New Solutions Being Developed to Help Patients Avoid Opioid Prescriptions

Pain Doctor Tim Deer on WCHS ABC 8

Original article by WCHS ABC 8 News

CHARLESTON, W.Va. (WCHS) — The more we learn about addiction and the effect opioids have on the brain, the more people are starting to shy away from taking them when given the option.

Shasta Bell has been in long-term recovery for 10 years from drug addiction. When she had to get knee surgery, doctors informed her opioids were an option for pain relief afterwards. Worried she would fall into addiction again, she opted for a nerve blocker instead.

She said she believes if she’d taken the opioids she would have slipped back into active addiction.

“I wouldn’t be sitting here,” Bell said. “I think I would have went back out and used. I’d be in active addiction, there’s no doubt in my mind that’s what would have happened.”

Patients aren’t the only ones hesitant when it comes to prescription opioids. Doctors are now offering alternative options, including cutting-edge procedures.

Dr. Barry Mitchell said sometimes prescribing an opioid is like sending a patient down a road to the unknown.

“Is the pain that I’m treating real or can they manage without that opioid?” he said. “What are they doing when they leave there? Are they selling it or giving it away or are they abusing it in some other fashion?”

When he first started his career 16 years ago, things were different.

“We were a little more cavalier with our prescribing practices, quite honestly,” Mitchell said. “In the ED, we treated pain because it was considered a vital sign.”

But there was a shift as studies on opioid addiction grew along with the number of those he knew who battled it.

“I’ve had friends and family die of overdoses,” Mitchell said. “My father died of a methadone overdose 12 years ago. I’ve been touched as well as anybody has.”

Now, the opioid epidemic has changed the way doctors think and prescribe.

“What we’ve seen in the last six or seven years, we worked with WVU and the CDC and developed guidelines on things you should do before you go on opioids, and those were published and adopted by the state medical association,” Spine and Nerve Center of the Virginias President Tim Deer said. “I think we’ve seen a mark in a reduction in opioid prescribing, overdose deaths and diversion.”

The road that once offered two options for pain treatment now offers another avenue.

“Giving you a choice somewhere between an opioid, which isn’t a great idea for anyone, or a large very invasive surgery,” Deer said. “That’s been the biggest change.”

Deer and his crew now offer cutting-edge treatments to get people away from opioids.

“New software for the brain, virtual reality integration and we are looking at more and more ways to do things that use to be done by large surgeries to change spinal disease,” Deer said. “Through an incision of an inch or less.”

In Huntington — what was once ground zero for the epidemic — the Cabell-Huntington Pain Management Clinic is also offering alternatives. Dr. Ghassan Moufarrege’s motto is “motion is medicine.”

“I see a lot of patients that come to me with terrible pain – like back pain — but have never been to physical therapy,” he said. “That’s not good.”

Moufarrege first suggests patients try things like massages, yoga and acupuncture.

“They have surgery, and you put them on opioids for a couple weeks, and that’s it,” he said. “Once they see how the medicine makes them feel, they become addicted. Some people hate it.”

Many doctors rely on a moral compass to steer their patients along the proper path.

“There’s always this moral pull one way or another,” Mitchell said. “I don’t want to give that drug because I don’t want to create another problem, but I don’t want to withhold that drug either because I know they’re going to be miserable without it.”

But with new treatments on the horizon, the path ahead looks a little less bumpy.

“An alternative to opioids is something that we’re fighting for, but our toolbox is sort of limited and we need some new tools, and that’s what we hope to get within the next few years,” Mitchell said.

There are certain situations, like if you experience an intense trauma or end of life care, where prescribing opioids may be the only option.