Pain Management Case Study

Pain shot through his body as he pulled a cutting board from the cabinet.Slowly, deliberately, he tapped the bag's white contents onto the board and crushed it with the flat edge of a butter knife, forming a line of fine white powder.

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Pain Management Case Study

(Andrew's wife had left him shortly after he broke his femur, and his son took him in.) Pain became Andrew's all-consuming nemesis, devouring most of his waking hours.

With nowhere to turn, Andrew mentioned his situation to his neighbor, who sold him diverted opioids—prescription medications hawked on the street. Andrew's dependence on heroin terrified him, and at 0 a day, it threatened to bankrupt him as well.

This trajectory is by no means unusual, according to Andrew's lead doctor, William Becker, an addiction medicine specialist and assistant professor at the Yale School of Medicine: “Chronic pain is the new initiation to heroin.

The brain has an elaborate network of receptors, neurons and centers dedicated to pain.

Opioids exert their effects by binding to mu-opioid receptors, which are densely concentrated in brain regions that regulate pain perception and reward.


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