There had never been a period in his life when the pain had resolved despite treatment with multiple medications, including tricyclic antidepressants, systemic corticosteroids, and nonsteroidal anti-inflammatory drugs; transcutaneous electrical nerve stimulation; and multiple pain medication regimens that were coordinated by pain clinics. He started drinking heavily at age 13 years. He used cocaine, diazepam, marijuana, oxycodone and acetaminophen, and alcohol to try to get rid of the pain. He thought that cocaine worked best for the pain. He underwent detoxification as an outpatient in 1994. There was no family history of similar problems, and he was otherwise in good general health.