Opioids: Doctors and a non-narcotic solution

Published: Nov. 10, 2017 at 1:46 PM EST
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We hear every day that we are facing an opioid epidemic. In fact, this is the deadliest drug crisis in U.S. history.

It's not just our kids who are affected. Our doctors are as well.

Michiana learned that in the most horrific way last July when a well-known and respected pain doctor was gunned down after refusing to prescribe opioid drugs.

Before Dr. Todd Graham's senseless death, the South Bend-Mishawaka medical community had already started taking a non-narcotic approach of easing patient pain, but it's a mission that's gaining momentum.

The community was left reeling when, in June of 2015, brothers Nick and Jack Savage of Granger were found dead by their mother after the teens had gone to a party the night before and consumed alcohol and opioids.

The prescription drugs were brought to the party by a third person.

Becky, who along with her husband had always talked to their sons about alcohol and street drugs, says she was shocked and horrified that the drugs her sons took came from somebody's medicine cabinet. "Totally shocked because it was something we never talked about, but it wasn't something we ever thought we had to talk about. Because prescription drugs, being in the medical field, they know that they get a prescription and they take the prescription to get better. It wasn't something that we abuse or we talked about abusing."

On average, 91 Americans overdose every day.

The Michiana community was stunned when Dr. Graham, a pain specialist, was gunned down outside his Mishawaka office after refusing to prescribe opioid drugs.

Dr. Stephen Mitros, a long-time South Bend orthopedic surgeon, says Graham's death shocked the medical community and beyond. "Todd's death was absolutely tragic, completely unnecessary. It's got a lot of doctors really scared now because all of us are trying to do the right thing. Todd was doing the right thing."

Mitros has been an orthopedic surgeon for over three decades and said he brought a surgical technique back to South Bend from Indianapolis four years ago so that he could offer effective pain relief and get his patients back on their feet sooner. "I did not do it with any crusading idea about cutting down on my contribution to the opioid crisis."

But that's what he and other area surgeons started seeing.

Instead of putting his hip and knee patients under general anesthetic, they followed a non-narcotic approach using local anesthetic in the spine with one shot, a block in the thigh depending on the surgery, and a cocktail which he injects around the area where he is operating. It's called the Exparel Administration Technique.

And the benefit?

Mitros says it's night and day. "Now patients come into the recovery room and it's like, 'Hey doc, look what I can do.' Bending their knees, lifting their legs up."

Because they are not getting heavy narcotics before and during surgery, "They have much more effective pain control early on, they rehab a little faster, they recover a little quicker, their pain sensors aren't as sensitized as the patients who didn't get this system. We're up to the range here between 80 and 85 percent reduction in narcotics compared to March of 2014."

While patients are still discharged with pain pills, he says that has also been greatly reduced. "I think you still have to be careful when you discharge your patients that you don't overprescribe. If you look at the volume of prescriptions written, total volume of pills, it's become less."

When asked if that meant fewer narcotics sitting in patients' medicine cabinets, his answer was, "Exactly."

That means the world to Becky, who knows she lost her sons because somebody had enough prescription pain killers in their medicine cabinet to share with her sons at a party. "I'd like to think that because of what happened two and a half years ago, that's it's maybe spurred some momentum to make some changes."

When asked whether doctors like Dr. Mitros can make a difference, she responded, "I think they can. I think they're not the problem but they're part of the solution. I think our whole community can be part of the solution."

In the meantime, Becky continues to spread her message through the 525 Foundation she and her husband started. She's making local and national television appearances. She does it in hopes of sparing even one other family of their devastating loss.

"I'm going to Texas. It's kind of neat, it's not something that we ever expected, but it's something that we love to do only because we are telling Nick and Jack's story and they're living on through us telling their story, and they're saving lives."

Mitros and his colleagues are also doing their part to find other ways to provide pain relief so fewer of these drugs are out on the streets. "I don't know what kind of effect it's going to have on the national scene, but I sleep better at night knowing my contribution is less."

That upcoming trip to Texas really shocked and honored Becky. She'll be sharing her story with the likes of former NFL football player Hershel Walker, who speaks about mental illness, and the wife of American Sniper's Chris Kyle, who lost her husband after he was shot by a vet he was trying to help.

If you would like more information on the Savages' 525 Foundation, visit

For more information about the Experal Administration Technique that Mitros is using in hip and knee replacement surgery, visit