Pain patients also victims in war on opioid epidemic

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A fentanyl patch used for pain management. (June 2017)


GRAND RAPIDS, Mich. (WOOD) — There’s no question opioids have devastated countless lives, killing tens of thousands of Americans yearly. But they’ve saved many others.

“I do not like to hear fentanyl and heroin in the same sentence,” said Melissa, a suburban Grand Rapids woman who lives with crippling back pain. “It’s like they don’t belong together, and they’re mixing them together. And fentanyl’s getting a bad rap over it.”

Drugs like heroin, methadone, fentanyl, hydrocodone, oxycodone — or mixtures of them — are among the opioids most often cited in the overdose crisis, now labelled an epidemic by the U.S. Centers for Disease Control and Prevention.

“I’m very frustrated with the news lately,” Melissa told Target 8.

She’s one of at least a dozen people who reached out to Target 8 about its series of special reports, A Killer Among Us.

“I want people to know that you’re not on fentanyl to feel good in terms of, ‘Oh, I’m going to get high.’ Fentanyl is a lifesaver for people like me who have a debilitating illness, and, in my case, it will never get better,” she said.

RESPONSIBLE FENTANYL USER: ‘I SHOULD ALWAYS HAVE ACCESS’

Melissa, now in her 50s, wasn’t diagnosed with scoliosis until a dozen years ago when her back started hurting after she took a job at a child care center. An X-ray clearly shows a curvature in her spine.

“I’m being twisted alive,” Melissa explained. “The twisting’s from the scoliosis and then all through my spine I have arthritis, and I have a bulging disc.”

She also suffers from spinal stenosis, which is a narrowing of the spine, and osteopenia, a weakening of the bones.

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Fentanyl patches for pain management. (June 2017)

Melissa puts two new fentanyl patches on her arm every 48 hours, depending on 37 micrograms to make her life bearable.

“My biggest fear is that with all the bad press that Congress and everybody else in Washington is going to muck this up to the point where people who need the fentanyl, it’s going to be so hard to get it,” Melissa said.

When asked what would happen if she could not access fentanyl, Melissa said she didn’t know.

“This is how people end up searching the streets for something,” she said.

Later, she said she would go back to her pain doctor to try to find an additional remedy for her constant pain.

The 50-something wife and mother asked that her identity be concealed to protect her home and family.

There’s a criminal market for the fentanyl patches her doctor prescribes her, which she takes faithfully and responsibly.

Opioids, which can suppress respiration, are especially deadly when mixed with alcohol or benzodiazepines because all three drugs depress the central nervous system.

Melissa said she’s well aware of the risk of accidental overdose, never drinks alcohol and always heeds the warnings listed on the medication.

“My doctor prescribes me fentanyl, and I use it exactly the way it should be,” Melissa said. “So I think I should always have access to fentanyl as long as it’s helping me.”

DOCTOR: OPIOIDS MUST BE PRESCRIBED RESPONSIBLY

“Narcotics are not going to be taken away,” said Dr. Keith Javery, owner of Javery Pain Institute on Kenmoor Avenue SE in Grand Rapids. “Bottom line, (opioids) are not going to be taken away, nor should they be.”

Javery said that while most patients don’t need opioids for more than a couple weeks, some chronic pain sufferers do require them to function long-term. He doesn’t want doctors to be afraid to prescribe them. But he also says physicians have been too quick to write opioid prescriptions in the past and too lax on monitoring patients’ use of the drugs.

“I will tell you that half the patients who come to me on opioids didn’t have to be on them for that long,” Javery reported. “Finally we have people listening, but look what it took — it took a national epidemic for people to finally start to listen.”

Javery’s main message is that doctors must keep closer tabs on opioid patients, for instance requiring that they sign a contract, involve their family, undergo counseling and — if called upon — submit to random urine testing and pill counts.

Javery also says that narcotics alone are never the answer. His opioid patients also take advantage of myriad other pain management techniques including physical therapy, stress management, nerve block therapy, spinal stimulation and pain pumps.

“While sometimes narcotics are necessary, we have found that utilizing these other methods, fractions of the doses are needed for fractions of the total number of patients,” Javery explained.

Melissa isn’t a Javery patient, but she was required to sign a contract and uses pain management techniques in conjunction with her fentanyl prescription. She undergoes routine spinal injections and has done physical therapy and behavioral counseling.

She says she was initially resistant to using opioids and waited until the fentanyl prescription had nearly run out before she got it filled.

“I’ve been to a faith healer,” Melissa said. “I’ve done everything I can to avoid going on the fentanyl, but nothing’s worked.”

Melissa had surgery planned last fall, but had to postpone it when her husband lost his job.

State lawmakers in Michigan are currently working on multiple bills designed to fight the overdose epidemic, but part of their challenge is finding ways to do so while still protecting the rights of patients like Melissa.

Target 8 will continue to track progress on both fronts: the fight to ease chronic, debilitating pain, as well as reduce the number of deadly overdoses.