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For 20 years, Karen has been managing her pain with a strict daily regimen of opioids

“My nerve damage causes pain, and where the scar tissue wraps around the spinal cord it’s like sandpaper,” said 53-year-old Karen Begeal, who lives in Vancouver, Wash. “Every time I move, it gets worse. I can look fine to you right now. I can walk in the store for a few minutes but if I’m not leaning on a cart, after just a few minutes I get to where I can hardly stand up.”

Begeal says this while sitting in a plush beige easy chair, surrounded by a dozen personal items. Her purse, computer, briefcase, pillow, blanket, sweater, cane, pens and paper, and a cup of water are all within arm’s reach. That’s by design, since Begeal’s chronic, debilitating back pain keeps her in the chair for most of her day, every single day.