Who is a Candidate for the NESP Program ?

In general candidates for the NESP Program include:

• Any patient who has been taking opioid painkillers for 6 months or longer and has not undergone recent (within 6 weeks) surgery and are not currently surgical candidates. By definition, these patients have chronic pain and are dependent on painkillers.
• Patients with Chronic Pain Syndrome (PSD) (chronic opioid painkiller use, insomnia, anxiety, and depression).
• Any patient who is clearly addicted to opioids including Heroin. These patients have shown true addictive behavior with continued use/abuse in the face of things such as loss of employment, divorce, incarceration, fraud, doctor shopping, etc. This type of patient is more likely to need long-term maintenance on buprenorphine and other anti-craving supplements and modalities after the program ends.
• Chronic Pain Patients who have failed all treatment to date but are stable on an opioid painkiller regimen. Taking daily opioids may control pain in some patients but chronic use of the medications have ramifications and is associated with significant health problems. Therefore, even though stable on a regimen achieving pain control without Chronic Opioid Therapy (COT) is the healthiest choice. I believe there are a small percentage of chronic pain patients that will need lifetime COT (5-10%) but the majority of patients currently on COT do not have to be. They have simply been given no other alternatives and have been told they have to “learn to live with the pain” and take pills. This is NOT true for the vast majority of patients. The majority of patients that have undergone the NESP Program were told this ridiculous statement by their healthcare provider(s) at one time or another and they are living proof that this is not true.

The bottom line is the NESP program is designed as the final plan for the catastrophic-type cases where patients are on multiple prescription medications, have little to no physical function and have reached a dead end in their current treatment plans.

Finally, the ultimate goal is to get patients off all medications including Buprenorphine (Suboxone, Subutex) and give patients a variety of non-pharmaceutical ways to control any residual pain, increase physical function, quality of life and in many instances return long-term disabled patients back into the workplace.

All patients are required to undergo an initial evaluation that will determine if the patient is or is not a candidate for the program. Some patients may simply need more effective pain management treatment plans and not need to undergo detoxification, functional restoration or a pain management program. In these cases, the assessment and plan portion of the initial evaluation will outline an appropriate treatment plan going forward.

Previous NESP patients are available to speak to you about their experiences. Some of these patients had multiple previous spine and extremity surgeries and had been on multiple medications for decades. Their experiences are compelling.