Prescription drugs are the most common remedy for millions of Americans suffering from chronic pain. But the painkillers have become abused, creating an untold number of addicts.
In July, the White House Office of National Drug and Control Policy published a report on the rise of prescription drug abuse in America. The U.S. Centers for Disease Control and Prevention reported that the prescribing of painkillers has become an epidemic. Opioids have quadrupled in number of prescriptions from 1999 to 2010. Consequently, the number of admissions to treatment centers and deaths related to opioids has quadrupled as well.
To prevent chronic pain sufferers from spending a fortune on treatment methods that may only provide temporary relief, Silver Hill Hospital in New Canaan engages patients in everyday activities to help them achieve independence from medication. It is one of few hospitals that admit chronic pain patients with any level of dependence on painkillers.
“What the program does is address what I think is a huge need across the country today,” said Seddon Savage, medical director of the chronic pain and recovery center at Silver Hill and a professor at Dartmouth College. “In 2011, there was an Institute of Medicine report that looked at the prevalence of chronic pain and found that over 100 million Americans have some form of chronic pain that requires treatment. The cost is around $600 billion a year in terms of medical expenses and lost productivity. As baby boomers age, we”™re going to have many more people with chronic pain. So it”™s already a challenge.”
People with chronic pain syndrome can”™t sleep and are afraid to move for fear of being in pain, Savage said. They get withdrawn from group activities because everything becomes stressful. The more people get isolated, the less they become active and the more they get depressed and anxious. Her program offers ways for patients to gain control over the pain and empowers them to keep pain at its lowest levels to get their lives back, she said.
Imagine if your body was in constant pain and you had an addiction to painkillers, Savage said. Eventually, the medications would wear off, but the need to satisfy the drug cravings would lead to taking higher doses and making multiple trips to the hospital.
Of the 84 percent of patients who use opioids upon admission to Silver Hill, 63 percent are entirely off the drug by the time they complete the program, Savage said. About 17 percent need to be on opioids because without it, they may turn to more addictive drugs such as heroin. Another 19 percent of the patients are on much lower doses. On average they are on doses of less than a quarter of what they were using when they came in, she said. People on lower doses of opioids often alleviate pain better than those on higher levels of opioids, Savage said.
Silver Hill Hospital opened its chronic pain and recovery center in March 2012. To date, it has admitted 125 patients and graduated 110 patients.
“Until we see outcomes, three, six months down the line and a year out, we really don”™t know the impact we have on people,” Savage said. “But we know that when you put people in a supportive environment, you teach them skills and you remove medications that may be harmful to them, our patients look and feel much better when they leave.”
As people recognize the limitations of procedures and medications, there has been a resurgence of interest in meditation and therapy to treat chronic pain and drug addictions, Savage said. Injection of pain medication was a popular method of treating patients in the 1980s and 1990s, but it became evident that medications have side effects and don”™t work as effectively if used for a long period of time. Many patients even stop responding to them.
“What we have is a reincarnation in a contemporary model of very classic approaches to pain treatment,” Savage said. “Many integrated pain treatment programs in the ”™60s and ”™70s focused on physical rehabilitation and channeling pain out of the body with the mind. Cognitive behavioral therapy was used to help empower people to manage their pain, improve their level of function and re-engage in lives that are joyful and have meaning.”
Silver Hill Hospital provides programs for adolescents, patients with chronic pain, persistent psychiatric disorder, adult dialectical behavior and addiction. It also serves patients with co-occurring chronic pain and addiction, which often means they could be suffering from anxiety and depression. In the morning, the chronic pain and recovery center holds classes on neurology, tai chi and yoga and focuses on meditation and daily physical activities. In the afternoon, patients meet with a physician, psychologist or licensed clinical social worker. Silver Hill admits eight patients at a time. The hospital ground includes a gym, an indoor swimming pool, group activity rooms, housing and a dining hall.
