain or location, no one was questioned to see if they were faking. The ground rules were clearly laid out. Whatever was discussed in the group was confidential, but the participants could take the information to their doctors. The staff facilitating (Ms. Cline and Dr. Combs) neither interfered with nor were involved in prescribing medications or discussing medical treatments.
Nor was the group meant to be a gripe session. Its focus was on how one can have an increased understanding of chronic pain and how to better cope, using that knowledge. Some of the things discussed were the practice of various mindful meditation techniques and body scanning, and this was accompanied with an accepting support group.
Another discussion concerned treatment with opioids (methadone, morphine, codeine, etc.) and how the American Medical Association at large is pulling back on their use. Only 30 percent of those with chronic pain are effectively treated with opioids. Many changes are happening throughout the nation in both the dosage amount and reasons for prescribing them.
When asked what he thought those involved should take away from the workshop, Dr. Combs stated: “To understand they won’t necessarily get rid of their pain but that they have a sense of control in order to make it more tolerable—pain will interfere less with their quality of life.”
Over 100 million people in the U.S. (about 30 percent) suffer from chronic pain. As a result of the lifestyles of those in prison, one can easily conclude that the percentage is even higher behind the walls.
Ms. Cline stated that she wished those involved would find new skills to deal with pain and learn that they are not alone. Those who participate in this 12-week program do not have to be a part of the Mental health delivery system and will receive a certificate of completion. If this program continues, those who qualify should be referred by a doctor.
