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Drug abuse and addiction on pain killers and opioid like drugs is common in patients suffering from chronic pain
problems. Pain killers, tramadol and many opioid like drugs are used and abused frequently and on regular basis to elevate the
pain due to chronic health issues.
Through years in our pain clinic we used nerve block in the management of chronic pain such as: Migraine
(intractable headache), Sciatica with or without Myofacial pain syndrome, Reflex sympathetic dystrophy.
Patients suffering from sciatica are chronic users of pain killers, opioid like drugs and many of them are on antidepressants
(SSRI, SNRI). These patients use those drugs to relieve them from their back pain to be able to function and manage their
daily activities; which then leads them to addiction. Patients were treated for lumbar radiculopathy. Epidural infiltration was
performed on L3-L4; L4-L5; L5-S1 based on the location of the radiculopathy. In this group of patients with back pain, some
had positive lumbar myofacial syndrome associated to their sciatica and were treated with epidural infiltration and infiltration
of their myofacial trigger points. As for patients with intractable migraine, most of them were on tricyclics such as tryptizol and
use frequently drugs containing codeine and tramadol. For this group of patient we use the nerve block: A greater occipital nerve
block along with the lesser occipital nerve block, using a nerve stimulator was done bilaterally on all patients using Bupivacine. A
third group complaining of RSD of the ankle, and chronically treated with antidepressant and opoid like drugs were treated with
nerve block of the ankle. With the use of a nerve stimulator and ultrasound, the common peroneal nerve at the fibular neck and
the posterior tibial nerve at the distal third of the leg were visualized and blocked.
Nerve block in treating chronic pain such as migraine, back pain and reflex sympathetic dystrophy have shown its
efficiency, and follow up of this patient showed a improvement of their pain and we notice an important decrease in their use
of their drugs and opioid like pain killer. A question is to be asked: is nerve block is the adequate tool to cure addiction on pain
killers and opioid like drugs by decreasing or eliminating their pain and providing a better life style free of pain and free of the
need of addictive drugs
Souheil Chamandi, M.D. Head of pain clinic, Holly Spirit University (USEK) Medical Faculty Anesthesia Department, Tony Matta, MD. PGY2
Anesthesia and Reanimation, Holy Spirit University (USEK) Medical Faculty Anesthesia Department.
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