Successful Pain Management…..



After hearing from my friend Long Hair, and her desire to try some kind of  pain management with her bad back while going through her journey towards a recovery and sober lifestyle, I did some research on line and came across this article. I wanted to share this with others who need to know that there is help out there if, you seek it. If you have more information please share with us in the comments above here, thank you and peace :-)


Successful Pain Management for the Recovering Addicted Patient

Christopher D. Prater, M.D., Robert G. Zylstra, Ed.D., L.C.S.W., and Karl E. Miller, M.D.

Author information ► Article notes ► 

This article has been cited by other articles in PMC.



Successful pain management in the recovering addict provides primary care physicians with unique challenges. Pain control can be achieved in these individuals if physicians follow basic guidelines such as those put forward by the Joint Commission on Accreditation of Healthcare Organizations in their standards for pain management as well as by the World Health Organization in their stepladder approach to pain treatment. Legal concerns with using pain medications in addicted patients can be dealt with by clear documentation of indication for the medication, dose, dosing interval, and amount provided. Terms physicians need to be familiar with include physical dependence, tolerance, substance abuse, and active versus recovering addiction. Treatment is unique for 3 different types of pain: acute, chronic, and end of life. Acute pain is treated in a similar fashion for all patients regardless of addiction history. However, follow-up is important to prevent relapse. The goal of chronic pain treatment in addicted patients is the same as individuals without addictive disorders—to maximize functional level while providing pain relief. However, to minimize abuse potential, it is important to have 1 physician provide all pain medication prescriptions as well as reduce the opioid dose to a minimum effective dose, be aware of tolerance potential, wean periodically to reassess pain control, and use nonpsychotropic pain medications when possible. Patients who are at the end of their life need to receive aggressive management of pain regardless of addiction history. This management includes developing a therapeutic relationship with patients and their families so that pain medications can be used without abuse concerns. By following these strategies, physicians can successfully provide adequate pain control for individuals with histories of addiction.

Providing pain control for the 5% to 17% of the U.S. population with a substance abuse disorder of some type1presents primary care physicians with unique challenges. When these individuals experience pain, they are less likely to receive adequate pain management than individuals in the general population.2 While relapse in a recovering individual may occur in spite of appropriate use of opioids and psychotropic medications required for effective pain management, inadequate pain relief is also a significant risk factor for relapse.3 Some of the challenges that physicians face include distinguishing between seeking pain relief and seeking drugs for the euphoric effects and identifying predictable neuroadaptations such as tolerance and physiologic dependence that can be misinterpreted as drug seeking or relapse behavior.4 In addition, comorbid psychiatric and medical illnesses may complicate effective pain management.5

This article will address 5 areas related to successful pain management in the recovering addict: (1) basic principles, (2) legal concerns, (3) substance abuse terminology, (4) active addiction versus recovery, and (5) management strategies for acute, chronic, and end-of-life pain. This information will provide physicians with a better understanding of the unique challenges of providing pain control in these individuals.



The following vignettes describing 2 actual patients* highlight some of the issues that can confront primary care physicians in their daily practice:

John is dead. He committed suicide last week. Until a year ago, he was a successful physician enjoying 5 years of recovery from addiction to hydrocodone and alcohol. He was doing well until he fell and fractured his distal ulnar (styloid process) and experienced associated mild-to-moderate pain. Like his primary care physician, the orthopedic physician who evaluated John knew that he was in recovery from “drugs” and prescribed the nonscheduled pain reliever tramadol. Significant pain was resolved after 1 week. John had his cast removed 4 weeks later and was released to the care of his primary care physician. Although John subsequently did follow up with his primary care physician regarding his fracture and had several office evaluations for different medical problems, the issue of his addiction was never readdressed. Drug testing at the time of his death revealed the presence of hydrocodone.

Ben enjoyed 22 years in recovery from addiction to alcohol, was gainfully employed, and had an active and stable family life with his wife and 2 children before suffering a back injury in an auto accident 3 years ago that resulted in a moderately severe pain syndrome. At the time of his accident, the emergency room physician successfully managed his initial pain with a combination of bed rest, cyclobenzaprine, and oxycodone. A week later as instructed, Ben followed up with his primary care physician, who continued his bed rest and scheduled him for magnetic resonance imaging (MRI) of his lumbosacral spine. Due to concerns related to Ben’s addiction history, his primary care physician changed his pain medication at that time to tramadol, a nonscheduled pain medication. Ben called back 2 days later to report a marked increase in pain, so his physician changed his medication to hydrocodone. When Ben called again in another 2 days, he asked to be given oxycodone, saying that the hydrocodone was not providing the pain relief he needed. He also reported not being able to get his MRI because of the incapacitating pain he was experiencing. Ben’s noncompliance related to obtaining the MRI and his request for a specific, stronger narcotic suggested to his physician that Ben was seeking drugs rather than pain relief. His physician became worried about relapse for Ben and the possible legal consequences for himself of “inappropriate” prescribing of narcotics and refused to change the prescription. Ben subsequently began self-medicating his pain with his drug of choice, alcohol. His alcohol use continued to escalate, causing significant consequences including the loss of his job and family.



Regardless of substance abuse history, there are several basic principles in pain management.6 The first principle is to provide effective pain management, and this requires certain strategies. First, medications should be chosen on the basis of their ability to afford adequate pain relief. There are multiple medications and delivery routes that supply health care providers with a variety of pain relief strategies. An important principle is to use the level of pain the patient is experiencing in determining the strength of pain medication that may be warranted and as a guide for effectiveness of pain management. As discussed in the preceding vignettes, while John’s physician appropriately prescribed tramadol for his mild-to-moderate pain, Ben’s physician failed to adequately address his more severe level of pain. Considerable inconsistency has been found when assessments of pain intensity are compared between primary care physicians and their patients, with primary care physicians tending to rate patients’ pain much lower than the patients.7 The Joint Commission on Accreditation of Healthcare Organizations recommends a numerical scale for adults8 because of the ease of implementing the scale, the ease of understanding it, and its reproducibility. An example would be a scale of 1 to 10 where 10 represents severe pain. Perhaps the use of a simple tool such as this would have allowed Ben’s physician to deal more effectively with Ben’s pain.

A second strategy is to provide pain relief around the clock. Pain medications that are used strictly on an as-needed basis allow pain to escalate and require more medication for pain control. The use of around-the-clock dosing suppresses the pain and will provide better comfort for patients. This schedule is frequently best accomplished by continuous use of long-acting opioids with the p.r.n. addition of short-acting opioids for breakthrough pain. Opioids should be titrated to a level that provides adequate pain control (Table 1). Most opioids have no dose ceiling, and large doses have not been shown to suppress respirations or decrease life expectancy if patients are in pain.10

Table 1.

Table 1.

Pain Management Strategies Based on the World Health Organization Stepladder Approacha

When choosing pain medication, the emphasis should be on using medications that provide adequate pain relief. Attempting to use “less addicting” narcotics may result in inadequate pain relief, which may actually precipitate relapse by forcing recovering individuals to self-medicate their pain. This appears to have been the case in Ben’s situation, with his former drug of choice—alcohol—being used to help manage unresolved pain.

The choice of pain medication is based on the World Health Organization’s stepladder approach for mild, moderate, and severe pain.9 Step 1, mild pain, can be treated with acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and cyclooxygenase-2 (COX-2) inhibitors. Step 2, moderate pain, can be treated with the same agents with the addition of a weak opioid such as codeine or hydrocodone. Step 3, severe pain, should be treated with strong opioids such as morphine, oxycodone, hydromorphone, or methadone. Meperidine should be avoided because of its short length of effectiveness and its tendency to induce euphoria. Propoxyphene and its combinations should also be avoided because they provide minimal analgesia with a high abuse potential. Agonist-antagonist drugs such as pentazocine, nalbuphine, and butorphanol should be avoided in treating addicts who are actively abusing narcotics and those on opioid maintenance programs (i.e., methadone maintenance) because the agonist-antagonist drugs can precipitate an opioid withdrawal syndrome.

The second principle is that acute pain is a medical emergency and should be treated as such. If not treated aggressively, the pain can escalate, making it increasingly difficult to control. Finally, addiction concerns for those without an addictive disorder, although real, are frequently overrated, given that only approximately 3% to 5% of individuals with pain treated with opioids experience subsequent problems with addiction.6



Many physicians have a fear of using opioids in adequate amounts to relieve pain (“opiophobia”).11 This is in part due to fear of legal repercussions for overprescribing narcotics. Even if Ben’s physician had correctly assessed his level of pain, the fear of “possible legal consequences” may still have resulted in the prescription of inadequate pain medication.

Through the Uniform Controlled Substances Act of 1970, federal law regulates the use of narcotics only when used for purposes of opioid detoxification and/or maintenance; it does not regulate the use of narcotics for pain relief. The Psychotropic Substances Act, a 1978 amendment to the Controlled Substances Act, specifically prohibits restrictions on opioid prescription for pain relief. Individual state regulations usually follow the federal guidelines. It is, therefore, the responsibility of individual practitioners to treat patients for legitimate medical purposes in accordance with generally accepted medical standards,12 such as those outlined by the Joint Commission on Accreditation of Healthcare Organizations in their standards of pain management8 and the World Health Organization stepladder approach to determining the medication to be used.9 Of utmost importance is clear documentation in the medical record of the need for narcotic analgesia, for both clinical and potential legal purposes. This documentation includes the indication for narcotic use, medication provided with the dosage, dosing interval, and amount provided. It is also important to document the timing for the next medication refill that is agreed on by the patient and the physician.


To understand treatment strategies for recovering addicted patients, physicians need to understand substance abuse terminology (Table 2). The terms physical dependence and tolerance have been inappropriately used in the past to define the term addictionPhysical dependence is defined as development of a physical withdrawal syndrome following abrupt dose reduction. Its presence does not indicate the presence of addiction, but rather is a normal physiologic consequence of chronic use of many psychotropic medications. Tolerance likewise is not indicative of addiction and can be defined as a normal physiologic response at the cellular level to chronic use of many psychotropic medications that results in requiring more drug to elicit the same physiologic response. Physical dependence and tolerance to opioids are normal and predictable physiologic events that are natural consequences of chronic opioid use. Their development can be expected after extended use of these drugs (several days to 2 weeks) and does not imply the presence of substance abuse or an addictive disorder.13

Table 2.

Table 2.

Substance Abuse Terminology

Substance abuse is defined as use of any illegal drug (marijuana, cocaine, heroin) or inappropriate use of a controlled substance. In addition to the procuring of medications through nonmedical sources (e.g., buying drugs “on the streets”), another example of substance abuse would be the use of an opioid left over from a previous prescription for relief of a subsequently developed emotional pain.

In this article, the term addiction refers to the condition of both someone who is currently active in their addiction (“active addiction”) and someone who is in recovery from their addiction (“recovery”). The presence of active addiction may be difficult for the physician to determine. Active addiction is frequently characterized by the presence of potentially maladaptive, drug-seeking behaviors (Table 3).14 Physicians should familiarize themselves with these behaviors, because the presence of these behaviors can be instrumental in differentiating between drug-seeking individuals and pain relief–seeking individuals. Most important is the presence of a pattern of behaviors rather than the isolated presence of a behavior.14

Table 3.

Table 3.

Maladaptive Behaviors Suggestive of Active Addictiona

However, adding to the already difficult task of determining the presence of active addiction is a phenomenon called “pseudoaddiction,” which may mimic active addiction. Out of fear of not receiving adequate pain medication, individuals may hoard medication or ask for amounts that seem out of proportion to their pain.15 This behavior may be particularly evident in individuals who have previously experienced the prescribing of inadequate amounts of pain medication by physicians who fear using opioids in patients with substance abuse disorders.13



Active addiction can pose clinical problems distinct from those encountered with patients in drug-free recovery and those in methadone maintenance programs. Attempts to provide compassionate treatment to these challenging individuals may be skillfully subverted by patients seeking to obtain narcotics for purposes other than pain relief.16Addicts, especially opioid addicts, often require larger opioid doses and more frequent dosing intervals than nonaddicted patients to adequately control their pain. Ben’s need for what seemed to his physician to be excessive pain medication may have been due to a similar increased opioid requirement to relieve his pain.

Narcotic withdrawal symptoms can interfere with attempts to control pain. The time for detoxification is not when pain management is needed but rather when opioids are no longer medically indicated. For acute pain situations, opioids should be administered in doses adequate to prevent withdrawal and afford effective pain relief. The best analgesia is achieved when withdrawal states and anxiety related to inadequate pain relief are prevented. One way of controlling opioid withdrawal symptoms while maintaining effective pain control is the use of methadone, 15–20 mg/day, to control withdrawal symptoms, while additional opioids can be given for control of pain at their usual therapeutic doses.3

Methadone maintenance patients should be given their usual daily dose of methadone in addition to the opioids required for effective pain management. Methadone may also be used in increased doses (10–20 mg every 3–4 hours) for pain management in these individuals; however, the dosing intervals are adjusted for effective pain control because the pain-relieving effect of methadone may last only 4 to 6 hours. Because of the potential to precipitate an acute withdrawal syndrome, a mixed antagonist-agonist opioid such as pentazocine, nalbuphine, or butorphanol should never be given to anyone on a methadone maintenance program or to individuals in active opioid addiction.17



In a recovering individual, the fear of experiencing withdrawal symptoms can be a substantial block to successful discontinuation of narcotic medication when no longer needed for pain control. While continued use of opioids is warranted in patients experiencing tolerance, continued pain syndrome, or pseudoaddiction, patients who are physically dependent on opioids may continue their use despite resolution of pain solely to avoid withdrawal. Such use does not necessarily reflect addiction. Successful management of these concerns may be accomplished by slowly tapering medications over several days under close supervision. In certain cases, short-term admission to a detoxification unit may be necessary.

Colloquial definitions of addiction and dependence used by individuals with substance abuse disorders can be helpful in making this determination. Dependence is frequently defined as “I can’t quit” because the individual is unwilling to experience withdrawal symptoms. Active addiction is defined as “I can’t stay quit,” which is the result of reinstituting opioid use for reasons other than pain control after their appropriate use has been successfully discontinued. Such was the case for John. While tramadol is a pain reliever with a relatively low addiction potential for the general public, it has greater potential harm for the recovering addict because the mild “high” it produces can trigger the need for an even stronger “high” and subsequent relapse. Reserving the term addict for this second group of individuals can help limit the inappropriate labeling of every individual seeking pain medication as an addict and improve the diagnostic value of the term by putting the emphasis on the need for long-term rather than short-term monitoring for relapse when managing pain in individuals with addictive disorders.

Pain management with opioids for recovering addicts should include a pretreatment agreement for random, witnessed drug screens 1 month, 3 months, and 6 months after pain management has been discontinued. Any failure to follow through with the drug screen when a drug screen is called for is considered a positive screen. Once relapse is suspected, management includes offering medical intervention. Perhaps if John’s physician had established a screening schedule at the beginning of treatment, this extra level of accountability could have encouraged John to remain abstinent or detected his substance abuse in time to reinitiate treatment.

Acute Pain

The goal of acute pain management is effective pain relief, with elimination of pain as a reasonable endpoint.6Maintaining functional levels of physical, social, and cerebral activity is generally a secondary concern. Nonopioid and nonpsychotropic pain relief treatment options should be utilized whenever possible to provide effective pain relief. However, when effective pain management cannot be achieved by these measures alone, use of opioids and other psychotropic medications is warranted (Table 4).19 Physicians may need to overcome their fear that prescribing narcotics and other psychotropic medications for an addict will necessarily result in relapse.11

Table 4.

Table 4.

Guidelines for Directing Effective Acute Pain Managementa

If tolerance to opioids develops, more frequent analgesic dosing may be needed.17 A change should be made to nonopioid, nonpsychotropic medications such as acetaminophen, NSAIDs, and COX-2 inhibitors only when it does not sacrifice adequate pain relief. Because the “high” that addicts achieve from psychotropic drugs is directly proportional to the rate at which the concentration of the drug rises in the blood, long-acting opioids are used when possible.14 Use of opioid agonist-antagonists in known or suspected active opioid addicts is absolutely contraindicated because they can precipitate an acute withdrawal syndrome.14

The presence of a psychiatric disorder such as depression can significantly hinder treatment initiation and limit treatment effectiveness if not adequately addressed. John’s suicide could have reflected the presence of a clinical depression that may have contributed to his relapse.

Structured control of medication access can decrease the chance for relapse.18 Such control may be achieved by giving the medication at fixed intervals and by arranging distribution of the medication by someone other than the patient. Giving medication at fixed intervals may also help minimize conflict between patients and caregivers. As previously noted, inadequate pain relief may encourage addicts to seek pain relief through self-medicating, thereby increasing the chance for relapse.3

Risk of relapse is also related to the quality of a patient’s substance abuse recovery and support program.20 Active involvement in a recovery support program should be initiated or intensified during a period of pain management.21Additional suggestions for enhancing recovery are listed in Table 5.

Table 5.

Table 5.

Measures That Enhance the Recovery Program

Chronic Pain

The goal of chronic pain management is to obtain reasonable pain relief while maintaining a maximum level of function.13 When possible, opioid treatment should improve occupational and social functioning while minimizing any decrease in cerebral function. Physical rehabilitation is appropriate to help restore patients as much as possible to their premorbid levels of physical and social functioning.

Addiction and chronic pain may reinforce each other.3 However, while requests for increased amounts of opioids may initially appear to be drug-seeking behavior, such requests may also reflect the presence of pseudoaddiction or suggest the development of physiologic tolerance. In addition, an increased need for pain medication may be indicative of an exacerbation of the underlying disease process causing the pain or heralding the presence of an undiagnosed or ineffectively treated comorbid medical or psychiatric disorder. Prior to any increase in pain medication, patients should be evaluated for the possible development of new disorders or exacerbation of existing disorders. Physicians should be alert for lowered pain thresholds and subsequent increase in pain perception resulting from emotional pain, sleep deprivation, and fear of inadequate pain relief.22

When possible, pain should be specified as being inflammatory, neurogenic, muscular, etc., and medication directed at those specific sources should be used.23 Nonpsychotropic drugs should be used when they do not sacrifice adequate pain control or level of physical functioning. Comorbid emotional discomfort can be managed with nonpsychotropic medications, disorder-specific psychotropic medications, and counseling.5

Factors that contribute to effective chronic pain management include the following: (1) having only 1 physician prescribe all pain medications, (2) encouraging maintenance of stability at home and at the workplace, (3) periodically weaning the patient from the pain medication to assess the pain syndrome and level of function, (4) reducing opioid use to the minimum dose necessary to effectively relieve pain while maintaining an effective level of function, (5) using nonpsychotropic pain management options when possible without sacrificing effective pain relief or level of function, and (6) being aware that increased doses may be required to maintain effective pain relief and/or level of function due of the development of drug tolerance or the progression of the underlying disease.

End-of-Life Pain

One of the common concerns patients have at the end of life is control of symptoms, with pain identified as their biggest fear.24 Despite advances in pain management and increased awareness of the need for pain control during the terminal phase of life, patients still suffer from undertreated or untreated pain.25–27 This failure to adequately treat pain causes a significant amount of stress.27

As stated earlier, good pain control can be achieved for most patients, and acute pain should be considered a medical emergency. Escalation of pain could represent a progression of patients’ terminal disease or an increased pain perception secondary to nonphysical causes such as psychosocial or spiritual issues.

When providing pain management, opioids are not the only option for providing pain relief. In fact, in certain cases such as bone pain, opioids are usually unable to provide adequate analgesia. In situations where musculoskeletal or bone pain is present, first-line therapy consists of nonsteroidal anti-inflammatory agents or corticosteroids. There are 2 distinct types of neuropathic pain. The first is continuous dysesthesias, which are characterized by continuous burning, electrical, or other abnormal sensations. The second is chronic lancinating or paroxysmal pain, described as sharp, stabbing, shooting, knifelike pain that often has a sudden onset. The current first-line treatment recommendation for the continuous dysesthesia type of pain is tricyclic antidepressants such as amitriptyline. For lancinating or paroxysmal neuropathic pain, first-line treatment options are the anticonvulsants, with gabapentin representing the best choice in this class.

In pain management at the end of life, addiction should not be an issue. The philosophy of providing comfort during this time period is the same regardless of any current or past history of addiction. The mechanism for pain management, however, does differ. The recovering or active addict may require more opioids to control pain because of increased opioid tolerance than those who do not have a history of addiction. Another concern is whether escalation of opioid requirements for pain control is related to disease progression or a sign of substance abuse. This escalation can be controlled to some extent by providing only a specific amount and number of pain medications with strict dosage instructions and establishing a contract with the patient and family concerning these issues. If substance abuse or diversion of controlled substances does occur, a frank discussion concerning these issues needs to be performed with the understanding that these behaviors are not acceptable. Pain control is obtainable in patients with addictions, but it needs to be a collaborative effort between physicians and patients.



Successful pain management, while complicated by substance abuse activity or history, can generally be accomplished in primary care settings. Recognition and attention to withdrawal concerns, relapse triggers, and comorbid conditions are essential, as is proactive support for long-term recovery.

Drug names: amitriptyline (Elavil, Endep, and others), butorphanol (Stadol and others), cyclobenzaprine (Flexeril and others), gabapentin (Neurontin), hydrocodone (Lortab and others), hydromorphone (Dilaudid and others), meperidine (Demerol and others), nalbuphine (Nubain and others), oxycodone (Percocet and others), pentazocine (Talwin and others), propoxyphene (Darvon and others), tramadol (Ultram).



The authors report no financial affiliations or other relationships relevant to the subject matter of this article.

*Patients’ names are fictitious, to protect the anonymity of the individuals.


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Posted in Recovery

A call to a friend….

Touch screen mobile phone

Well as the summer goes so does this heat go up here in South Florida, The other night I thought I would call one of my friends from out at the Pike. She just went through open heart surgery. She is out-of-state now and in a hospital recovering.

You might have heard me bring her up before I call her Long Hair! She is also a friend of Angel Face, and also an addict. Her story is one of what many is with her addiction. You see, she has bad back problems and was per-scripted the very same pills that she got addicted too!

She was thrown off of them so the doctor would not be liable for anything and had to turn towards the street for her medication. One thing as with many young ladies under this curse is that she found herself homeless sleeping in a tent with her then boyfriend and turned towards prostitution to pay for her medication that she needed for her pain.

This is what she always told me anyway, after knowing her for a while I personally witness some of the pain and trails that she went and still goes through. Her journey has not been easy at all and she does have my prayers and support when ever I can give it.

So she did answer the phone for I have been waiting for her to heal a little to talk to her, her voice was soft and weak but she still wanted to talk to me and clue me in on want was going on. She shared with me that she went through detox and does not want any more to do with them damn pills anymore!

This made me very happy and I told her that I was happy and proud that she was thinking like this and that there is always a reason for the season. She also shared with me, “Robert I need to do something about managing my pain and need to find a way to get off the Opioid s!” Will I brought up about seeing Angel Face again and I should have stayed on her instead because before you know it she had to go because a nurse came in the room and she was also very tiered.

So there is a time for change with this addiction and it is a lie and as anyone finds the courage, and do something about it, you will stay stuck in that cycle! So what is it my friend? Are you to stay stuck with all the lies and pain, or are you to be set free as my friend Long Hair?

You can put your comments up above and what ever you decide, peace and happiness in your journey :-)

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Posted in healing, Love, Recovery

Transcending addiction and redefining recovery: Jacki Hillios at TEDxBoulder


Why are some able to transcend their addiction while others are not? What do people really need to escape the shame of their addiction and achieve sustained recovery? Jacki’s talk focuses on answering these questions and demonstrates how resilience of the human spirit intersects with social contextual factors to set the stage for those struggling with addiction to choose a pathway to health.


We here at Angel Face Foundation also believe that addiction doe’s not necessary define the addict. It is a treatable disease in which anyone if they truly desire can break the chains. We have meet and also from personal experiences know this to be factual. 



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Posted in Recovery

Heroin at Home: Rise of Opiate Use

Published on Jul 30, 2013

A resurgence of heroin use, complicated by prescription pain-killer abuse, has dramatically risen in the last few years. The consequences, including a number of overdose deaths, have devastated a range of communities across Minnesota. This half-hour documentary explores some of the history, science, and social factors of opiate addiction. The voices of those in treatment and recovery are woven into analysis from some of Minnesota’s leading thinkers on the deadly rise of heroin and opiate use in the state. Co-produced by the Minnesota Department of Human Services and Twin Cities Public Television.

In the end some of the addicts vent and share that they hope family members and friends would understand and get educated about this epidemic and disease, we here at Angel Face Foundation share their wish also, this would help everyone through the journey towards recovery.

Please leave a comment above if you wish, peace and Gods speed :-)

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Posted in Awareness, Education

Meeting great people that beat addiction…….




Just got back from the GYM and it really has been helping me out a lot. After all the years of my past drug abuse and beating up my body and mind I do believe I owe it to myself. I actually get a high off my workouts and help me deal with stress from this screwed up world!


Now I have come to learn that it is totally up to me to stop playing the victim role and take charge of my own life. This means no more complaining and accusing others for my own short comings. I am my own master of my own realm and I do have the ability to see who fits into it.


As I sit here again at McDonald’s using their Wi-Fi , it has been about three weeks since I have been in here. The reason why I do bring this up is while here you sometimes meet interesting people that do fit in ! And as I was here three weeks ago, I was in my usual spot in the back. In comes walking this young lady with a big smile on her face as are eyes lock up. She went to the front and got something to eat and then she came to the back and sat down at the table next to me.


As she was eating we begin to talk and I must say it was quit pleasant. She was charming and I felt quit comfortable with her, I got the same in return when it came to her. We started to just talk about what is going on and how crazy things are now. You see there is a T.V. In the back here with C.N.N. On 24 hours. So we saw things the same and this is how we started to talk even more about this journey we are all on.


I found out that she is an addict that has been sober now and is very comfortable talking to me about it. I also shared with her about my passed and about Angel Face Foundation. I gave here my domain name and she said it was a great cause and if she can help in any way that if she had the time she would love to pay it forward.


This I felt was Divine and she was God sent. She had a long journey just as my friend Angel Face. This was great to meet another person, (young lady) that has been there and has defeated her spell of addiction!


I was finding myself on a high just from meeting her and it was very rewarding to have meet her. After a while she had to leave because she was working, gave me her contact information and we hug and she left. I do wish her nothing but the best in her journey and I am sure she will do just find. I can tell you she is a champion and has a purpose now in her life, this is a beautiful thing to witness in someones life and journey.


So how about you, have you had enough of this endless cycles of lies and death? Have you wish you could break it? Well you can, and others are doing it right now, even as I type this out. If others are doing it so can you, put yourself around the right people that care and are willing to give you the encouragement and support that is needed! Yeah it is your battle, but you really don’t have to do it all on your own.


Leave your comment above if you wish. Peace towards your journey :-)





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Posted in Recovery

Stop living in denial, grow and move forward towards acceptance.

What you conquer

“Some people believe holding on and hanging in there are signs of great strength. However, there are times when it takes much more strength to know when to let go and then do it.”
―Ann Landers

You are changing.  The universe around you is changing.  Just because something was right for you in the past doesn’t mean it still is.  This could be a relationship, a job, a home, a habit, etc.

It happens to you slowly as you grow.  You discover more about who you are and what you want out of life, and then you realize there are deliberate changes you need to make to keep up with the changes happening around you and within you.

The lifestyle you’ve been living no longer fits.  The specific people and routines you’ve known forever no longer align with your values.  So you cherish all the memories, but find yourself letting go and moving on.

If you’re currently dealing with this process you may feel a bit awkward, and that’s OK.  This feeling is normal.  I’ve been right there with you on more occasions than I can count.

Reasons to Let Go and Move On

  1. Someone’s negativity is rubbing off on you. – You are the average of the people you spend the most time with.  In other words, who you spend your time with has a great impact on the person you are and the person you become.  If you are around cynical and negative people all the time, you will become cynical and negative.
  2. You have grown apart from someone. – Sad but true, no matter what you do or how much you explain yourself, some people will gradually evolve away from your core values.  As time goes on they will prove over and over again that they are committed to misunderstanding you and clashing with your needs.
  3. You are truly unhappy with your current circumstances. – It’s always better to be struggling at something you love than succeeding diligently at something you despise.  (Read Quitter.)
  4. Your goals and needs have changed. – What was right for you then is not necessarily right for you now.  Sometimes the hardest part isn’t letting go but rather realizing that you have changed, and then learning to start over with your new truth.
  5. Fear is holding you back. – Part of letting go and moving on is facing the fears and disappointments of the past that are binding your spirit.
  6. You catch yourself living in the past. – If all you do is attempt to relive something that has already happened, you’re missing out.  The mental space you create by letting go of things that are already behind you gives you the ability to fill the space with something fresh and fun.
  7. An old grudge is still hurting you. – Holding on to the weight of anger, resentment and hatred will not only hold you back, but also block your present blessings and opportunities.  You’ve just got to drop some things to move forward.
  8. You aren’t learning anything new. – Living is learning.  All positive change is the end result of learning.  If you aren’t learning, you’re simply dying slowly.

One Small Example of Letting Go

We had been friends since grade school when I finally told one of my childhood friends, “Enough is enough!”  Although we had basically grown up together, we were now on different planets when it came to our goals and dreams.  He believed there was one right way to do things – go to college, get a degree, get a job, and dedicate every waking moment of your life to it.  I had other plans.

Although I did get my degree and a job after college, in our free time Angel and I started writing articles on the blog you’re reading now.  As the blog’s reach grew, my friend discredited our success.  Whenever I shared one of our small success stories, he would say something negative like, “Whatever.  It’s just a blog.  I have one too.”

When Angel quit her job to work on the blog full-time, my friend basically told me we’d fail.  “That’s ridiculous!  Angel had a good job,” he said.  “You’re just playing with fire in this economy if you ask me.”  To which I replied, “I’m not asking you.”

That was the beginning of the end of our story as friends.  Years later, our relationship is now a mere shadow of what it was and my life is honestly far brighter for it.  Letting my friend go wasn’t easy, but it was necessary for my own well-being and growth.

Ways to Let Go and Move On

Holding on is like believing that there’s only a past; letting go and moving on is knowing in your heart that there’s a bright future ahead.  Let’s take a look at eight ways to design the latter.

  1. Accept the truth and be thankful. – To let go is to be thankful for the experiences that made you laugh, made you cry, and helped you learn and grow.  It’s the acceptance of everything you have, everything you once had, and the possibilities that lie ahead.  It’s all about finding the strength to embrace life’s changes, to trust your intuition, to learn as you go, to realize that every experience has value, and to continue taking positive steps forward.  (This process is something Angel and I discuss in the Adversity chapter of 1,000 Little Things Happy, Successful People Do Differently.)
  2. Distance yourself for a while. – Sometimes you need to take several steps back in order to gain clarity on a situation.  The best way to do this is to simply take a break and explore something else for a while.  Why?  So you can return to where you started and see things with a new set of eyes.  And the people there may see you differently too.  Returning where you started is entirely different from never leaving.
  3. Focus only on what can be changed. – Realize that not everything in life is meant to be modified or perfectly understood.  Live, let go, learn what you can and don’t waste energy worrying about the things you can’t change.  Focus exclusively on what you can change, and if you can’t change something you don’t like, change the way you think about it.  Review your options and then re-frame what you don’t like into a starting point for achieving something better.
  4. Claim ownership and full control of your life. – No one else is responsible for you.  You are in full control of your life so long as you claim it and own it.  Through the grapevine, you may have learned that you should blame your parents, your teachers, your mentors, the education system, the government, etc., but never to blame yourself.  Right?  It’s never, ever your fault… WRONG!  It’s always your fault, because if you want to change, if you want to let go and move on with your life, you’re the only person who can make it happen.
  5. Focus inward. – It’s important to make a difference in the world.  Yes, it’s important to help people, but you have to start with yourself.  If you’re looking outside yourself to find where you fit in or how you can create an impact, stop and look inside yourself instead.  Review who you already are, the lifestyle you’re currently living, and what makes you feel alive.  Then nurture these things and make positive adjustments until your current life can no longer contain them, forcing you to grow and move beyond your current circumstances.
  6. Change the people around you. – Some people come into your life just to strengthen you, so you can move on without them.  They are supposed to be part of your memory, not your destiny.  The bottom line is that when you have to start compromising your happiness and your potential for the people around you, it’s time to change the people around you.  It’s time to join local meet-ups, attend conferences, network online, and find a more supportive tribe.
  7. Take a chance. – When life sets you up with a challenge, there’s a reason for it; it’s meant to test your courage and willingness to make a change and take a chance on something new.  There’s no point in denying that things are different now, or being fearful of the next step.  The challenge will not wait even if you hesitate.  Life only moves in one direction – forward.  This challenge is your chance to let go of the old and make way for the new.  Your destiny awaits your decision.  (Read The Untethered Soul.)
  8. Focus on today. – You can decide right now that negative experiences from your past will not predict your future.  Figure out what the next positive step is, no matter how small or difficult, and take it.  Ultimately, the only thing you can ever really do is to keep moving forward.  Take that leap without hesitation, without looking back.  Simply forget the past, look straight ahead and forge toward the future.

The floor is yours…

What are you holding on to that’s holding you back?  What’s the first step you need to take to let it go?  Share your thoughts with us by leaving a comment above.


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Posted in Recovery

After More Than A Year……


Well it has been a little while since I wrote and since then I have had a few things happen in my life. I had to get a hotel room for a week because where I was staying at she had family come in town for a while. So I went back out to the Pike! The place that I stayed in was the old Treasure Coast Inn, which was closed by the State for all the activities that went on there. You know drugs, prostitution, pimps, johns & truckers! This area in Fort Pierce Florida seems to bring it all in.

I choose this place because of the cost was with in my rage and they completely remodeled it and I must say did a great job of cleaning it up. No more of the same old that use to be there.

The Pike activities still going on just different girls and has sifted over to other hotels. The place I was staying at has zero tolerance for it and you will get a visit to your door and one hour to get your stuff out. This is what I heard from the staff there. They have change the name from Treasure Coast Inn to, 3 Palms Hotel.

Well the week I was out at the Pike gave me the chance to meet up with some people who I knew from out there. One was Granny which is a friend and I am always glad to see, and the other was a dude that we all call Peanut! I keep in contact with Granny, she is good people and just in a hard spot right now in her journey. If I had the funds right now she would not be out there now.

Dunkin Donuts

I one day decided to take a walk around and went to the Mobile gas station were the Dunkin Donuts is with the tables out front were people gather. While I was there this is when I meet up with Peanut. He ask me, “were the hell have I been at in jail or what,” since he has not seen me for long. I told him, “that I have been out in Texas for a while.” He then said, “hell it has been a while that Angel Face has had a baby and the State took it away from her.”

He then went on to say, “Robert you was the best thing for her out here!” I was surprise that he told me that and it kinda made my day. We started to talk more about her and then I said, “ no disrespect, I really don’t want to talk about her it is her battle and all what I can do is encourage her if this is what she wants!” And as soon as I said that, Peanut said, “load and behold, speaking of the devil look who just pulled up!”

I look up and there was this big white rig pulling in and I saw Angel Face in the passenger side of the truck! I told Peanut, “ I am out of here, for as much as would love to see her I do not want to be around her as long as she is with him.” What I mean by this is I knew things were rough and heard no good news and I did not want to be in any way apart too it! So I got up and walk away as doing so Peanut said “too late she already seen you!” I still walk away, and it was very hard for me to do but I did.

I saw Granny later on and she told me that Angel Face was in town and that she saw me. Well I did ask her for more details and she really did not have any, but said that she will be back around and that she was happy to see me.

Well that was earlier in the week now it is the fourth of July and as I was walking from the B.P. Truck Station, I saw this big white rig pull up about 20 feet away from me as I was walking back to the 3 Palms Hotel. I looked up and once again I saw Angel Face closer this time waving and smiling at me as they were pulling up. It was early fireworks! I went around the backside and still kept walking towards the hotel, and then he started his rig and pulled out in front of me and hopped out.

He ask me, “are you Robert?” And I said “no!” He said, “you are Robert,” and I said, “you don’t know me and I don’t know you!” He then went on to say, “ I don’t like the pictures you have of my wife on the Internet!” At that I responded, “what the hell are you talking about?” He then shout out to her to come out of the truck. He was very angry and aggressive and also scared at the same time. He felt as if he had to prove something to her. He pick up some stones while doing this my face had a big smile on it and he thought I was smiling at him but in reality, I was smiling at my friend Angel Face, which at this time was out of the truck and screaming at him to leave me alone and to get back into the truck.

At that moment I fully understood that the bond that I have with Angel Face is still there and this is what he fears in many ways which is sad. Everything and every time when this man is around it is just bad news and I am sure my friend can do much better than him and she has but she don’t quit see it I guess, or maybe she does?

For that brief moment, all the feelings towards this young lady came back, in fact they never really did leave just the high of the moment was out of this world! This man may control my friend with drugs, but I will be damn if he can control me in any way. She is worth it to me and he just wants me to forget about her. All what I can say about this is, “that dog ain’t gonna hunt!”

I will keep loving her even long after my heart stop beating, this is just how I am wired and what I am made of. So as I write you this post today I am still feeling the high from that moment and will carry it over to this cause, this Foundation that I have named after my friend. Yes life is a cycle and after more than a year since I heard from her this was heaven for me and still this day I do thank God for bringing her into my life, even for only a moment.

You can add your comments if you wish, Peace towards your journey :-)


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Posted in Love
Today is the present.
July 2014
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Robert Christopher Mergupis


Robert Christopher Mergupis

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