Herman, Tony (2019, January 23). Mary Lanning doc combating opioid addiction. Hastings Tribune. Retrieved from http://www.hastingstribune.com. Photo credit: Laura Beahm
One local pain management specialist is helping patients pursue other pain management options besides opioids and, in the process, stemming the tide of addiction.
Dr. Kartic Rajput, a physician with Mary Lanning Healthcare, said even though the number of opioid-related deaths in Nebraska has been comparatively low, the number of prescriptions written for them is higher than the national average.
He said while the national average of opioid prescriptions written is 70 per 100 people, the average in Nebraska is 73.
“So we have a high number of pain pill prescriptions that are given out to the patients,” he said.
In December 2018, Rajput was named president of the Nebraska Society for Interventional Pain Physicians, which is an advocacy group for interventional pain physicians. The organization is involved in advocacy on a state and national level, creating awareness about pain medication. He’s been involved in the organization for 5 1/2 years, since moving from Louisiana to central Nebraska.
The organization is focused on finding alternative treatment, so fewer opioids are prescribed.
Rajput also serves on a statewide care advisory committee that recommends treatment options for Medicare and Medicaid.
In addition to his offices in the Mary Lanning Medical Services Building and Lanning Center for Behavioral Services in Hastings, where he has a psychiatric clinic, Rajput also works in a Mary Lanning clinic in Grand Island.
He serves as a panel member for the Hall County Opioid Prevention Project, a grant-funded effort for central Nebraska that works to identify shortfalls in addiction treatment.
In his practice, he offers treatment for patients who are struggling with opioid addiction, chronic pain and substance abuse.
One of his goals is to see in-patient opioid detox units in this area.
Rajput has been approached by friends looking for treatment options for family members struggling with opioid addiction.
“I think it’s much more common than we know of,” he said.
He sees patients — including in his psychiatry practice — who are on higher doses of pain medication, sometimes for many years, without being properly evaluated.
“More of these patients are on these multiple different medications,” he said. “When we combine these different kinds of medications there’s a much higher risk for abuse. Along with Mary Lanning we have been working to cut down on this epidemic and cut down on the number of pills that are written.”
For instance, Rajput said a patient might be prescribed 100 Percocet pills to manage pain following a knee surgery but only use a few of the pills.
The rest of those pills then sit on a medicine cabinet shelf and could end up stolen due to the street value.
“Some of the patients have told me it’s easier for them to get pain medications on the street than getting it from me or from other providers,” Rajput said. “That tells us how many of these medications are ending up on the streets.”
He’s worked in the pain field for more than 16 years, holding a doctorate of philosophy and a psychiatry degree, and has researched finding alternative pain management treatments and doing other interventions.
“Addiction can be to anything, it can be to pain pills, meth, heroin or cocaine — anything like that,” he said.
Based on that he decided to go into psychiatry, dealing with addiction and mental health. He worked in out-patient and in-patient detox services during his psychiatry residency at Tulane University in New Orleans.
“I knew about these problems, but that’s when I started learning more in-depth about treating those issues,” he said.
Research has shown opioid pain pills could be a gateway drug, leading to the use of other drugs like heroin or cocaine.
Opioids became a pain management mainstay in the late 1990s and early 2000s.
“When you complained of severe pain you were getting opioid pain medication,” Rajput said. “I moved away from that. I don’t use opioid as a first-line treatment. I use it as a last resort when other things don’t work.”
He focuses instead on options like exercise and weight loss.
Patients might have underlying depression, anxiety or other mental health issues that have not been addressed or poorly addressed.
Rajput provides multidisciplinary treatment for chronic pain, including cutting-edge spine interventions. He also is an expert in cancer pain, working with the Morrison Cancer Center.
“So if they have back pain we try to see what is causing back pain and if that can be managed without using any medication than we are all for it, or if we can use non-narcotic treatments instead of narcotic treatment,” he said.
He’s had referrals for patients, including those from Colorado and Kansas, who were on higher doses of pain medications.
“We have offered them alternative treatment and we have been able to wean them off,” he said. “Some of the patients are completely off of pain medications and doing much better.”