How non-opioid pain management became a ‘silver bullet’ for medicine

Dylan Glaser is free from the pain that has plagued him for years thanks to non-opioid pain management. Photo provided by Dylan Glaser

Dylan Glaser is finally free of the haze of pain that has plagued him for years, enabling him to reclaim his life – without ever taking an opioid.

The 24-year-old Jackson was born with congenital spinal stenosis, but didn’t know it until he was in a car accident at Garden State Parkway at the age of 19.

“After the accident, I was in pain literally every day of my life,” Glaser recalled. “I never got a break from it. It was terrible. But I never wanted to go down the path of drugs, like opioids.”

After a few years of experimenting with physical therapy and other therapies, he met Dr. Robert Jungko, a board-certified anesthesiologist at the University of California, San Francisco Rutgers Robert Wood Johnson Medical Collegewho offered a non-opioid solution – spinal cord stimulation.

Similar to the technology used in pacemakers, this procedure places devices in the spine that essentially block pain signals from reaching the brain. Eight weeks after the operation, Glaser was doing plank exercises, swimming, running, and playing baseball.

“I felt great,” he said. “When you’re in pain, you’re really living in this blurry world. Now that I’m feeling better, it’s like my sanity has come back. I’m literally just a happy person.”

Dr. Robert Jongko, right, a board-certified anesthesiologist at Rutgers Robert Wood Johnson Medical School, offers a range of non-opioid solutions, such as spinal cord stimulation. Image courtesy of RWJBarnabas Health

Glaser is one of a growing number of patients dealing with pain without resorting to highly addictive opioids, spawning an addiction epidemic that has killed hundreds of thousands of people, many of them young adults.

One response to the overdose crisis has been to dramatically reduce opioid prescriptions. According to the Centers for Disease Control, in 2020, the layoff rate fell to its lowest level in 15 years. In New Jersey, the 2020 rate was 31.8 prescriptions per 100 people, well below the national average of 43.3 and about half the number of prescriptions in 2012.

“There was an emphasis on changing the framework from pain management to interventional pain management,” Jongco explained. We are looking for ways to not only treat the pain but also the underlying cause.

He added that a customized approach to pain management yields much better results, without the risk of addiction Dr. Christine DiFranco, MD, ER, holy name Pain Management Center at Holy Name Medical Center.

“We have a lot of tools in our bag that we can use to manage pain safely and effectively” DeFranco said. “Pain doesn’t have to mean opioids.”

Dr.. Christine DeFranco uses many methods, from nerve blocks that use injections to block pain from specific nerves to radiofrequency ablation. Photo courtesy of Holy Name Medical Center

Modalities run the gamut, from conservative treatments, such as physical therapy and acupuncture, to nerve blocks that use injections to block pain from specific nerves, and radiofrequency ablation, which sends waves through a precisely placed needle to heat an area of ​​a nerve, preventing pain signals from getting through. to the brain. These approaches are used to treat everything from pain in cancer patients and surgery patients to migraines, herniated discs, and other orthopedic conditions.

Non-opioid medications also play a transformative role in pain management. One drug slowly gaining traction is low-dose naltrexone, which ironically is used to reverse overdoses. The drug has produced amazing results in patients, relieving chronic pain caused by all kinds of conditions, including HIV, lupus and rheumatoid arthritis, according to Dr. Christine Cardamon, an interventional physiotherapist at Summit Medical Group.

“With my chronic pain residents, this is the closest thing to a silver bullet,” she said. “Using a tenth of the normal dose of what we’d use for an overdose, we can reduce inflammation and help the neural pathway. It triggers your natural endorphins. Amazing thing. Even though it’s not covered by insurance, it’s very cheap.”

Al-Hail regrets that more doctors are not offering patients this option.

“Most people are so happy they wonder why they didn’t know this before,” she said. “A lot of docs don’t know about this.”

Conservative therapies, such as naturopathy and acupuncture, are part of the non-opioid treatment arsenal at physicians’ disposal. Image courtesy of Getty Images

Then there is cannabis.

said James Salwitz, MD, a medical oncologist at Cancer care at Asterawith offices throughout New Jersey. “It is an essential part of our treatment method.

“This is the safest complex ever,” he added. “There are concerns about overuse when people’s brains are shaped, but I’ve never seen a single case of a marijuana overdose.”

At Holy Name, combating pain with non-opioid methods is a systemic shift that permeates every area of ​​medicine.

“Seeing this pandemic has helped drive the medical community to make sure that the drugs we choose are the best medications to manage a specific condition,” DiFranco said. “Where opioids were once used across the board, we’re now focusing on what’s most appropriate – with great results.”

Nancy Barillo writes frequently for NJ Advance Media / Jersey’s Best. A former state correspondent, she previously worked for the Associated Press and The Record.

This article originally appeared in the Winter 2022 issue of Jersey’s Best. Subscription here For in-depth access to everything that makes the Garden State great.

Leave a Comment