OGDEN — When J.B. Griggs, who had suffered 3rd- and 4th-degree burns to 80 percent of his body, was told he had to drastically cut the pain medications he was taking and do it in just three weeks, he figured he was going to die.
"I felt like I was a man waiting to be executed," Griggs, who lives near Phoenix, Ariz., said Thursday. He didn't seem to have any other option.
That was until an addictionologist at MountainStar Healthcare's Ogden Regional Medical Center decided to help.
"This man was desperate for help and someone needed to help him," said Dr. Nadya Wayment. "There was no question to me that someone needed to take the risk."
She had learned about Griggs' medically complex situation from Dr. Carrie Bordinko, internal medicine specialist at Consolaré Primary Care in Paradise Valley, Ariz., who made calls to premier health systems across the country to find him some support — and fast, because new Arizona law forbade Griggs' pain management doctor from prescribing him the level of opioids he had grown to depend upon since the accident.
On Sept. 10, 1998, Griggs was working on a construction site in California and had jumped into a tractor-scraper to smooth paths for storage units to be built when an electrical malfunction occurred, leaving him covered in 300-degree hydraulic fluid, which then ignited, all while he was trapped inside the cab.
"I was trying to get out of there pretty quick," Griggs recalls, saying his seat belt wouldn't come loose. When he finally got the seat belt off, he ran from the rig, still on fire, to a nearby water truck for cooling relief.
"I never felt anything so good in all my life," he said.
For years, he struggled to merely exist, suffering unimaginable pain, even with higher-than-recommended doses of opiate medications.
"He lived and he survived and he existed, but he never left his room. He never left his bedroom. He slept most of the day," Bordinko, Griggs' primary care doctor, said. "He was chronically miserable."
And his tolerance for morphine increased over the more than 20 years, to newly clarified medically unsafe levels.
Griggs needed highly supervised medical detoxification — sedation — to come off the 540 morphine milligram equivalents and 120 milligrams of Ketamine he took each day. The physical and emotional complications resulting from his accident would need around-the-clock care in an intensive care unit, something only Ogden Regional Medical Center was willing to offer.
"His body cannot handle stressors like the rest of us can," Bordinko said. "A 'rough day' for one of us could be a fatal day for him."
She said modern medicine is saving more and more people, "bringing them back from the brink of death," only to be told they can't have access to the medications they might need.
"We bring them back and they set arbitrary guidelines on their pain management," Bordinko said. She wants better systems in place to help people like Griggs.
Not everyone needs the type of detox that Griggs did. In fact, his complicated case is quite rare. But Wayment said there are people experiencing opiate addiction for medically legitimate reasons — acute, chronic pain — and they need options written into the laws, too.
Arizona's new law, much like Utah's law that limits the number of days a person can be prescribed certain pain medications, is similar to those passed in at least a dozen other states. The laws limit a doctor's ability to prescribe opioid medications, the likes of which are often the best solution for patients experiencing ongoing pain. It is a political response to a growing nationwide problem, including a opiate-related death rate that the U.S. Centers for Disease Control and Prevention says has nearly quadrupled since 1999.
Wayment said tighter regulation is within reason and probably necessary, but it does not consider people who really need opiates for treatment. She said the laws should allow physicians to make exemptions for certain patients.
"The pain is so intense at times, it drives you places you don't want to go," Griggs said, admitting he needed the high dose pain meds, and at times, maybe even more.
Yet, he felt criminalized for needing them.
Griggs, who has endured at least 125 skin graft surgeries over the years, said his pain levels hovered between a seven and eight (on a scale of one to 10) every single day, even with the high opiate doses he was taking.
"I was existing, not living," he said. "I saw no way out."
The 61-year-old met with Wayment with less than two weeks to being cut off from his meds.
"I have always believed that it is very, very important to be in medicine for the right reasons and those reasons are for the patients' care," Wayment said. "Knowing this courageous man needed help, we were most definitely going to help him."
Griggs said he wasn't sure it would work.
"Detox pain is as great, if not more than when I was burned," he said. "It's excruciating pain."
Wayment and a team of intensivists at Ogden Regional Medical Center's intensive care unit put Griggs into a medically controlled comatose state, allowing him to relax through the detoxification, but keep his vitals, and the pain, in check.
Eight very long and difficult days later and he was managing his pain with 20 milligrams of Suboxone, a different pain management medication approved in 2002, that isn't nearly as harmful to the rest of the body. And, for the past few months, his pain level has stayed down around a four, which is great for someone who has endured what Griggs has.3 comments on this story
"I feel alive again," Griggs said. "I feel like I've been reborn. I just feel alive. I want to go out and do things."
At the top of his list is helping others.
Griggs wants to offer support to burn survivors and their families, and to advocate for better opiate drug laws throughout the country. He doesn't want people to suffer the way he has, and for so long.
"We need to help make more people feel like survivors and less like victims," he said. "We need to give more people a chance to be alive."