1. On the horizon……. PAIN as the
pathology
Christy Baxter MSN, MHA, RN, CPN
Clinical Nurse Manager-Complex Pain Medicine
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2. Addiction vs. Dependence
Addiction = psychological
“Socially aberrant behavior to obtain or use medications of any kind for a
way that it was not intended for” (Rebstock)
Dependence = physical
Drug dependence means that a person needs
a drug to function normally. Abruptly stopping the drug
leads to withdrawal symptoms (MedlinePlus)
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3. Addiction vs. Dependence
Addiction = psychological
“Socially aberrant behavior to obtain or use medications of any kind for a
way that it was not intended for” (Rebstock)
Dependence = physical
Drug dependence means that a person needs
a drug to function normally. Abruptly stopping the drug
leads to withdrawal symptoms (MedlinePlus)
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4. Vicious Pain Cycle
More
Catecholamines Noxious stimuli
produced
Spinal cord
More intense pain
Stimulates SNS
Decreased
blood flow to
non-essential
organs and the
Nociceptors Catecholamines
periphery , <
sensitized released
O2 and >H+
Dr. Sarah Rebstock MD, PhD
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6. Process/Who to call?
Process:
Inpatient Pain Medicine Team
Pain Medicine Fellow (Ascom 8345)
1. Inpatient Pain Medicine Consult
2. Inpatient Pain Team will collaborate with Outpatient team
Pain Medicine Center Contact Information:
Appointment Line: (202)476-EASE (3273)
Outpatient Providers:
Dr. Sarah Rebstock MD, PhD (Director)
Dr. Angela Fletcher PsyD (Pain Psychologist)
Kathy Sheehy APRN (Ascom 7734, Pager 202-259-4502)
April Steiner PNP (Ascom 8387, Pager 202-259-2993)
Christy Baxter (Clinical Nurse Manager)
Office: 202-476-1210
Pager: 202-259-2189
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7. Reference
MedlinePlus (2012). http://www.nlm.nih.gov/medlineplus/ency/article/
001522.htm
Rebstock, S. (2011). Director of Complex Pain Medicine. Children’s National
Medical Center.
Sherry, D. (2003). Amplified musculoskeletal pain or reflex neurovascular
dystrophy-A guide for parents of children with RND.
Pain Resources:
• www.pain-topics.org
• www.ampainsoc.org (American Pain Society)
• www.painfoundation.org
• www.iasp-pain.org (International Association for the Study of Pain)
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