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    Pain management and reduction of opiate use: A proven model meets resistance

    Recently, Drug Topics received an e-mail that got us thinking. Commenting on the dilemma of chronic pain patients who face continued restriction of access to opiates, Allen Nichol, a pharmacist entrepreneur in Columbus, Ohio, wrote to tell us about his two-pronged approach to optimizing pain management and reducing opiate use — and his struggles to interest the medical, industrial, and government establishments in it. Here is what he said:

    Allen NicholAbout five or six years ago, I was approached by the Ohio Bureau of Workers’ Compensation. At that time, more than 50% of Workers’ Comp recipients in Ohio were using opiates to treat chronic pain. I was asked to find a way to help reduce opiate use in this population.

    After evaluating the literature for more than two years, I came up with a seven-part approach to identify the etiology of patient pain. I presented this to the Bureau’s pharmacy director, who forwarded the proposal to the decision-making body. The proposal was rejected out of hand.

    I then tried interesting multiple state cabinet members in the program and also applied for a federal grant for funding from the National Institute on Drug Abuse through the National Institutes of Health. This too was rejected.

    Allen Nichol, PharmD
    Allen Nichol is COO/VP Clinical Operations, CeutiCare Inc., and the 2014 recipient of APhA’s Daniel B. Smith Award. Contact him at ...

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    • SteveLeuck
      Thanks or posting this, I admire Dr. Nichol's passion. I was astounded that there were so many institutions that refused to implement his program. My best guess is that many institutions, including mine, do have programs that involve the implementation of a "pain cocktail" as such that addresses nerve pain, inflammation, break through pain, accompanied with non-medication alternatives such as acupuncture, meditation, diet and others. That said, a standardization of chronic pain treatment that includes appropriate lab testing as well as all of the suggested alternatives would be a tremendous step forward. I certainly encourage Dr. Nichol to continue his education process. On the bright side, there was a significant number of institutions that took the time to review the pain algorithm. That tells me that everyone is looking for a better solution than what we currently have. Thanks Steve Leuck, Pharm.D.