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The following article was published in Your Health Magazine. Our mission is to empower people to live healthier.
Netsere Tesfayohannes, MD, ABA, ABAP
Pain Killers and the New National Epidemic
Georgetown Pain Management
. http://gtpain.com/

Pain Killers and the New National Epidemic

Pain Killers and the New National Epidemic

According to the Centers for Disease Control (CDC), prescription drug abuse is agrowingnational epidemic. The treatment of chronic pain, therapeuticopioiduse andabuse, and thenon-medical use of prescription drugs have been topics of intense focusand debate. Addiction, overdoses and deaths involving non-medical prescription drug use, especially narcotic pain relievers, have risen dramatically over the last decade.

In addition to human cost, theepidemic has significant national financial implication costing about 70 billion dollars a year. In 2008, the most recent year in which data has been analyzed, more than 36,000 people died from drug overdoses, and 20,000 cases were involved with prescription drugs. Drug-related poisonings are now the leading cause of death due to unintentional injuries in the United States, having surpassed motor vehicle accidents in 2009.

These classes of drugs have a very highstreet value and diversion by means of sharing among friends and family, doctor shopping, prescription fraud, and theft. Another disturbing pattern that has been reported in various states in those whobecome dependent has seen aswitch to heroin use due to its low cost, and ease of availability.

In the United States,although we represent only 4.6% of the world’s population, we have been consuming 80% of the global opioid supply, and 99% of the global hydrocodone (brand name Vicodin) supply. The rise in prescription narcotic pain killer use, misuse, and addiction in part can be traced to a rise in availability of the drugs, a result of increased prescribing.

The increased prescribing in turn has been driven by more aggressive treatment of pain in response to liberalization of laws governing opioid prescribing for the treatment of chronic non-cancer pain by state medical boards in the late 1990s, rise of patient advocacy groups, and theintroduction of new pain management standards implemented by the JointCommission on Accreditation of Healthcare Organizations (JCAHO) in 2000. The development of new formulation of opiate pain killers to meet the market demand, and aggressive marketing of narcotic pain killers by pharmaceutical companies have alsocontributed to the overall problem.

While the medical, social, and legal implication of treatment with narcotic pain killers is evident, we should not forget that patients who suffer from chronic intractable pain have a legitimate medical need for treatment with opioid pain killers. More often, patients who would benefit from minimally invasivetherapeutic intervention do not get the proper referral to an interventional pain management specialist, favoring insteadreferralto practitioners who favor treatment with high dose narcotic pain killers orinvasive surgeries.

Our clinic specializes in interventional pain management techniques,referral to physical therapy, and strictmanagement of pain medications in order to avoid the problem of excessive dependence or addiction. Although not all, the majority of pain syndromes are amenable to interventional pain management techniques that utilize state-of-the-art precision fluoroscopic guided interventions ranging from nerve blocks to implantable devices to control acute debilitating andchronic intractablepain.

Back/Neck Pain

By far the most prevalent pain complaint, 70-85% of all people have back pain with an annual prevalence rate of 15-45%. It is number two reason for doctor visits and work absenteeism with significant economic implication.

Patients who have chronic back pain due to problems such as herniated discs, spinal stenosis or arthritis are surprised to discover the many non-surgical options available to treat their pain.

Carefully tailored medical management,and physical therapy are sometimes enough to address the pain. If conservative approach fails, then the patients will be offered the latest treatments available lumbar transforaminal epidural steroid injection, facet nerve blocks and radiofrequency ablation, minimally invasive disc decompression, spinal cord stimulator, and intra spinal drug delivery system.

Headache

Depending on the type of headache (most often Cervicogenic), a variety of neuroblock techniques, radiofrequency ablation, or stimulators can be used to help treat the headache.

Complex Regional Pain Syndrome (CRPS)

The condition is characterized by severe, chronic pain usually following an injury (can be very minor) or surgery. The resulting pain is usually out of proportion to the original injury or illness.

Using the latest technology, Georgetown Pain Management is in a position to treat this debilitating condition.

Shingles

This painful rash, caused by the herpes zoster (chickenpox) virus most likely resolves in its own the majority of the time. In some cases, the pain continues long after the rash has disappeared, a condition known as postherpetic neurolgia.

This painful condition needs to be treated aggressively as soon as possible, before it becomes permanentintractable pain.

ChronicPelvic Pain

Non-menstrual pelvic pain of more than three months duration sever enough to cause functional disability. It is often described deep-seated, aching pain that often interferes with sleep and work, leads to urinary urgency and frequency causes pain with sex and/or urination. Although majority of the patients affected with this condition are women, males can be affected too (chronic prostatitis). Endometriosis, interstitial cystitis,irritablebowel syndrome, seems to be common sources of diagnosis for chronic pelvic pain.

Abdominal Pain

While often the cause of abdominal pain is known and surgical and medical treatments can help treat the pain, in some instances despite an extensive work-up, the cause of the pain may not be clear. Whether the cause is known or unknown, interventional techniquesexist to help manage chronic abdominal pain. The most frequent causes of abdominal pain our clinic manage is abdominal pain caused by chronic pancreatitis, and irritable bowel syndrome.

Making accurate diagnosis for chronic pelvic and abdominal pain is very challenging as many other causes can be at play, including vascular, neurologic, spinal issues, or no obvious cause all together.

Pain Associated With Osteoporosis and Compression Fracture

Literally meaning “porous bone,” osteoporosis occurs with age as bones become thinner and weaker. It strikes women more often than men and the frail are at special risk.

If left untreated, the pain can last up to three months and beyond, and can interfere with standing, walking, or even taking deep breath increasing the risk for potential medical complications. Georgetown Pain Management offers a procedure called Kyphoplasty. The procedure is a minimally invasive, same day procedure with usual immediate results. The procedure can also help patients who sustain vertebral compression fracture due to cancer.

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