BUFFALO, N.Y. — Rick Tabbi has dealt with severe pain for more than a decade, since he was first diagnosed with Multiple Sclerosis. He also suffers from Osteoarthritis, Osteoporosis, Spinal Stenosis and Chronic Pain Syndrome.
For more than 10 years, he was taking four Lortab painkillers per day.
"It was controlling the pain, but it also was controlling my brain," Rick said, describing how he was in a constant fog.
Rick is now treated at UBMD's Behavioral Medicine Clinic at ECMC, where Cognitive Behavioral Therapy (CBT) has allowed him to reduce his opioid treatment to half of a pill a day. Sometimes he takes no pills.
Dr. Alison Vargovich, a psychologist who specializes in treating pain, says CBT is all about teaching patients how to control their stress responses, which helps control the pain.
She and the other psychologists at the clinic use techniques including guided imagery, breathing techniques, and relaxation.
"When we think of relaxation, sometimes we think, 'Oh I'm just putting my feet up, watching TV, eating potato chips, enjoying my life.' That's not what we're talking about," she said. "We're talking about techniques that help patients to control that stress response because if you're feeling increased stress or tension, your pain is going to increase as well."
Dr. Vargovich acknowledged it can be tough to convince patients that this type of treatment can help replace opioids.
"Initially we can get some pushback from some patients," she said. "But that usually just comes from not understanding kind of what we do."
While CBT has dramatically reduced the number of opioids Rick takes, it won't work that way for everyone. Dr. Vargovich says many people with chronic pain need opioids, and she worries about access due to increased regulations and restrictions caused by the overdose crisis.
"There's a population of patients who don't misuse their medication, who don't abuse it, who are maybe being forced off this medication in a way that they don't understand," Dr. Vargovich said, adding that opioids should be part of a treatment plan for many chronic pain patients.
Rick just got tired of the side effects of the opioids, that he says stole 10 years of his life. Now, he feels like a new man.
"My life today is wonderful," Rick said. "I'm happy with my life now. I am dealing every day with chronic pain, and I just look it straight in the face and say, 'I win.'"