psychopharm resp dq1 Ell

Ellie

During one of my practicums I was performing pre-screening evaluations for clients who had chronic pain and wanted to undergo an invasive surgery for a spinal cord simulator. Prior to seeing me, many clients had tried almost every option in the book, physical therapy, back surgeries, ablation, cortisone shots, and medications. Spinal cord simulators are subcutaneous implants. They are commonly surgically implanted beneath the skin on the lower back. It is a small wire that transmits electrical signals via a remote held by the client.
However many clients who were not psychological fit to undergo the surgery were often referred back to the PCP and given various forms of medications for nerve pain. A common medication for nerve pain were anticonvulsants. One of the more common ones was Gabapentin. According to WebMD there are various forms of Gabapentin from capsules, to creams, patches, and powders. More often than not I have come across the capsules. Specifically the Gabapentin extended release tablet so that the drug is released slowly over 24 hours, allowing clients to take them less frequently.
Many are cautioned that with oral medications and extended release medication in particular, if crushed will release all of the drug at once. Here is where a concern for addiction and abuse may come into play.
One thing that I have seen consistently for clients with chronic pain is that many of them will do anything to experience relief. Many start off with the basics and no medications only to use them or an invasive surgery as a last resort. Oral medications are the most common and for those with chronic pain, often come with an additional list of medication that are administered by one way or another.
References
Hamm-Faber, T. E., Aukes, H., Gorp, E.-J., & Gultuna Ismail. (2015). Subcutaneous stimulation as an additional therapy to spinal cord stimulation for the treatment of low back pain and leg pain in failed back surgery syndrome: four-year follow-up. Neuromodulation: Technology at the Neural Interface, 18(7), 618622. https://doi.org/10.1111/ner.12309

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