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August 23, 2012
Doretta Royer 315 464-4833

Upstate offers new treatment for painkiller addiction after back surgery

SYRACUSE, N.Y.— Individuals who have chronic back or leg pain following back surgery where no further surgical remedy exists, known as failed back surgery syndrome (FBSS), and who continually rely on opiates, or narcotic medications such as Vicodin, OxyContin, Norco, and Hydrocodone to relieve their pain, may be eligible to receive an innovative treatment at Upstate Medical University.

This treatment may result in remission from drug dependency and restoration of the individual’s natural ability to deal with pain. In addition, the treatment usually reduces the pain associated with the FBSS. The treatment approach is being offered at Upstate’s Addiction Medicine Service.

According to Brian Johnson, MD, director of Addiction Psychiatry at Upstate, after continued use, painkillers can actually be the cause of the pain.

“Those who participate in the neuropsychoanalytic treatment will take low dose naltrexone, an FDA- approved, non-opiate medication that helps the body to restore endorphin function,” said Dr. Johnson, who is an associate professor of psychiatry and anesthesia. Endorphins are natural pain killing substances found in the human brain and painkillers actually stop the production of endorphins. “It is hoped that use of low-dose naltrexone, as part of neuropsychoanalytic treatment, will lead to improvement of pain symptoms.

According to Dr. Johnson, three percent of Americans use opiates for pain relief and one-third of those individuals become addicted to those painkillers. He says that most patients on opioid maintenance will show both withdrawal and tolerance.

To meet the criteria for opioid dependence (addiction), those interested in the innovative treatment must have at least one of the following:

• Opioids taken in larger amounts over a longer period of time than intended; patients then run out of their prescriptions early.

• Unsuccessful attempts to cut down or control use.

• A great deal of time is spent in activities necessary to obtain the opioids such as visiting multiple doctors, emergency departments, etc.

• Important social, occupational or recreational activities are given up or reduced because of opioid use; such as going on disability.

• Opioids are used despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused by or exacerbated by the opioids. Examples would be the depression that is so common in patients maintained on opioids, or opioid-induced hyperalgesia.

Those interested in treatment will undergo a complex biopsychosocial evaluation. Permission to confer with the patient’s referring physician is a condition of treatment.

“There is an initial period of daily treatment during which patients undergo detoxification, medical management and psychotherapy. Then they are put on low dose naltrexone to restore their brain’s own pain fighting opioid hormones, and seen twice a week until better,” said Dr. Johnson.

For more information about the treatment or to make an appointment, call 315-464-3130.

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