St. Louis pain clinic says most patients taper below 30 MME

A St. Louis interventional pain practice released internal opioid data on International Overdose Awareness Day, saying most patients either wean off opioids or drop below 30 morphine milligram equivalents per day after treatment. The figures are meant to argue that treating the pain source directly can reduce opioid need more effectively than tapering alone.

Why it matters: - The Padda Institute Center for Interventional Pain Management is using its own patient data to argue that the opioid debate has missed a key point: treating the pain generator can reduce opioid use without making tapering the goal. - The practice says its results suggest many patients with chronic pain can move to lower doses or off opioids entirely when care is interventional first. - The clinic frames the findings as especially relevant on International Overdose Awareness Day, when opioid policy and pain care are under a closer spotlight.

What happened: - The Padda Institute Center for Interventional Pain Management in St. Louis published internal opioid numbers on Aug. 31, 2026. - The practice said the average new patient has been in pain for more than 2.5 years and is taking more than 90 morphine milligram equivalents per day. - Within 90 days of active interventional treatment, 21% of patients were completely weaned off opioid pain medication. - Within one year, 34% of patients were completely weaned off all opioid pain medication. - Among patients who could not be fully weaned, most were reduced below 30 morphine milligram equivalents per day. - Dr. Gurpreet Singh Padda, who directs the practice, said the field’s failure was not only overprescribing but also treating the prescription as the treatment.

The details: - The clinic said it is interventional first and does not offer medication-only pain management. - The practice said it identifies the pain source and treats it directly, including inflamed facet joints, compressed nerve roots and irritated sacroiliac joints. - Procedures are performed under fluoroscopic or ultrasound guidance rather than by anatomical landmark, so placement is confirmed before medication is delivered. - Diagnostic blocks are used to determine which structure is producing pain before treatment begins. - Padda said tapering reduces a dose, while treating the generator changes why the dose was needed. - The clinic said sustained opioid exposure can contribute to opioid-induced hyperalgesia, a state where pain sensitivity rises as dose rises. - The practice also cited long-term opioid effects including suppression of the hypothalamic-pituitary-gonadal axis, hypogonadism, and impacts on insulin sensitivity, bone density and immune function.

Between the lines: - The clinic is arguing that opioid reduction should be seen as an outcome of effective pain treatment, not just a policy target. - The practice is also pushing back on a common narrative in pain medicine: that the solution is either more prescribing or abrupt tapering. - Its broader view is that chronic pain, opioid dependence and metabolic disease are linked through inflammation and central sensitization. - The clinic said visceral adipose tissue releases inflammatory cytokines that can sensitize pain pathways, and that insulin resistance can worsen neuropathic pain. - That framing supports why the practice says it pairs metabolic and lifestyle care with procedures instead of treating those issues later.

What's next: - The Padda Institute appears to be using its internal results to support continued interventional-first care and broader attention to metabolic factors in pain treatment. - The clinic’s public reporting may encourage other pain practices to publish their own opioid outcomes and treatment pathways. - Dr. Padda said the goal is to change the body’s pain source, not just move a medication number.

The bottom line: - The clinic’s message is simple: if pain is treated at its source, opioid use may fall without making tapering the only measure of success.