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Handouts

Note:  The following are for educational purposes only and are not for commercial use. If you are interested in distribution or commercial use please contact authors.

General Topic Areas are included below or please follow the links:  


1. Acupuncture

2. Addiction/Substance Use Disorders

3. Brain/Central Nervous System Health

4. Pain Management

3. Medical Cannabis

3. Post Traumatic Stree Disorder and Anxiety

3. General Issues


1. Acupuncture Related: Also please look under Acupuncture Tab
2. Addiction Related: General, Family & Alanon Issues, Alcohol, Opiates, Marijuana, Tobacco

General Addiction issues
Family and Alanon Related Issues
    Alcohol Use Disorders
    Opioid Use Disorder
    Marijuana/Cannabis Addiction - See #5 below for handouts and information related to Cannabis use for Medical Purposes and what is involved for medical authorization for use of same.  
    Tobacco Addiction/Tobacco Use Disorder
    3. Brain Central Nervous System (CNS) Health General
    4. Pain Management Related: Also Please look under Pain Management tab
    • Overlap of chonic complex pain with other conditions  by Dr. Rotchford 2017
    • "Mystery of Chronic PainA Ted Talk by Dr. Krane reviews the evidence for considering chronic non-cancerous pain a disease unto itself.
    • Pain and the brain: How love, fear, and much more affect the experience of pain
    • Syllabus Regarding the basics of Chronic Pain and its management Dr. Rotchford
    • Neuropathies -  A Brief Overview by Dr. Rotchford
    • Washington State Guideline on Prescribing Opioids for Pain (2015 revised)
    • Methadone and Pain Centers in Western Washington - A partial list
    • There are a number of online references.  Here are just a few that Dr. Rotchford recommends to look over:
      • Books to Know -  This is a compendium of books about behavioral ways to better manage pain.  If you think you've tried it all.  Please think again.  
      • Change your Brain, Change your Pain by Mark Grant, M.A.  2011 - This book is consistent with Dr. Rotchford's approach to chronic pain problems.  While emphasizing behavioral approaches the author clearly recognizes the importance of a "both/and" approach rather than simple either/or approaches.  Dr. Rotchford recommends EMDR for any patient who has chronic pain and particularly those with known history of trauma or positvie response to medical cannabis.  The hitch is to find qualified practitioners and secondly to get payment for same through third parties.   There is a helpful CD included that promotes some of the brain changes discussed within the book.  It's available online for around $40.
      • Patient Self-Help Resources by Forrest Tennant, M.D.
      • Neuroplastic Brain and Body
      • Managing Pain before it Manages You by M. Caudill, M.D -  Available online for purchase.- I consider this the "standard" workbook for behavioral management of pain.
      • The Pain Toolkit - online Free
      • The Divided Mind by John Sarno, M.D., who has written a number of books on the interplay between pain and emotional states, particularly anger and unexpressed rage. Practical suggestions are eventually provided and it is an eye opener for many who continue to believe that pain is simply a matter of what the x-ray or other biomarkers reveal. Please see the Anger Appreciation handout below.
        • Dr. Rotchford has different opinions from those of Dr. Sarno.  While it is understandable to be critical of the lack of the formal appreciation of emotional stressors as potential explanations for many patient symptoms, Dr. Rotchford does not agree that contrasting psychological vs. physical vs. spiritual vs. energetic vs. cultural explanations is the best way to proceed. Dr. Rotchford finds these models are constructs. He believes the "truth" often lies outside of our man-made constructs, however appealing and effective our constructs may be.  The history of medicine is that our best "constructs" often change over time.  Nonetheless, Dr. Rotchford values Dr. Sarno's approach, because it is relatively safe and can be quite effective. There is also a definite value in appreciating how the unconscious "mind," however it is understood or defined (The "mind" is a "construct" too),  along with the measurable functions and physiology of the central nervous system, has a predominate role in the understanding and management of painful conditions.   Lastly, it is Dr. Rotchford's opinion that "either/or" ways of thinking and responding, while they are sometimes effective, are not often as effective as "both/and ways" of thinking and responding.  This is particularly true when managing complex diseases,  particularly those that affect the central nervous system. The following are additional resources related to "Sarno" interventions.
    • Pain Management -  A recent CME update for physicians - While this link was intended for physicians, I think it might be helpful for some to read in order to view the current "party line" as it relates to pain managment.          
    • Managing Acute Pain in Patients on Buprenorphine by Dr. Rotchford
    • Managing Acute Pain in Patients Prescribed Methadone by Dr. Rotchford
      • These 2 link are intended primarily for clinicians; however, patients may find them informative as well. Patients who use buprenorphine and methadone for opiate use disorders or for chronic pain are advised to only use opioids for pain as directed by a physician. Every attempt to diagnose the source of the pain is indicated and without a clear source of tissue injury or damage, opiates or other controlled substances are best avoided.  In cases where a clear cause of pain is not present every attempt to avoid pain pills is best.  Exceptions might be when one is dealing with a potentially life threatening problem such as a heart attack.  In brief, patients on buprenorphine should be provided options for pain management that do not involve opiates or other controlled substances whenever it is possible or reasonable. The following is a link to a slide presentation intended for clinicians about the use of buprenorphine in pain management: The Role of Buprenorphine in Pain Management by Gregory Rudolf, M.D.
    • Specific for Migraines & Headaches in General
      • Dr. Ready's Slide Set :   Dr. Ready is currently my "Guru" when it comes to headache management.  At the 2016 he gave a presentation which not only entertaining was so very informative.  I'm please to be able to provide a link to his slide set for managing intractable headaches.
    • 5. Medical Cannabis Related

    6.  Post Traumatic Stress Disorder (PTSD) and Anxiety

    7. General Issues

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