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  • Dr. J.I. Madubata

Pain Management Journey During Opioid Epidemic

Updated: Apr 23, 2023

I thought extremely hard about what topic to write for my first blog. I had several ideas going through my mind. I felt that the topic I chose should resonate with me. Since people live with pain daily, I decided to write about pain and pain management in the age of the opioid epidemic. When my friend started having pain in her shoulder in her late forties, she did not know it would progress as the years passed. Instead of the pain decreasing, it increased in intensity as time passed. I never knew that pain management was challenging.

Her pain started during her last graduate program. She self-medicated with over-the-counter medications (Tylenol and Ibuprofen), which did not relieve the pain. The first physician she saw blamed the pain on many hours of studying in front of computers. Her doctor prescribed several opioid medications (Percocet, Tylenol #3, Vicodin, Naproxen, Tramadol, etc.) as needed over some time. She reacted to the drugs badly, and she did not retake them. The only medication that she tolerated was Darvocet. She used Darvocet until it was banned in 2010 in the United States.

What can one do when the only pain medication you are not allergic to is discontinued? She continued taking over-the-counter pain medication for several years until she met her current doctor. She said that this doctor was the best doctor she had ever seen. The first thing the doctor did was do diagnostic tests. The reason for her pain was muscle tears on her upper back and upper arm. At least there was a reason for her problem. She has no idea how she sustained muscle tears. She received muscle relaxants, non-steroidal anti-inflammatory Drugs (NSAIDs), and Physical Therapy.

Over the years, she had several sessions of Physical Therapy, Acupuncture, and Chiropractic medicine. She even had significant surgeries to reduce the pain. When her doctor referred her to a pain specialist the first time, the doctor increased her muscle relaxant and suggested surgery. She declined surgery. Taking muscle relaxants as prescribed is difficult when you are a full-time employee. The medication makes you sleepy and tired. Due to her ongoing complaint of pain despite her pain treatment, her doctor sent her to another pain expert. The referral to her new pain doctor was during the opioid epidemic.

She discovered that even pain specialists fear prescribing pain medications since the federal bank of opioid prescribers is tracking them. Her new pain doctor only prescribed adjuvant medications. These are medications that were initially manufactured for depression, seizures, etc. The adjuvant medications did not work for her. She had new diagnostic tests this year due to severe pain. The results showed progressive muscle tears, which resulted in increased pain. Her new orthopedic doctor was the first to tell her that her muscle tears would not heal but would increase in size. The information means that she would continue to live with pain indefinitely. What is one’s quality of life with pain?

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