Posted on June 11, 2019
“I’m addicted to pain killers but need them for pain. I want off them but don’t want to live in pain. What can I do?”
At Advanced Pain Management & Spine Specialists, a new patient finds a fairly rigorous screening process for a first visit. We do this so we are primarily welcoming individuals we can truly help. We also do this to eliminate people essentially in search of drugs.
In southwest Florida, many are surprised that the opioid epidemic runs so rampant. After all, this is supposed to be a high-retirement area seemingly removed from “big city” problems.
Yet, in the state of Florida, 11 people die a day, on average, from prescription medications such as Oxycontin, Oxycodone, Vicodin, and morphine. This statistic rose nearly 6 percent from 2016 to 2017, with the number of teenage deaths skyrocketing. (https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/florida-opioid-summary)
These drugs can be as addictive and deadly as heroin. Appropriately so, the U.S. has implemented careful regulation of prescription distribution of these medications.
Sadly, there remain doctors who freely write opioid prescriptions, which do nothing to “treat” an individual; they simply dull the pain. A legitimate Pain Management practice will perform a thorough examination of each patient, carefully review prior diagnostic tests and order updated tests if needed, review medical history, and determine medical necessity before prescribing these drugs.
Our goal is to see only those patients who wish to live an active life with minimal (or no) need for these harsh and deadly drugs. Although we DO prescribe these medications, we strive to help patients achieve comfort while moving them to a non-medicated life (or “need only” usage).
However, some patients need an opioid level of pain relief as they begin treatment, which may require weeks to experience full results. Additionally, for cancer pain or chronic pain that can only be lessened, pain may simply need to be managed with medications.
Opioids aren’t necessarily the enemy. It is in the distribution and patient monitoring where the problem often begins. Because opioids can be highly addictive, they are best used for short terms. After all, addressing pain shouldn’t mean merely “masking” it.
But what if you are already dependent on these drugs when you arrive?
For patients who arrive at our Fort Myers office already addicted, we are structured to help those who desire a better way of life. We find that most people dislike the groggy, spaced-out feeling they get from these meds.
In our Lee County pain management office, we often work with patients to “taper down” their dependency while maintaining a desired level of comfort. We do this through the use of a safer, yet highly effective, prescription medication – buprenorphine. The drug provides pain relief in an 8-12-hour dosing schedule with a far less addictive nature than opioids.
A few years ago, I led a study involving patients in need of opioid therapy (or who were already chemically dependent on opioids), using this new pain medication. During the study, we monitored 35 patients who were previously on high-dose opioid therapy and converted them to buprenorphine film (suboxone). (https://www.ncbi.nlm.nih.gov/pubmed/25220043/)
The study’s patients were monitored for two months through “pain scores.” All but one of the patients experienced a significant decrease in pain while reporting a notable increase in “quality of life.”
I followed this study with another, tracking over 100 patients who were converted from high-dose opioid to buprenorphine. These patients had either built up a tolerance to opioid medications or were experiencing undesirable side effects.
By tapering the study’s participants down from high doses of opioids and moving them to the low dose, less problematic buprenorphine, these patients, too, experienced significant decreases in pain of 50% or more. (https://www.ncbi.nlm.nih.gov/pubmed/22786462/)
Buprenorphine comes in many forms. It can be a film, tablet, or a small dot of “film” that is held against the inside of the cheek for several seconds. The medication is quickly absorbed and begins to work at a faster pace than pills that are swallowed. It even comes as a patch in much lower dosages.
The benefits are (1) most patients need this pain medication only every 8-12 hours; (2) the addictive/dependency nature of the medication is far less likely; (3) pain relief is experienced at desirable levels; (4) side effects are minimal; and, (5) patients do not have the “spaced out” feelings that are often associated with opioids.
According to a 2018 statement by the CDC, “Buprenorphine doses are not expected to be associated with overdose risk in the same dose-dependent manner” as opioids. Essentially, this means buprenorphine provides a safer, yet effective, alternative to opioid therapy.
No one wants a life of pain that is limiting and debilitating. We believe our patients can achieve this through our advanced pain management technology and techniques. When medications are needed to achieve a desirable level of comfort, we have seen many people experience positive results by converting them to buprenorphine.
If you have become dependent on opioids, developed a tolerance to them, or want to avoid them, let’s sit down together to discuss regaining your comfort and, most importantly, your life! Call 239-437-8000 to begin the new patient process.