Patient Stories

Abstract for Midwest Pain Collective Conference 2025

Case Study: From Addiction to Advocacy – The Success of Pain Pumps
Zeeshan Tayeb, MD
RegenLife & Pain Specialists of Cincinnati

Introduction/Statement of the Problem:
Individuals with a history of substance use often face significant stigma in medical settings, particularly in pain management. This can hinder access to effective, compassionate care. We conducted a case study following a female chronic pain patient with a long-standing history of substance use and over 20 years of sobriety. The chronic pain was initially managed with oral opioids by her primary care provider. Due to changing prescribing guidelines and concerns related to her substance use history, she was referred to a pain management specialist, Dr. Tayeb. She presented with chronic pain that significantly impaired her quality of life. Her case illustrates how tailored, multidisciplinary care can achieve positive outcomes even in patients considered high risk for opioid misuse.

Materials and Methods:
At presentation, her pain scores ranged consistently from 8 to 10, and her Morphine Equivalent Dose (MED) was 80 mg. A single-shot intrathecal pain pump trial was conducted, yielding a successful response. Subsequently, she underwent permanent pain pump implantation on 01/07/2025. The pump was titrated using manufacturer protocols and dosing guidance from Grider et al., emphasizing microdosing strategies tailored for patients with prior substance use disorders. Following implantation, her VAS and MED scores were collected at 1 month and 3 months.

Results:
Following implantation, the patient reported sustained pain relief of 65–80%, with no use of oral opioids. Patient-reported outcomes using PROMIS and SF-36 instruments demonstrated significant improvements in pain interference, emotional well-being, physical function, and overall quality of life.

Conclusions:
This patient’s case underscores the potential for successful chronic pain management in individuals with a history of addiction when care is stigma-free, evidence-based, and personalized. Her experience challenges prevailing assumptions about opioid use in recovery and highlights the importance of multidisciplinary strategies, including implantable therapies—to support both pain control and sobriety.

References:

Grider JS, Etscheidt MA, Harned ME, Lee J, Smith B, Lamar C, Bux A. Trialing and Maintenance Dosing Using a Low-Dose Intrathecal Opioid Method for Chronic Nonmalignant Pain: A Prospective 36-Month Study. Neuromodulation. 2016 Feb;19(2):206-19. doi: 10.1111/ner.12352. Epub 2015 Oct 19. PMID: 26477685.

Medtronic Pain Pump Workflow Protocol Indications, drug stability, and emergency procedures SynchroMedTM and IsoMed implantable infusion systems 2022-06-30.

Ohio Cares Opioid Agreement https://ohiocares.ohio.gov/home