UK headache clinic among top 20, and affiliated orofacial pain program is only one in Midwest or South; they give relief

Headache sufferers often struggle with finding the right treatment, and some even find themselves on medications that don't work and become completely unable to function. One of those found relief at the headache clinic at the University of Kentucky.

Tonya Morgan, a 30-year-old chemist, got a debilitating migraine headache that wouldn't go away in 2011. Before she connected with the UK clinic, she had seen many doctors and was taking as many as 30 different types of medicine a day to no avail, and had been given a recommendation from the Cleveland Clinic after an 11-week evaluation, for "extremely risky brain surgery," says a UK news release. "I was so sensitive to noise that I could lie in my bed and hear my mother down the hall eating potato chips. Going to a restaurant, driving, going to church -- all of those became unbearable. I was miserable," Morgan said.

Her doctor is Dr. Siddharth Kapoor, director of the Headache Clinic at the Kentucky Neuroscience Institute at UK HealthCare. He and Dr. Jonathan Smith are part of the headache program at UK that is considered among the top 20 accredited programs in the country, according to the release. It uses a multidisciplinary approach; UK HealthCare's orofacial pain program, which complements the services of the headache clinic, is one of just 12 accredited programs nationally, and the only one in the entire Midwest and South.
Kapoor's strategy, says the release, includes spending enough time with the patient to find out as much as he can about their headaches and finding the most effective way to get rid of them. "Headache is an extremely complex neurological process, and there usually isn't a quick fix for pain relief," Kapoor said. "Unless you spend a lot of time with each patient, listening to their problems and asking a lot of questions, it's nearly impossible to find the right way to help them."

Kapoor tried several different treatments on Morgan before they found the most effective: radio-frequency ablation, during which a high-frequency electric current was targeted at specific nerves in the brain, destroying the tissue responsible for her headaches. She is now headache free and has resumed a "normal life," the release says.

Headaches and other chronic pain affect more than 36 million Americans, and many of them don't seek help -- or see doctors who aren't completely aware of the full range of pain management, according to the release. Smith said there are many myths surrounding headache causes, such as foods or changes in blood vessels in the brain, and the UK clinic can "attack headache on many fronts." 

More treatment needed to deal with painkiller abuse, expert witness tells Senate caucus; McConnell says jail helps, too

Addiction to prescription painkillers, and increased addiction to heroin by people originally hooked on prescription medicine, is "a public health disaster of catastrophic proportions" that "was caused by the medical community," the chief medical officer of a New York drug-treatment program said at a U.S. Senate hearing Wednesday.

"The medical community, including dentists, must prescribe more cautiously," Dr. Andrew Kolodny of Phoenix House told the U.S. Senate Caucus on International Narcotics Control. In areas where abuse is rampant, "Treatment capacity does not come close to meeting demand," he said. "If we don't rapidly expand access to treatment, the outlook is grim." He also called for better education of physicians about the risks of prescribing painkillers.

Senate Republican Leader Mitch McConnell of Kentucky attended the first several minutes of the hearing and read a statement calling for the problem to be attacked by a combination of treatment and incarceration, with the use of multi-agency partnerships. He also said, "It's clear that the increase in heroin addiction is tied to our fight against prescription drug abuse."

Part of that fight included requiring Kentucky doctors to participate in the state's prescription-drug monitoring program, which Kolodny said made the state one of only three with such a requirement. The others are New York and Tennessee.

Officials have said that when Kentucky cracked down on disreputable "pill mill" pain clinics, making prescriptions harder to get, addicts turned to heroin. "Heroin is just a symbol for the prescription-drug problem," Joseph Rannazzisi, deputy assistant administrator of the Drug Enforcement Administration, told the senators.

Rannazzisi said the largely successful effort against pill mills in Florida has driven them to Georgia and Tennessee. He said Tennessee has 300 pain clinics. "They're moving north and west," he said. "Regulatory boards in the states need to take control."

Sen. Dianne Feinstein of California, the Democratic co-chair of the caucus, said the testimony made prescription-painkiller and heroin abuse seem worse than the drug problems she dealt with as mayor of San Francisco in the 1980s. "Nothing like today," she said. "I am really struck."