Area physicians, patients still see a place for opioids

Area physicians, patients still see a place for opioids

URBANA — Life with chronic pain started for Kristen Blanton with a back injury.

The pain persisted after surgery, then through years worth of one treatment she tried after another.

Then her doctor put her on a low-dose opioid medication that worked for her — and continues to work a decade later.

"That's the only thing that really gives me some semblance of a normal life, to where I can take care of myself and function," said Blanton, 44, of Danville.

While she's not having a problem with her own use of opioids, Blanton said many pain patients have found themselves ridiculed and stigmatized in the midst of a national opioid addiction epidemic.

"You get labeled an addict, a pill-seeker," Blanton said. "Some people don't speak to their families anymore because of it."

And many others with serious pain have had a tough time getting doctors to prescribe opioids at all — especially since the Centers for Disease Control and Prevention published new prescribing guidelines in 2016, Blanton said.

The guidelines were intended for primary-care doctors prescribing opioids such as Percocet, Vicodin and OxyContin for purposes other than active cancer, palliative care and end-of-life care. Among the recommendations are that preference be given to non-opioid solutions for patients in other categories and that opioids be prescribed in the lowest effective doses possible.

Blanton said the plight of pain patients being abruptly cut off from medication motivated her to join in a national movement called Don't Punish Pain, which will be conducting rallies today in Urbana and several other cities.

Blanton, a co-organizer of the Urbana rally, said America needs to distinguish between legitimate and illegal uses of opioid drugs.

Anyone could wind up in pain, she said.

"We're all just one serious illness or horrible car accident away from needing strong pain medication," Blanton said.

Her own pain began after she fell at work, tore a disc in her back and had spinal fusion surgery, Blanton said. After the surgery, she was left with chronic pain in her back and legs, and then tried years of acupuncture, water therapy, use of a spinal cord stimulator and spinal injections. She has since been diagnosed with the chronic pain disease fibromyalgia.

Blanton doesn't worry about becoming addicted to opioid medication. Her dosage is low, she sees a pain specialist once a month who monitors her carefully, and, she said, "this is what works for me."

Still, about 72,000 Americans died of drug overdoses last year, with about two-thirds of the deaths linked to opioids. That was more than a four-fold increase over 2002, according to provisional data released last month by the CDC.

Nearly 30,000 of last year's overdose deaths — and the sharpest increase — were linked to the illegal use of potent synthetic opioids, largely fentanyl.

Dr. Ivan Santiago, a pain specialist at Christie Clinic, said opioids are prescribed a lot less freely these days. But he still sees a place for this treatment option — with restrictions and careful monitoring — when at least two or three other kinds of treatments have been tried and continuing pain is impacting quality of life.

Santiago, too, has seen the stigma attached to patients — sometimes even by their own family members — when they take opioids for pain management, he said.

"It's come to the point where anyone with chronic pain is demonized, looked down upon, if anyone finds out they're taking medication," he said.

Safe prescribing of opioids includes limiting dosages and amounts, seeing patients frequently and asking careful questions, Santiago said.

"Things have to add up," he said. "If someone says their pain is severe, yet my exam doesn't seem to justify that, my radar goes up, and I have to start thinking of possible abuse — so it takes a little bit of investigation work."

Santiago said he has had success gradually lowering opioid dosages for many patients and, for some, weaning them off the drugs completely. There are also those pain patients who have continued opioid treatment without problems at the same level for as long as 15 years, he said.

"I don't think, if you spent a day in the pain clinic with us, you would question the patients' intentions and their need for help," he said.

The Don't Punish Pain rally in Urbana is open to all, Blanton said. It will be from noon to 2 p.m. today outside the federal courthouse at 201 S. Vine St., U.

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