The multidisciplinary treatment team will review the client’s progress regularly and staff will report progress

to the
workman’s compensation case manager. Our clinicians will set up treatment goals, which are regularly reviewed in these
Pain Recovery at Las Vegas Recovery Center
multidisciplinary staff meetings. Return to work may be one of the goals of the treatment plan if feasible. We will address
any fears or uncertainty about returning to work in coordination with the case manager. Discharge planning is crucial in
the early stages of treatment. The multidisciplinary treatment team will facilitate appropriate levels of care upon discharge.
Referrals will be made to applicable service providers upon discharge. We will consult with the case manager about this
process prior to completion.

Family Renewal Program We have found that chronic

pain like addiction needs to be addressed with family as well as the client.
LVRC provides a monthly Family Renewal Program designed to educate
and provide tools for the family to begin their own process of recovery. We

also provide a weekly support group to provide identification and support
for the family to find freedom from enabling and codependency. LVRC
recognizes family involvement as critical for successful outcomes. Our staff
will do everything we can to ensure that family members participate in this
important program.
Las Vegas Recovery Center is a private, free-standing, chemical dependency and chronic pain facility licensed by the
State of Nevada and accredited by The Joint Commission. The facility was established in 2003 and is dedicated to providing
a complete continuum of care to clients and their families in a beautiful, confidential, and secure environment.
L
as Vegas Recovery Center (LVRC) provides services for those suffering from chronic pain and abuse/dependence
on drugs. Approximately 50 million Americans—one in six people—suffer from chronic pain. Nationwide,
chronic pain causes more disability than cancer and heart disease combined and costs $550 million annually in
lost workdays and $20 billion overall. The costs of pain are not reserved for the individual; families suffer as well. There are
numerous pharmacological and non-pharmacological treatments for chronic pain; however there is no “one-size-fits all”
course of treatment. Las Vegas Recovery Center is providing a solution to this complex situation through our unique and
comprehensive opioid-free Chronic Pain Rehabilitation Program.
Pain Management vs. Pain Recovery

LVRC Chronic Pain Rehabilitation Staff
Frank Szabo LADC, Senior Vice President of Clinical Services
Mel Pohl MD, FASAM, Medical Director
Lori Konopa-Berbano, RN, Director of Nursing
Dan Shiode, Ph.D., Clinical Psychologist
Stephanie Jordan, OMD, PsyD, Acupuncturist
Susan Rocchio, LMT, Massage Therapist
Rich Bakir, DC, Chiropractor
Monica Serna, RD, Consulting Dietician
A
widely accepted course of pain management treatment is opioid pain medication. Painkillers can be quite
effective in diminishing pain, but for some, there is a risk of developing chemical dependency. Over time, with
some patients, the amount of opioid pain medication is increased with initial pain relief, but not prolonged pain
resolution. With these people, the dose continues to escalate with continued unrelenting pain and decreasing function.
Our program will safely detoxify someone from his/her opioids and other habit-forming medications and then begin to
treat his/her physical and emotional pain that usually accompanies years of suffering. Our multidisciplinary team will
review a potential pain client candidate to determine if we are the appropriate facility for that client.
LVRC is proud to introduce the concept of pain recovery, which reduces the physical symptoms of pain and teaches clients
how to eliminate emotional suffering.

Robert Hunter, Ph.D., Clinical Psychologist Scott Pensivy, PT, ATC, Physical Therapist

John Lanzillotta, PA-C Counselors, nurses, Yoga instructor, Chi Kung instructor, and
consulting psychiatrist.

For more information about our chronic pain program or any of the other programs we offer, please
call to speak with an admissions specialist at 702-515-1374.
 Pain Recovery B. (cont.) inability to limit intake, compulsive use, and continued use despite significant harm to family, job, emotional
well-being, and health. These clients may be acquiring medications from multiple sources, legal and illegal.
Pain Recovery Medically Managed Withdrawal (Detoxification) LVRC treats
complicated drug dependencies in this program. The withdrawal process is medically managed under the supervision of When we work with a client and his/her family prior to admission, it is important to clearly explain the nature of
the medical director, physician assistant, and nursing staff. the treatment program. This is communicated verbally and information is also sent usually via email. We encourage the
client and family to review these documents and ask any questions they may have prior to admission. A member of our
During this part of treatment, clients are emotionally supported and their physical symptoms are minimized whenever medical staff will interview the potential client by phone as part of a pre-admission pain assessment. We will NEVER tell
possible with the support of medication. Certain substances can cause significant and difficult withdrawal symptoms. Las a potential client that we can take away his/her pain. We explain that the goals of our program are to reduce pain and
Vegas Recovery Center is one of the few residential facilities, nationwide, that has a license to dispense methadone as part improve function. It is important to understand that we will not force someone to identify as an addict.
of the withdrawal process.
We are experienced in detoxification from high doses of methadone (>100mg/day), which we have found responds Through the process of treatment, pain clients may ultimately find that
best to relatively rapid weaning off methadone (10–40mg per day as tolerated). We also have the ability to prescribe their thoughts, feelings, emotions, and behaviors are similar to those of
an addict. Those in category A may be resistant to chemical dependency Addiction is a chronic, relapsing
buprenorphine (Subutex) to ease the symptoms of withdrawal. We use opioids only through the detoxification phase—
groups, assignments, and twelve-step meetings, but these groups are brain disease characterized by compulsive
everyone who enters our pain rehabilitation program is free of opioids and other mood-altering habit-forming drugs
mandatory and will address many relevant issues for these clients. We drug seeking and use, despite harmful
including, sedatives, hypnotics, stimulants, and alcohol.
expose our pain clients to a variety of ideas to help them better understand consequences. In fact, a person could
have addiction without yet developing
Chronic Pain Rehabilitation The focus of Las Vegas Recovery Center’s Chronic Pain themselves. We also understand this topic can become a focal point for
tolerance or dependence. Addiction
Rehabilitation Program is to reduce pain and increase function thus improving the quality of life—all without opioid some, and we aim to tailor each program to maximize the clients’ willing
participation and reduce distractions. We will help them see that medicating is best diagnosed by observing drug-
pain medication. This is a four-week inpatient functional restoration program, which begins after medically managed using behavior over a period of time—
withdrawal is complete. feelings does not instantly give them a diagnosis of addiction, though they
often do meet DSM-IV criteria for substance dependence. until then, we can conclude that there
Program includes • Acupuncture (weekly)
is “problematic use,” which may end
• Functional Evaluation • Yoga (weekly) In our experience, clients who have depended on opioid medications up evolving into addiction.
• Psychosocial History • Reiki (weekly) for years, associated with a work-related injury, are often reluctant to give
• Physical Therapy (8 sessions) • Massage Therapy (weekly) up the only thing in their lives that seems to help. Educational efforts start Drug dependence (a synonym
• Interferential Device: nerve and muscle • Exercise and stretching groups prior to admission to help the client and family understand the principles of for addiction) is really a syndrome of
stimulation (as indicated) (daily) opioid-induced hyperalgesia and chronic withdrawal in patients on opioids. behaviors involving continued problem-
• Biofeedback (as indicated) • Intense individual and group The milieu provides a community environment where some of the clients atic use of mood-altering substances over
• Chiropractic (primary assessment followed by counseling regarding pain, have had similar experiences and expectations, but have some measure of a continuous period of time. Symptoms
visits 3 times per week) medication dependence, and the improvement over the course of their stay at Las Vegas Recovery Center. include problems with controlling use,
• Pilates (as indicated) addiction-pain syndrome This enables a new client to compare and contrast his/her experience and thus having an unpredictable outcome
to positively project a future without medications. once they begin using a substance. Fur-
At Las Vegas Recovery Center, we typically see clients with identifiable pain generators such as musculoskeletal pain, thermore, addicts try to cut down or
fibromyalgia, complex regional pain syndrome, Crohn’s Disease, headaches, back and neck pain, with and without disc Disabled clients present a unique set of stop, but are unable to “stay stopped.”
disease, residual post-surgical pain, and many other conditions associated with chronic pain. Typically, there are two challenges in treatment. Often these clients are They are preoccupied with the drug
types of chronic pain clients: adversarial, angry, and involved in litigation. Our and keep using it even though it causes
approach is even-handed—presenting that we problems for them and those who care
A. Those who are taking opioids and have become tolerant to the effects of their medications, but are using the medications are partners with the workman’s compensation for them. They don’t do the things they
as prescribed and display little in the way of addictive behaviors. Clients in this class will benefit from physical modalities company and will facilitate resolution of negative used to and “chase the high,” that is,
and learning about their emotional responses to pain, which increase suffering. They also benefit from withdrawal of feelings, which ironically, are actually causing more spend excessive time and energy get-
opioids with a reduced pain level due to the decrease of opioid-induced hyperalgesia.** In our program, these clients pain. Individuals respond to rewards, and it is our ting the drug and using it.
will have an opportunity to be in groups with others who have suffered similarly. The group support and milieu have clinical policy, through the use of well-utilized
proven invaluable in helping these clients change their attitudes and behaviors with respect to their chronic pain. cognitive behavioral therapy techniques, to help
the client reframe his/her experience of pain and suffering. Clients are rewarded for increased
B. Those with serious pain generators who clearly are taking excessive amounts of opioid analgesics and often other
function by each and every staff member in the center—very little attention is paid directly to the
addictive substances (benzodiazepines, sedative-hypnotics including carisopradol (Soma), stimulants, alcohol) and
pain complaints, though we grade pain three times a day using a traditional ten-point scale, as well
who demonstrate typical addictive behaviors. These behaviors include preoccupation with the drug, loss of control,
as the Pain Outcome Profile, which is administered weekly.
**Opioid-induced hyperalgesia occurs in a percentage of people on chronic opioids. It refers to increased pain caused by opioid medications. The proper
treatment of this condition is discontinuing opioids medications and treating residual pain with other modalities.