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Jill Cottel, MD - Treatment of Chronic Pain in a Free Clinic Setting (2019 Conference) (LDN, low dose naltrexone)
Caring for patients with chronic pain in a free clinic setting presents its own unique set of challenges. Patients often wait until later in the presentation of their illness to seek care. Obstacles to care can include language barriers, literacy and educational issues, and lack of consistency with health care services. Medication options can be limited due to cost and availability, and patient compliance with the available medications is variable. Patients have limited financial resources and struggle with basic needs such as food, clothing, transportation and housing. Many patients have had traumatic life events, and therefore are dealing with emotional and mental health issues as well.
Low dose naltrexone (LDN) has consistently been demonstrated to be helpful in the treatment of chronic pain from a wide variety of causes. Despite the high prevalence of chronic pain in free clinic patients, the use of LDN has not been common due to issues with cost, availability, and lack of familiarity with the treatment. In this presentation we look at a case series of patients receiving care at a free clinic in the Commonwealth of Virginia, who have been prescribed LDN for chronic pain.