doc martens mary janes Pain patients worry that opioid crisis could restrict availability
KRISTEN: DR. KRISTEN: OUTCOMES DR. HEVERN
“We were pouring it with a coal chute,” he said. “It was 16 feet long, and I went to lift it up and step up, and when I did, I ruptured two discs in my back.”
The injury severed the man’s nerves to his right leg, leaving minimal feeling. After he went through several unsuccessful surgeries, he was put on painkillers that he said didn’t work.
“I was in bed for almost 22 years. and I would get up to do the minimal daily activities bathroom and get a drink of water and then it was back into bed,” he said. “I could barely move.”
His pain is now being managed with opioids such as methadone and oxycodone at Elliot Hospital in Manchester. He said he can now walk with a cane.
“If you use the right medicine with the right dose, you get outcomes that are profound for the individual,” Dr. Gerard Hevern said.
Hevern treats chronic pain syndrome, which he said affects about 11 percent of the adult population.
“Chronic pain syndrome is actually a disease process, and when it persists beyond three months, lives get changed,” he said.
Hevern said that over the past few years, he has seen an increase in referrals from physicians who are unwilling to prescribe even minimal doses of opioids.
New guidelines were put in place in response to the state’s crisis in 2016 for physicians who prescribe the drugs. Under those rules, doctors can only prescribe opioids that are the equivalent of 100 milligrams of morphine daily.
“Trying to ratchet down just the prescription of opioid medication is doing an injustice to many of these people, because many of them have gotten tremendous value and actually have functional outcomes,” Hevern saud.
Hevern said he uses the guidelines in a modified manner but does not set opioid limits. He said he prescribes as the situation demands and slowly weans stable patients down to lower levels, something he said he has been successful doing over the past few years.
Hevern said he also prescribes opioid alternatives when possible.
Another patient who said she was bed bound after suffering herniated discs said she can now live a normal life with the use of a Butrans patch, which delivers a mixed opioid that has low risk for abuse.
“I put it on once a week and forget about it,” she said. “You don’t have to think about it, and you can literally function. I have a function of life.”