He needed help coping with back pain while ending his reliance on opioids. His care team came through.
Tom, 72, has suffered from chronic back pain for decades. He found some relief after a back surgery in the mid-1990s, but within a few years the pain was back and getting progressively worse.
Over the years, his doctors prescribed different medications at various doses, but nothing dealt with the pain the way he hoped it would.
“Percocet seemed to hold it in check better than anything else,” said Tom, a Kaiser Permanente member who asked that his last name not be shared to protect his privacy, “but at some point, I got addicted to it and I couldn’t be without it. At the end of the month, I’d be counting pills to make sure I had enough to get to my next prescription.”
Percocet is the brand name of a pain-relieving medication that contains the opioid oxycodone. Opioids are used to relieve moderate to severe pain, but they are strong medicines and long-term use can lead to physical dependence. Deaths from overdose due to opioids and other substances were on the rise even before the COVID-19 pandemic, according to the Centers for Disease Control and Prevention, and experts say stress, isolation, and the loss of many traditional sources of support have contributed to a new surge since 2020.
Tom had worked in health care for decades, serving as a nurse at Kaiser Permanente before earning an MBA and turning to administration, so he was well aware of the risks. But in spite of his clinical background, he found himself slipping into addiction.
“We were trying to solve a chronic condition that wasn’t getting any better, and my body just wasn’t sorting it out,” he said.
While Percocet helped lessen his pain, his quality of life wasn’t what he wanted. His daily activities were tough to get through, and his pills left him feeling fuzzy and unfocused most of the time. He decided it was time to explore other options.
His doctor referred him to Kaiser Permanente’s chronic pain program in Martinez, California. Carlo Estevez, DO, who specializes in pain medicine, developed a treatment plan for Tom that included working with Asma Asyyed, MD, chair of addiction medicine and recovery services for Kaiser Permanente in Northern California.
Dr. Asyyed prescribed Suboxone, a brand-name medication for opioid addiction that helps with withdrawal and cravings, to help wean Tom from his dependency on opioids.
Tom’s treatment plan also included regular group therapy for mental health support. There are 2 group therapy tracks available for members. Those who are ready to give up all substances can join an abstinence-based program. Others can participate in a harm reduction program, which involves providing treatment and support for patients while minimizing the negative consequences of drug or alcohol use.
“It’s important to help people develop their own reasons for abstaining from substances,” Dr. Asyyed explained. “Forcing someone to change doesn’t work. They need to achieve the change in their own head, and then it will work.”
Tom initially started in the harm reduction program because he wasn’t yet sure he could function without Percocet, but he switched after just one session when he realized how effective Suboxone could be in curbing his cravings and helping to reduce his pain.
“My wife and I are blown away at how coordinated everything has been,” he said. “I’ve had a full complement of experts guiding me through this in such a short period of time — 2 doctors, 2 psychologists, a pharmacist, and a case manager. The number of people involved in my care and the expertise they all bring to the table really is amazing.”
After 2 months on his new treatment plan, his back pain is much better. In addition to physical therapy, Dr. Estevez recommended that he join Kaiser Permanente’s medical weight management program, since excess weight was putting pressure on Tom’s back and contributing to his pain. He walks several miles a day, and now that he isn’t using opioids, his head is clearer than it’s been in years.
“It’s still a work in progress, but this program put all the pieces together for me and put me on the path to have a better life,” Tom said.