Drug and narcotic addiction has plagued the tri-county area for a long time, but some doctors are fighting against it. Northern Medical Group Pain Management, a department of Northern Hospital of Surry County, is a pain management department that has been working to relieve patients of chronic pain as well as lower the abuse and addiction of drugs and narcotics in the area.
Formerly called Revival, the Northern Medical Group is located at 110 Dutchman Court in Elkin and is open four and a half days a week and works eight to 10 hours a day with patients.
Dr. Emidio Novembre is one of the driving forces of the center. He went to Medical School at The Chicago College of Osteopathic Medicine, and has obtained fellowships in obstetric anesthesia, anesthesiology, and pain management. He has been practicing medicine for about 25 years and has seen about 25,000 patients during his years.
“When I came here 14 years ago, I came here to do primarily pain management, but at that time it became evident that there was a problem with opioid addiction,” said Novembre. “There’s been a crisis of opioid abuse and misuse here. When I got here, Wilkes County was the worse in the state and Surry wasn’t far behind. It was at that time that I realized I had to get a certificate in addiction medicine.”
One of the major aspects about the Northern Medical Group is the intense screening process for patients seeking help. The pain management office does not take any kind of walk-ins. All of the patients must be referred by their primary doctor, urgent care, or by going through the suboxone website. Patients go through drug screening, confirmations, agreements and assessments during each visit.
“We’re pretty strict, but we do it to protect the patients and the community,” said Novembre. “We have a narcotics, opioid agreement where the patient agrees to only get their medications from us and what pharmacy they go to. Every time a patient come in we do assessments to make sure what the patient needs. We’re also very aware of ways patients can trick doctors and are proactive in making sure people aren’t selling medications. We educate patients on how to keep their medications from being stolen or from being used by someone in their family.”
Medications used by the center include non-narcotic medications, anti-convalescent, anti-depressants, intervention pain management procedures, epidurals, spinal-chord stimulation, and conventional therapies.
Northern Medical Group is very keen on looking for addiction in patients. Some red flags for spotting addiction have included patients running out of prescriptions early, saying they lose their medications, and wanting early refills.
Drugs commonly abused in this area include prescription narcotics and opioids such as opana and hydromorphone. Novembre also stated there’s been an increase in the use of alcohol and cigarettes, cocaine abuse, marijuana and methamphetamine. However, the biggest problem has been through the overdose of opioids.
“Part of the addiction has to do with the pleasure center in your brain which releases dopamine, which is a feel-good hormone, released in your brain through activities that make you feel good,” said Novembre. “This can be as simple as taking a nice shower, listening to music, or putting on nice clothes. Most people manage to feel good by doing a lot of the things I just said, but when they do a drug, it gives a stronger release and the amount needed for regular living is no longer enough. A lot of drugs and narcotics release a lot of dopamine.
“Another factor is age. When you are an adolescent, your pre-frontal cortex is not completely developed and that’s the part of your brain that controls impulse and that does not completely develop until as late as 24. Any kind of substance abuse before the age of 21 increases addiction.”
For patients at the center, the main goal is to return them to a level of functioning that is satisfactory to the patient.
“Everyone of our patients is given goals in terms of function which is measured by measurements of activities in daily living,” said Novembre. “Can you get up without assistance? Can you sit through a meal? Can you sit through a movie, church, or visiting a friend? We also look at their mental status. Are they depressed? Are they active with their social network? Most of the patients come to us because they’re not functioning and the goal is to return them to a previous level of functioning before they got sick.”
Patient Kendra Williams began going to Northern Medical Group back in February to help with an addiction problem and believes the center has helped her tremendously over the past year.
“It’s been great. I love going there,” said Williams. “The doctors, nurses and staff are very nice. They really care for me there. I had an addiction problem to opioids and I needed help so I got referred from my primary doctor and they put me on suboxone. If it weren’t for the doctors there and the treatments, I probably wouldn’t be clean and sober today.”
The center also does counseling led by Licensed Clinical Addiction Specialist (LCAS) Melissa Nelson, who has worked with the center for two years. After patients are recognized for needing psychiatric or dependence issues, she performs tests to make recommendations.
“The evaluations are very important, because they help determine appropriateness of treatments,” said Nelson. “There are many types of complications to pain, such as anxiety, depression, addiction and history. Some people may receive therapy if they need it such as cognitive behavior therapy, stages of change, and step-work. They may have things like family loss, sleep deprivation, or anxiety that are compromising their ability to be successful. The thing about chronic pain is that people are going to get it in their lives and they’re going to need people to help them through the matter. One of the things that draws me to the clinic, asides from the staff, is that the input matters to both the patient and the physicians.”
The office attempts to detox three to five patients a day, if their drug screen is clean, and the staff sees an average of 1,700 patients a month, with patients traveling from Surry, Wilkes, Yadkin, Alleghany, Ashe and Watauga counties as well as Carroll and Patrick in Virginia.
Novembre hopes to continue to expand services in the future and reach out to more people in need.
“One thing we want to establish is a headache clinic,” said Novembre. “We treat headaches, but I would like to expand that service. I’m talking to a physician who is one of the most renowned experts in the country. I also want to reach out to more of the veterans and reach out to the Fayetteville area. We’re also interested in the Yadkin County area because a void’s been created there and we’re looking into possibly opening up a clinic there one day a week.”
One thing Novembre is proud of is how caring they are about their patients.
“I’ve been here for 14 years and some people associate pain clinics with distributing narcotics,” said Novembre. “I’ve been actively been involved in reducing the number of narcotics and we’ve become a regional resource for the physicians here. There are other practices that treat pain, but this practice is owned and run by the Northern Hospital of Surry County. We’re dedicated to the patients in these areas, we look to provide the highest quality and care for the lowest costs. The majority of my day is spent making sure patients don’t get unnecessary medical bills. We treat our patients with dignity and respect because addiction is just another medical disorder that needs to be treated and recognized.”
Troy Brooks may be reached at 336-258-4058.