At 6 feet, 3 inches tall, Brett Muccino is a big man with a powerful frame, so he finds it hard to imagine how he could have flown through the narrow windshield of his old Ford Ranger. “It was a little, tiny thing,” he recalls. The devastating 1986 car crash crunched vertebrae in his neck and lower back. It also launched a 34-year battle with chronic pain and a love-hate relationship with the opioids he relied on to manage it.