Surely, anyone who has lost a loved one to an overdose would welcome the Snyder administration’s recently announced plans to combat the alarming increase in prescription drug deaths in the state.
But there is another side to this story and it, too, is distressing. It is the fallout that happens when the remedy to prevent overdoses ends up crippling a group of people already disabled because of their chronic pain.
“Many, many physicians right now are afraid to treat chronic pain because they are fear their license to practice will be suspended or they will be put in jail, or worse,” says Dr. Dawit Teklehaimanot, a pain management and rehabilitation physician in Oak Park. “Meanwhile, patients with chronic pain suffer needlessly. There is just no reason for that.”
As reported in The Detroit News on Monday, the Michigan Prescription Drug and Opioid Task Force will be making recommendations later this month to counteract an “epidemic” of prescription drug deaths in Michigan. The state’s health department said overdose deaths linked to opioids were increasing at a faster rate than for illegal drugs like heroin.
But because these drugs are legal when prescribed by a physician, counteracting the abuse is not as clear cut as arresting the drug dealers. And the paradox is that prevention of prescription opioid abuse often doesn’t distinguish between those for whom the drugs help and those it harms.
The prospect of restricting doctors to write prescriptions at much lower doses or for no more than one month’s supply at a time can be terrifying for patients with chronic pain.
Dr. Teklehaimanot, or “Dr. Tek,” as he is referred to by his patients, says chronic pain, or pain that is unrelenting and persistent, needs to be proactively managed. “Rather than a symptom, I look at chronic pain as a disease,” he says. “If a person has diabetes they have to be treated with insulin to be functional. My patients’ pain needs to be controlled in order to be functional.”
And while his patients may become dependent on prescription painkillers, they are not addicts or drug abusers. “An addict is someone who is not seeking pain relief; they have become addicted to the euphoric effects of the narcotics. My patients are dependent on their medications to be able to get up out of bed in the morning. “
Dr. Tek is a rare breed. I know this because my sister-in-law, Lin Hyland, is a patient of Dr. Tek’s. Lin, 62, who is married to my brother Rob, was diagnosed in 2000 with a rare and little-known disorder called Trigeminal Neuralgia (TN). TN produces excruciating facial pain that is described in medical literature as feeling like “repeated electric shocks, being poked with an ice pick or biting on a needle.”
It is no exaggeration to say that Lin and many other patients of Dr. Tek’s would not be alive had they not found him. If you don’t believe me, do an Internet search for “suicide disease.” What immediately comes up is Trigeminal Neuralgia. It earned its macabre moniker because of the sheer number of those in pain who felt they had no other option.
Over the years, Lin has exhausted entire arsenals of powerful painkillers: including morphine trials, fentanyl patches and anti-epileptic medications. She’s had numerous procedures: including nerve blocks,biofeedback, partial nerve severing and balloon rhizotomy. She’s also had two brain surgeries, both of which failed. (She has another surgery scheduled next week. To say that we are storming heaven with novenas is an understatement.)
To recount how doctors challenged Lin’s level of her pain — reducing her to tears — is to underscore the woeful lack of pain management training in the healthcare field.
Suffice it to say, Dr. Tek has gone to bat for Lin and no doubt, many of his patients, pleading with health insurance companies to cover their medications, all the while heavily monitoring them with urine testing, toxicology studies and counting of pills. In addition to pharmacological treatment, he also prescribes physical therapy, acupuncture, massage and supplements, anything to help his patient not rely solely on pain meds.
While he recognizes prescription abuse is a huge problem, he maintains: “A whole community of people who are suffering in pain should not be punished for the actions of a few.”
Not surprisingly, Dr. Tek’s deep commitment to his patients stems from personal experience. Born in Ethiopia, Dr. Tek’s mother had to have both legs amputated due to advanced diabetes. “The last two years of her life were spent in extreme, severe pain,” he says. “It was not a life.”
From that experience he became a physician specializing and physical rehabilitation and pain management. “Now when I see my patients, my mom is in their faces ... So, yes this is a risky practice. But I do the best I can to help patients in need.”