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Dealing with pain, avoiding opioids

This article originally appeared in the Richmond Times-Dispatch. 

BY KATIE DEMERIA Richmond Times-Dispatch

What to many is known as the opioid epidemic raging through most of the country is, to some, considered a chronic pain epidemic.

While illicit drugs like heroin are a major problem, what is becoming an even bigger issue is the improper use of prescription opioids, such as percocet or oxycontin.

An estimated 2.1 million people in the U.S. were dealing with substance use disorders related to prescription opioids in 2012, according to the National Institute of Drug Abuse, which is part of the National Institutes of Health.

Comparatively, an estimated 467,000 people were dealing with heroin addictions in 2012.

On its website, the National Institute of Drug Abuse cites three reasons why prescription opioid use is skyrocketing, including, “drastic increases in the number of prescriptions written and dispensed, greater social acceptability for using medications for different purposes, and aggressive marketing by pharmaceutical companies.”

Drug abuse is a multifaceted problem caused by various factors depending on each individual’s situation. But it seems one way to help stifle the growing problem is to change the way opioids are prescribed and then used by patients.

That was one of the reasons why Museum District resident Maribeth Hart was seeking alternatives to opioid drugs while trying to manage her chronic pain.

Hart has arthritis in both knees and said she was in “significant, terrible pain.”

Under the care of her doctors she tried various treatments, including steroid injections, which is a typical treatment for arthritis patients, but nothing was improving her pain. She was around 50 years old when she was diagnosed.

“The only other option was actually a knee replacement, and I thought I was too young to have a knee replacement, and it was very depressing, because my quality of life was that I couldn’t do simple things like get up from the sitting position or go upstairs,” she said.

But Hart was actually given another option for her chronic pain when she met with Dr. Michael DePalma of Virginia iSpine Physicians, who introduced her to a fairly new treatment option called coolief.

Coolief is a minimally invasive procedure that targets the sensory nerve supply in the knee and essentially makes those nerves dysfunctional, so the sensory nerve cannot send pain signals to the central nervous system.

“So carrying that one step forward, if someone is concerned about taking an opioid on an ongoing basis, then this would be a very reasonable procedure that could alleviate their knee pain,” DePalma said.

The procedure requires a careful examination of the pain, DePalma explained, to ensure the knee pain is stable and is not on track to improve naturally.

It is not the first option patients should go for, he added, because sometimes steroid injections, noninflammatory medications or therapy might help with pain, as well.

But it could be an alternative to an opioid prescription — at least for those with knee pain. Hart said her insurance covered most of the procedure, other than a copay, and it was done on an outpatient basis.

Coolief, though, only lasts for about two years or so. Eventually, the nerves may grow back. But for Hart, getting the procedure done again is preferable to relying on high-potency pain medications.

“I just really want people to know that they have an option (to cope with chronic pain),” she said. “There’s nothing to lose.”

This article originally appeared in the Richmond Times-Dispatch.