MemorialCare Orange Coast Medical Center, one of the premier spine health programs in Orange County, has been 99.9% opiate-free for six years – this is a remarkable undertaking for a spine program that has been at the forefront of spine pain for the OC community. According to the National Center for Biotechnology Information, opiates are the most prescribed drug class to treat lower back pain. In addition, opioid use prior to spine surgery ranges from 20%-70%, with nearly 20% of this population being opioid-dependent. Locally in Orange County, according to the OC Healthcare Agency, opioid overdose death rate is higher than the statewide rate and seven out of 10 drug related deaths in the county involve opioids.
“Prescription opioid use and opioid-related deaths have been an epidemic in the United States for years, and according to the CDC an estimated 40% of opioid overdose deaths, involved a prescription drug,” says Jason Koh, D.O., board-certified physiatrist and triage physician, Spine Health Center, Orange Coast Medical Center. “As the premier spine center in Orange County, it is important to us that we manage a patient’s pain through holistic and physical therapies so there isn’t a need for opiates. Our mission is returning people to health and wellness and opiate use doesn’t support that methodology.”
The Spine Health Center at MemorialCare Orange Coast Medical Center is a unique center offering a one-stop-shop for spine health. While the center is tied to a hospital, the first step in a patient’s spine journey starts at the outpatient clinic, where physical therapy, exercise therapies, stretching and other holistic approaches are used first, before there is a conversation about surgery. At the Spine Health Center, each patient is evaluated with a clinical exam to determine their pain generator so the patient can receive the right therapy for their unique issue.
“Most patients do well with a conservative approach like physical therapy, occupational therapy or minimally invasive procedures,” says Medhat Mikhael, M.D., medical director, Non-Surgical Spine Program, Orange Coast Medical Center. “If all of the conservative measures are exhausted, then a patient may be referred for spine surgery.”
This clinic is 99.9% opiate-free, prescribing to a max of 1-2 patients a year, and only in extreme and medically necessary cases. Often, through its approaches, the clinic helps patients not feel the need for opiate dependency to manage their pain, and often is instrumental in weaning people off the pain medication for good.
“We value the health of the people we serve and apply individualized, evidence-based clinical pathways for each patient. We are patient-centric and stewards in providing our patients who are suffering with back pain the right care, at the right place, at the right time” says Theresa Stern, director, Spine Health Center, Orange Coast Medical Center. This method has proven to provide leading outcomes.”
If conservative measures don’t provide the optimal outcomes for the patient, then the patient is referred for surgical consult. The Spine Health Center at MemorialCare Orange Coast Medical Center has leading surgical outcomes, often returning patients quality of life after intervention. Patients treated at the Spine Center, either with outpatient or surgical care, show exceptional improvement in their functional status.
“The surgical component at the Spine Health Center is second-to-none,” says Devin Binder, M.D., Ph.D., spine surgeon, Spine Health Center and medical director, Neurosciences Institute, Orange Coast Medical Center. “Post-surgery, our team is just as mindful of opiate use and seldom prescribes opiates. On a very rare occasion, for certain acute spine injuries, opiate therapy may be indicated, but the team works to ensure it’s a very short duration.”
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