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Opioid Therapy of Chronic Pain in Persons With Known Substance Use Disorder 

Opioid Therapy of Chronic Pain in Persons With Known Substance Use Disorder
Chapter:
Opioid Therapy of Chronic Pain in Persons With Known Substance Use Disorder
Author(s):

Julie Sorensen Franklin

and Seddon R. Savage

DOI:
10.1093/med/9780199768882.003.0002
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date: 11 April 2021

Chapter 2 introduces Jay Russo, a 42-year-old Gulf War veteran, who presents for initial evaluation for back and left lower extremity pain of 2 years’ duration. Jay Russo’s pain problem began approximately 3 years ago when a coworker dropped one end of an 'I' beam, resulting in a 'pop' followed by severe back pain and later pain radiating down Mr. Russo’s left buttock into his lateral thigh and across the top of his foot to his great toe. Due to radicular pain concordant with subsequent magnetic resonance imaging (MRI) fi ndings, Mr. Russo underwent L5-S1 discectomy, and immediately afterward his left lower extremity pain and weakness resolved and back pain improved. Unfortunately, between 6 and 12 months after surgery, his back and leg pain returned. Repeat MRI at that time demonstrated scar around the left L5 nerve root on gadolinium-enhanced images.

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