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Hypnotically guiding a patient through Tramadol detox
Dear collegues, what interests me, is how the medication can be reduced by using hypnosis? At the moment I am treating a patient, who has been taking tramadol and other painkillers for the last seven years. He was first doubtful about ever being able to stop anymore. He is noticing how the medication and pain attacks are controlling his life and changing his ability to concentrate or being focused, which makes him worried. He is reading a lot of medical information in the ihternet and so far has been giving himself very negative suggestions through that. Before the first hypnosis session we were setting a common goals such as him being able to stop medication and him getting back the control of his life and replacing the pain by physical activities like swimming and walking. So far we had one session of hypnosis with remarkable results: he has been sleeping better than for a long time, he is very optimistic about the progress he has already made, he even suggerated himself while the pain was about to start again ! He even so wonderfully said in the phone that he thinks that he will eventually propably just forget to take the medicin. We did during the first session a shorter version of "awaken painfree script", since the sleeping and awakening is one of his main concerns. My question is however, what is your ( or someone else`s experience in the hypnothoughts network) of stopping the intake of opioid like drugs? Normally in the medical field it is reduced step by step, but how far can one go with hypnosis regarding the withdrawal symptoms? I would be very grateful to hear someone`s experiences with their clients with chronic pain.
Replies to This Discussion
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Permalink Reply by Hugh Cole on -
Heli I am not a doctor and I do not give medical advice. However if some one came to me with a dependancy issue That I thought I could help them with. , I would do it the same way the Doctors would detox him. Gradually allow them to lower the dosage as they saw fit and support them with hypnotic pain management. I have had some clients like that who have been very successful in breaking drug dependancies by tapering off as they were comfortable and using me to manage the effects of the reduced dosage. It is very important if someone is under the care of a prescribing Physican that he be aware of your role with his client. In Some cases a referral from the Doctor is absolutely mandated.
Hugh Cole
The Pretty Goodest HYpnotist on the Planet
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Permalink Reply by Heli Jussila-Martineau on -
Hugh, thank you for your reply. The question arose because of my client`s eagerness to stop medication, because the results of the very first session were already so succesful. It is good to hear about your experiences! In this way I
think hypnosis can be a very good support for any addicts , following their process of recovery from addiction.
Hugh Cole said:Heli I am not a doctor and I do not give medical advice. However if some one came to me with a dependancy issue That I thought I could help them with. , I would do it the same way the Doctors would detox him. Gradually allow them to lower the dosage as they saw fit and support them with hypnotic pain management. I have had some clients like that who have been very successful in breaking drug dependancies by tapering off as they were comfortable and using me to manage the effects of the reduced dosage. It is very important if someone is under the care of a prescribing Physican that he be aware of your role with his client. In Some cases a referral from the Doctor is absolutely mandated.
Hugh Cole
The Pretty Goodest HYpnotist on the Planet
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Permalink Reply by Michael Ellner on -
Very good Points - Hugh...
I hereby suggest that Dr J-M (Dr J) let her patient be her guide.
According to the maps and weather reports that I've read on the "internet" Tramadol Withdrawal is likely to occur if her patient stops too quickly. Tramadol withdrawal symptoms can vary in intensity and no one can predict how long the withdrawal period will be because it depends on many factors and that's why it must be Dr J's call. I suggest that she plan on weaning her patient over a period of time that she deems to be reasonable and safe with the goal of hypnotically easing him through it as quickly as possible.
If Dr J teaches her patient self-hypnosis and has him focus on increasing his coping skills and self-help abilities, the daily practice will help him make the most of less and less medication... It is not unreasonable to think he will experience few, if any withdrawal symptoms. Dr J. can keep an eye out for any symptoms that require her attention without creating an expectation that he will experience withdrawal symptoms. He may not. And if he does they are likely to be much milder than without hypnotic assistance and Dr J. will be able to help according to his needs.
Okay Dr J - It starts with belief and expectation - You must help your patient wrap his mind around the belief that hypnosis can help him detox over a period of time with a minimum of, if any withdrawal symptoms. Remember: Informed Consent does not require giving a patient negative suggestions. Example: "Possible withdrawal symptoms could include (list them) and you probably won't have any problems, but if you do, they are likely to be mild and I can help" is a much better suggestion than "Side-effects are:"
A) Moving into "rest and digest" states will potentiate your patients self-balancing and healing resources which will automatically become more effective... Suggesting that practicing self-hypnosis on a daily basis will help your patient get more benefit out of less "medication making for a cleaner detox.
B) Just thinking that a medicine will relieve pain releases natural painkillers. This is the "placebo effect" component of hypnotic pain relief. This is evidenced by research done by Italian neurologist Benedetti who demonstrated that morphine was 50% more effective when patients knew it was coming.
C) We can help him with hypnotic pain relief techniques that will help him separate from his sensory experience which is the the "dissociative" component of hypnotic pain relief.
Put them together and it is as easy as ABC...
The abstract below may be of interest:
Warmest regards,
Michael E.
Note:
According to the abstract below, researchers have re-confirmed the two possible ways that people can utilize their mind-body connection to reduce or tune out pain: The researchers mention their difficulty in trying to figure out if the "effect" that they are measuring is psychobiological or non-psychobiological.
Snip: >"Moreover, it is unclear whether such placebo effects represent genuine psychobiological phenomena or just shifts in selective attention."< Unsnip
Eureka, "It's two mints in one!℠" --
http://www.ncbi.nlm.nih.gov/sites/entrez
Neurogastroenterol Motil. 2009 Dec 22. [Epub ahead of print]
Serum correlates of the placebo effect in irritable bowel syndrome.
Kokkotou E, Conboy LA, Ziogas DC, Quilty MT, Kelley JM, Davis RB, Lembo AJ, Kaptchuk TJ.
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Abstract Background In diseases defined primarily by the subjective nature of patient self-report, placebo effects can overwhelm the capacity of randomized controlled trials to detect medication-placebo differences. Moreover, it is unclear whether such placebo effects represent genuine psychobiological phenomena or just shifts in selective attention. Knowledge of predictors of the placebo response could improve the design of clinical trials and the delivery of personalized medical care. Methods In patients with irritable bowel syndrome (IBS), a subset of our previous study that were randomized to placebo treatment (sham acupuncture) or no-treatment group (waitlist), we tested an enriched panel of 10 serum biomarkers at the enrolment and the 3rd week of intervention, using a multiplex electrochemiluminescent immunoassay. Key Results More pronounced changes overtime in serum levels of osteoprotegerin (OPG) have been found in patients who received placebo treatment compared with the waitlist group (P = 0.039). Moreover, serum levels of OPG at baseline were found to be higher (P = 0.0167) in patients who subsequently achieved adequate relief (AR) of their IBS symptoms, independently of their treatment group. Besides, serum levels of TNF-related weak inducer of apoptosis (TWEAK) at baseline were also higher (P = 0.0144) in patients who reported AR and in particular in those who received the placebo treatment. Conclusions & Inferences These two measurable biological parameters associated with placebo, namely serum OPG and TWEAK, provide a proof of principle for discovering putative molecular signatures of placebo response in IBS and perhaps in other illnesses with patient self-reported outcomes.
PMID: 20028464 [PubMed - as supplied by publisher]
Hugh Cole said:Heli I am not a doctor and I do not give medical advice. However if some one came to me with a dependancy issue That I thought I could help them with. , I would do it the same way the Doctors would detox him. Gradually allow them to lower the dosage as they saw fit and support them with hypnotic pain management. I have had some clients like that who have been very successful in breaking drug dependancies by tapering off as they were comfortable and using me to manage the effects of the reduced dosage. It is very important if someone is under the care of a prescribing Physican that he be aware of your role with his client. In Some cases a referral from the Doctor is absolutely mandated.
Hugh Cole The Pretty Goodest HYpnotist on the Planet
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Permalink Reply by Ricky Strode on -
I would radically stop all pain medications, all at once , immediately
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Permalink Reply by Ricky Strode on
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Can you guess how I would handle the new situation, with no problem at all ? If not, think of what you could do to make this possible. There is alot more you can do with hypnosis than what you might of thought to be possible.
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Permalink Reply by Walt on -
Heli,
I've been taking morphine and hydrocodone for about two years because of arthritis of the spine. I had surgery 18 months ago. Three months after the surgery I was unable to go back to work due to the pain.
In August I learned how to use self-hypnosis to reduce and sometimes eliminate my pain. And I've been able to cut my pain medicines in half. I will be off the pain medicines in March. Sometimes I can take care of the pain in 30 seconds. Other times it takes 20 minutes. I do not know how to account for the difference. When it takes just 30 seconds I just go inside and stop the pain. Other times I go through a formal process using a endorphin wash, turning dials and throwing switches.
What surprises me is that my total pain level has gone down! I need to use the pills and the hypnosis less often. Gaining some control using the self-hypnosis took most of the suffering out of the pain. I've had no problems with withdrawal.
I would not have stopped the pain meds all at once. Taking a few of months after 2 years of use is not a problem for me.
I first learned self hypnosis in 1974. I learned pain control with a self hypnosis program developed by Steven Gurgevich, Ph.D.
Let your client know that it can be done, with some work and time.
Today I've only used 2 pills! No pain, lots of gain!
Walt
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Permalink Reply by Kelley Woods on -
Congratulations, Walt! Your testimonial is encouraging to all of us! I echo most of what has been written here: a gradual and informed reduction in pain meds can coincide with other changes a person is making in their life, be it improving health through exercise or nutrition, or additionally utilizing hypnosis for emotional and stress management. Each factor is part of the whole and reinforce each other through their independent successes.
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Permalink Reply by Henxy on -
Hi Walt,
An interesting use of opioids for an inflammatory condition...
So glad you're controlling your pain now.
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Permalink Reply by Walt on
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Henxy,
The problem was not the inflammation. The arthritis narrowed the channel carrying the spinal cord. Spurs dug into the exiting nerves. Nerve pain was the difficult problem.
Walt
Henxy said:Hi Walt,
An interesting use of opioids for an inflammatory condition...
So glad you're controlling your pain now.
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Permalink Reply by Henxy on
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Hi Walt,
Then why not be given a drug for neuropathic pain? E.g. gabapentin? Opioids have been shown to have little effect. I'm feeling for you :-(
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Permalink Reply by Michael Ellner on
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Walt, Henxy,
Oxycodone Enhances Gabapentin for Neuropathic Pain Relief
Reference: Hanna M, O'Brien C, Wilson MC. Prolonged-release oxycodone enhances the effects of existing gabapentin therapy in painful diabetic neuropathy patients. Eur J Pain. 2008(Aug);12(6):804-813.
Henxy said:Hi Walt,
Then why not be given a drug for neuropathic pain? E.g. gabapentin? Opioids have been shown to have little effect. I'm feeling for you :-(
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Permalink Reply by Henxy on
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Yes, my dear?!...
Michael Ellner said:Walt, Henxy,
Oxycodone Enhances Gabapentin for Neuropathic Pain Relief
Reference: Hanna M, O'Brien C, Wilson MC. Prolonged-release oxycodone enhances the effects of existing gabapentin therapy in painful diabetic neuropathy patients. Eur J Pain. 2008(Aug);12(6):804-813.
Henxy said:Hi Walt,
Then why not be given a drug for neuropathic pain? E.g. gabapentin? Opioids have been shown to have little effect. I'm feeling for you :-(
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