From Addiction to Advocacy

For people in long-term recovery from a substance use disorder, chronic pain can feel like an impossible bind: the pain is real and disabling, but the usual treatments raise real fears about relapse — and the stigma alone often stands between a patient and effective care. At RegenLife in Cincinnati, one patient's story shows there is another path. A 51-year-old woman with more than 20 years of sobriety went from taking daily oral opioids for severe chronic pain to 65–80% pain relief with no oral opioids at all — thanks to a personalized, recovery-aware approach built around an intrathecal pain pump. This case was presented by Dr. Zeeshan Tayeb at the Midwest Pain Collective Conference 2025.

Interventional pain care at RegenLife in Cincinnati

Key Takeaways

• Chronic pain in people recovering from addiction is often undertreated because of stigma and understandable caution around opioids.
• An intrathecal pain pump delivers medication directly to the spinal fluid, so it can control pain with a tiny fraction of the dose an oral medication would require.
• With a recovery-aware microdosing protocol, this patient reached 65–80% pain relief and stopped oral opioids entirely.
• Validated quality-of-life measures (PROMIS and SF-36) showed meaningful gains in pain interference, emotional well-being, and physical function at 1 and 3 months.
• The right answer isn't "opioids or nothing" — it's stigma-free, personalized, evidence-based care.

The Dilemma: Chronic Pain in Recovery

People with a history of substance use disorder frequently encounter stigma in medical settings, which can limit their access to effective pain care. When a new chronic pain problem develops years into recovery, both patient and provider face a genuine dilemma — the pain deserves treatment, but standard opioid therapy can threaten hard-won sobriety.

That was exactly the situation this patient faced. She began using alcohol as a teen and, after a DUI, found recovery through Alcoholics Anonymous (AA) — where she also met her spouse and long-term support network. After more than 20 years of sobriety, she developed chronic pain conditions later in life.

Her pain was initially managed by her primary care physician with oral opioids at a Morphine Equivalent Dose (MED) of 80 mg. As prescribing practices changed and concerns grew about her history, she was referred to Dr. Tayeb. At that point her pain scores were consistently 8–10 out of 10 and were significantly limiting her quality of life.

What Is an Intrathecal Pain Pump?

An intrathecal pain pump is a small device implanted under the skin that delivers pain medication directly into the fluid around the spinal cord (the "intrathecal" space). Because the medication goes straight to where pain signals travel, it works at doses far smaller than pills taken by mouth — often a tiny fraction of an oral dose. For someone in recovery, that targeted delivery, combined with careful medical oversight, can be a game-changer.

A Personalized, Recovery-Aware Approach

Rather than simply continuing or increasing oral opioids, the care team took a measured, multidisciplinary path:

1. A single-shot intrathecal trial was performed first to confirm the approach would work — and it showed a clearly positive response.
2. On January 7, 2025, a permanent intrathecal pain pump was implanted.
3. Dosing was titrated using the low-dose "microdosing" protocol described by Grider et al. (2016), with adaptations specifically for a patient in recovery — keeping medication exposure as low as possible while still controlling pain.

Throughout, the plan was built around her recovery, not in spite of it.

The Results

The outcomes were measured with objective pain scores and validated quality-of-life tools at 1 and 3 months:

• 65–80% sustained pain relief
• No oral opioid use at all following the implant
• Significant improvements on PROMIS and SF-36 across pain interference, emotional well-being, physical function, and overall quality of life

In other words, she got substantially better pain control while protecting her sobriety — an outcome that the "high-risk, hands-off" assumption would have said was out of reach.

Why This Matters: From Addiction to Advocacy

This patient's experience challenges a common and harmful assumption — that people in recovery can't be treated for pain, or can only be treated with the very medications that put them at risk. It shows that stigma-free, evidence-based, individualized care can achieve excellent results even in patients considered high-risk for opioid misuse.

At RegenLife in Cincinnati, that philosophy guides how we approach complex pain: combining interventional procedures like intrathecal therapy with comprehensive pain management and behavioral health support, tailored to the whole person. You can read the full clinical write-up in our case study on pain pump success.

If you or a loved one is navigating chronic pain — especially alongside a history of substance use — you deserve care that treats you with dignity and looks at every option. Reach out to RegenLife to learn more.

References

• Grider JS, Etscheidt MA, Harned ME, et al. Trialing and Maintenance Dosing Using a Low-Dose Intrathecal Opioid Method for Chronic Nonmalignant Pain: A Prospective 36-Month Study. Neuromodulation. 2016;19(2):206–219. PMID: 26477685
• Medtronic. SynchroMed™ and IsoMed™ Implantable Infusion Systems — Pain Pump Workflow Protocol (indications, drug stability, and emergency procedures), 2022.
• Ohio Department of Mental Health & Addiction Services. Ohio CARES Opioid Agreement. ohiocares.ohio.gov

This article is patient education adapted from a clinical case presentation and is not medical advice. Individual results vary; treatment decisions should be made with a qualified provider.