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Ankur Manvar, a medical doctor from Southeast Pain in Spine Care in Denver, discusses pain and the history of opioid use and pain management, including alternative medicine and addiction, at a seminar offered by the Lincoln County Substance Use Coalition on Thursday.

For some students, that game, be it football, baseball, soccer, volleyball or any other sport, is what defines them. For some, to have to miss games due to an injury can be like losing their identity. In an effort to alleviate the pain associated with an injury or recovery from surgery, a prescription may be obtained that may perhaps get them back into practice sooner. Unfortunately, that prescription may well be for opioids, which can be misused or lead to addiction.

A seminar was held for Lincoln County Schools physical education and health educators on Thursday to address the high incidence of young adults becoming addicted to opioids as a result of sporting injuries and to discuss alternative injury management modalities. The seminar was sponsored by the Lincoln County Substance Use Coalition, which was formed approximately two years ago to address the increased prevalence of opioid abuse in Lincoln County. 

Ankur Manvar, a medical doctor from Southeast Pain in Spine Care in Denver, Candice Fleming, who works both as an emergency medical technician employed by Lincoln County Emergency Management Services and as an athletic trainer employed by Atrium Health, Rev. Mike Devine and a former athlete, Derek Curl, were the speakers. Manvar opened the seminar with a discussion on pain and the history of opioid use and pain management, including alternative medicine and addiction.

I think doctors messed it up back in the 1980s,” he said. ‘Oh, youre in pain, let me give you this prescription and take it every day for the rest of your life.’I’m seeing 90-year-old patients these days that are on such high doses of narcotics that if I took half of what they take Id be knocked out for weeks.

Its not uncommon, Manvar told the attendees, that he sees patients who are still taking pain medicine prescribed after surgery that occurred years ago. They are also well versed on the different types of pain medicine available and ask for it by name. Manvar has to figure out why they are still on these narcotics and why or if theyre still having pain. He also has to deal with continuing requests for additional prescriptions.

“I’ve heard every excuse in the book,” he said. Its actually almost funny, I may write a book about it. One lady told me that a tornado blew all her pills in the drain and one time a cow tipped over the patient’s pill jar.”

While discussing the current opioid crisis, Manvar said that he did a surgical rotation in India where patients are given pain medicine during surgery and thats it. They werent given any pain medicine to take home.

The United States uses 80 percent of the world’s opioids,” he said. I have patients coming in after dental surgery wanting three months of narcotics. Its a culture thats built up here. Our job is to now to figure out how to change that.

These days, Manvar and his staff use a multidisciplinary approach to treat sports injuries and other injuries including physical therapy, acupuncture, surgery radiology and other modalities, including injecting pain medicine directly into the area where the pain is located instead of prescribing oral pain medicine.

A more in-depth discussion of alternative pain management was given by Fleming, as well as the basics of how to recognize and what to do in the instance of an opioid overdose.

The pastor at Covenant Church in Lincolnton and the faith representative for the Lincoln County Substance Use Coalition, Devine said he thought he had been invited to take part in the coalition due to knowing a lot of addicts, but the severity of the problem in the county has kept him involved.

“I’ve been blown away by the statistics,” he said. Our hospital is applying for grants to build a bigger morgue in Lincolnton because of opioids. Were the fifth leading town per capita for opioid deaths.

Devine then introduced, Curl who hes known since he was a child in his church youth group. Curl received a scholarship to play football at Lenoir-Rhyne University. An injury forced him out of football, at which time Curl became a volunteer coach at Lincolnton Middle School.

He was a great coach the first year but, during the second year I started noticing some things that were different about him,” Devine said. I didnt know what it was exactly. I really got concerned. He wasnt doing anything crazy around the kids or anything like that.

Curl called Devine one Sunday afternoon to share that he suffered from addiction and resigned as a coach. Curl quit narcotics cold turkey on that Sunday and that following Wednesday asked to come to tell the middle school football players goodbye.

He went with us to a game, we were playing at Burns.” Devine said with tears in his eyes. “I’ll never forget this as long as I live. In the middle of the second quarter, Im calling offense and out of the corner of my eye I saw Derek spinning around in a circle. He had his hands in his pockets, kind of like how they are right now. He literally fell into the middle of the field on about the 40 yard line having severe convulsions. I didnt know what to do, Im trying to figure out how to help my friend, what to do with 50 middle school students watching the coach that they loved having convulsions getting ready to die in front of them and how to get the attention of the referee to stop the game.

There was an ambulance at the game and Curl was able to get the care that he needed and was taken to the hospital. Back then, it wasnt well known that quitting such a severe addiction cold turkey was risky. For some reason, Devine said, Curl wasnt able to get into rehab until he quit.

Curl said that he had a great childhood and that church was not a choice in his house, he had to go every Sunday. He played baseball and basketball, but didnt start playing football until he got into middle school and fell in love with it. He also had an interest in music and started to play the drums for a praise band in church.

In high school, I played one year of JV and three years of varsity,” he said. I played hurt, bad hurt. The culture back then was to tough it out and get through it.

During Curls first year at LR, old injuries he suffered to his right ankle started to cause problems. Hed sprained it so many times that doctors had to replace all the ligaments in the ankle. They told him at that time that he was done playing football.

If I can convey one thing to you all today,” said Curl with a breaking voice,there is life after sports. I was never told thats who I was, but I didnt know who I was outside of sports. I think my addiction started because of an identity crisis and obviously because I had to have ankle surgery.

After Curl was sober for a year, he got into the Coast Guard and left Lincolnton, which he said was probably the best decision he ever made. Unfortunately, his relationship with narcotics wasnt over and he continued to use off and on, even while he was in the Coast Guard. Due to his medical history, which includes back surgery, a compound fracture in his leg and the ankle injury and subsequent surgery, he was in pain all of the time.

I never had to use a drug dealer, I just went to the doctor,” he said. I got medically discharged because of my back, met my wife and moved back here. I was still teetering back and forth until one day I found God. Im free now. Do I think about using? Every single day it crosses my mind, but I have an outlet now. I hit my knees and pray and I read my Bible.

Curl asked the coaches and other PE and health staff in the room to speak life” into the kids they see. To tell them that sports don’t define them.

Unfortunately for these kids, Friday night football is going to be the best it ever gets for them, its just a fact,” he said. Look for signs in these kids. Theres more information out there now to help you know what it is.

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