Suggest Treatment For Severe Back Pain Due To Opioid Abuse
'Opioid abuse'.Please visit a Methadone clinic.That's the solution.
Detailed Answer:
Hi XXXXXXX driver,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
If you would have presented to me as an outpatient with this medical history,I would have put up 'Opioid abuse' as your working diagnosis as you seems to fulfill the DSM(Diagnostic and statistical manual for mental disorders)criteria for the same.I can well understand that it all started due to your back pain and spinal issues.However,you must get out of it.Its the high time.
Main treatment guidelines are:
1)Opioid like hydrocodone or oxycodone will heve to be replaced by opioid agonists like methadone or buprenorphine followed by gradual taper of these medicines and finally stopping them.
2)Clonidine use to suppress the withdrawl symptoms after abruptly stopping the opioids.
3)During times of severe pain,short acting opioid analgesics have to be used along with other medicines to alleviate pain.Opioid analgesics given only during the times of pain,have been found, not to increase the chances of opioid abuse relapse in most of the research studies.
4)Cognitive-behavioural therapies
5)Psychodynamic therapy.
So,narcotics can still be given during the episodes of debilitating pain,but not on regular basis.After all,you have to get out of this hell.
Please visit a 'Methadone clinic' which are specialized centres which can help people get rid of the opioids.If you don't find one,please meet a psychiatrist as he is the person who can help you to get one.
A psychiatrist's opinion is also of value here regarding behavioural therapy and psychodynamic therapy.More than a pain specialist,a Psychiatrist can help you.
Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.Your rating can be of help to me.
Dr.Ajay Panwar,
MD,DM(Neurology)