The focus of last month’s digest was to compare and contrast two approaches to the treatment of chronic pain–Pain Recovery and Pain Management. This month we will explore how Pain Recovery began. Pain Recovery came out of the work of Mel Pohl, MD, FASAM and Frank Szabo, Jr., LADC at Las Vegas Recovery Center . Working with clients in Las Vegas Recovery Center’s addiction treatment program, Dr. Pohl and Mr. Szabo realized they were seeing more and more people with opiate dependence who also had chronic pain, so simply taking clients off of the opiates didn’t work. To help people better manage their daily life functions and tolerate the pain that they were left with, Dr. Pohl and Mr. Szabo developed a chronic pain rehabilitation program that offered a holistic approach. Pain Recovery evolved out of a deeper understanding of what the needs of their clients were. Once these needs were recognized, Pohl and Szabo then identified the four points of balance (mental, physical, emotional, and spiritual) that needed to be addressed in order for pain clients to improve and get healthy, which is the primary focus of recovery for addicts. The parallels between recovery from addiction and from chronic pain were compelling and undeniable. For chronic pain, Pohl and Szabo emphasized that it is simply not enough to stop medication; it is simply not enough to get physical therapy; it is simply not enough to use cognitive behavior therapy to change thinking; and it is simply not enough to look at one’s emotions. Clients needed to work on all of those components and also include the component of spirituality in order to find a balance that leads to enhanced function. The Pain Recovery program entails a holistic series of physical activities that include Reiki, acupuncture, massage, physical therapy, chiropractic, yoga, qigong; cognitive behavioral interventions that guide clients to find productive ways to think and to behave differently about their chronic pain; and then meditative practices that involve working with the breath and the mind in a noncognitive way. This approach modifies a person’s experience of pain, fear, and anxiety with a net reduction of suffering. Days are busy in the Pain Recovery program at Las Vegas Recovery Center. The initial premise of Pain Recovery is movement, even if the underlying feeling is discomfort. Clients start moving the first day they arrive in treatment, often in ways that they haven’t moved in years. They are taught how to stretch in a healthy, gentle way. They learn how to breathe properly. In turn, they are required to participate in their own treatment. They attend a group of their peers and facilitator-led groups over the course of the day. They have ample time to work on reading and writing assignments throughout the day, and they have scheduled activities that are individually arranged for the physical modalities in which they’re going to participate. All clients attend twelve-step meetings at the end of each day. All clients also attend a daily meditation session called body scan, a guided meditation adapted from an ancient Burmese practice.