Safe Medication Management
Medication, whether over the counter or prescription, will most likely play some role in a pain management plan. In some cases, it will play a small complimentary role, but in others it might be the primary form of pain treatment.
After our medical team identifies the main source of pain, we can develop a custom medication plan that functions as a stand-alone treatment or works in conjunction with other treatment options.
Through this process of working together, we can monitor your pain and safely prescribe medications that are right for you.
HOW WE’RE DIFFERENT
Our philosophy is to treat our patients with a combination of medications, rehabilitative, and behavioral therapies. Our patients often yield better results through this method than just utilizing oral medications. Access Pain Solutions is one of the few pain management centers in Tulsa with onsite pain specialists that specialize in a wellness approach to pain. Our program uses therapies and treatment plans derived from the latest scientific advances.
Chronic pain is pain that occurs constantly over an extended period of time, normally six months or more. We know that living with chronic pain is hard. When a person is in pain for an extended period of time it directly affects their quality of life. Chronic pain can be treated by a variety of procedures designed to block pain signals reaching the brain. Oral medications play a role in blocking the pain receptors and treating inflammation. Opioids significantly block pain, but are also associated with abuse and mortality. However, if used properly and responsibly, patients can achieve relief from pain, regain normal functions and abilities, and live normal, healthy lives.
Our practice takes the utilization of oral pain medications very cautiously. We follow state and federal guidelines for recommended morphine equivalent dose (MED) limits. These guidelines help us to make sure we are adequately reliving pain while still keeping our patients safe.
There can be many adverse effects to using medications that include nausea, vomiting, itching, dry mouth, delirium, hypothermia, and constipation. Higher doses have been directly linked to accidental over dose rates. The combination of Benzodiazepines and opioids also increases the risks for accidental death. This is because Benzodiazepines and sleep aids, like Ambien, are central nervous system depressants. These combinations cause respiratory depression and irregular eart rates.
As part of Access Pain Solutions efforts to maintain patient safety, we want all of our patients to have a full understanding regarding controlled substances they are currently being prescribed. The combination of scheduled opioids and benzodiazepines, barbiturates, sleep aids and muscle relaxants increase the risk of death by suppressing the respiratory system. Although these medications may be prescribed with the goal of improving comfort and functionality, their medical use is also associated with the risk of serious adverse effects. We strongly discourage our patients from being on a medication regimen that includes opioids and central nervous system (CNS) depressant drugs.
We ask that all of our patients sign an agreement that they understand the risks associated with medications they are prescribed. They must acknowledge that they have an increased risk of death due to taking a combination of opioids and a CNS depressant. We as a pain management provider, remain in contact with other healthcare providers for the purposes of sharing information concerning any situation, as is deemed necessary for coordinated, high quality care.
There are other risks associated with opioid use. These include a lack of alertness and motion control, most often associated with higher doses. This may affect the ability of patients to undertake activities such as driving. Opioids remain a popular and widespread option in pain relief to this day. They can elicit pain relief and the complete return of normal function in individuals whose chronic pain caused severe debility and the loss of mobility and normal activity.
Introducing opioid treatment for chronic pain should be considered a major step, and requires an assessment by one of our board-certified pain management physicians to determine what is appropriate for each individual patient. Before prescribing these drugs, our staff will ensure the patient has had an insufficient response to the non-opioid pharmacological options, such as NSAID. This is assessed by pain scores and patient reports. Screening of patients for abuse risk factors also plays a factor.
If opioid use is deemed necessary, and the patient is not at significant risk of becoming an abuser, our clinic will monitor the patient throughout the course of their chronic pain treatment. This can be done through documentation. Tracking pharmacy and prescription reports is utilized. In addition, recording information such as dose, changes in pain severity, any adverse effects and the patient’s quality of life, mood, physical, and functional findings at each visit to the physician’s office. Urine drug testing may indicate abuse or diversion to other drugs. Patients who require high doses (e.g. the equivalent of 120mg morphine per day) are monitored very closely by our clinic. Our physicians that are prescribing opioids are very familiar with issues of opioid administration, risks, and addiction. We also hand out patient education, as this may help the patient be responsible and help them avoid misuse.
Our compliance checklist includes the following steps:
- Recording of the patient’s pain score (0-10)
- A verification of the patient’s need for these drugs, including their condition
- Documentation of a clinical benefit from opioid treatment, e.g. return of function and/or significant pain reduction, that should follow
- Discuss and define the outcomes of treatment with the patient, so that they are aware of what to expect (e.g. what level of pain relief and/or functional improvement) as a result of opioid intake
- Obtaining an up-to-date list of the patient’s current medication
- Any records of substance abuse or of behavior to indicate this (e.g. the patient denies taking a medication or denies a history of high-dose intake) will be requisitioned
- If no records of substance abuse are found, a physical examination of the painful area will take place
- The risks and benefits of opioid intake will be explained to the patient
- Any additional evaluation and/or treatment will take place; for example, a patient may undergo psychiatric assessment for depression
- An updated pharmacy board review will take place
- A current urine drug screen will also be necessary
- If the above tests are passed, the patient will sign an Opioid Agreement (a contract similar to the example described above), and begin their treatment
At Access Pain Solutions, our wellness approach does more than mask pain or cause it to temporarily subside. Our goal is to identify the pain generator and use advanced techniques to nip the problem in the bud and control the pain.
You don’t have to spend your days and nights fighting constant pain. At Access Pain Solutions, we provide a variety of exceptional techniques for dealing with chronic pain without the need for narcotics. Our goal is to relieve your pain to an acceptable level, or, if we cannot, help you significantly minimize your requirements for pain medication.
Opioids are also commonly associated with tolerance, dependence, and addiction. Tolerance is developed when the same dose of a drug is less effective over time. Opioids produce tolerance in humans at a quicker rate than many other drugs. Individuals with an especially low tolerance are at a higher risk of toxicity caused by opioids, particularly morphine, which can be fatal. The development of tolerance may cause a patient to seek a higher dose to relieve pain, thus increasing the probability of adverse effects, and of another major risk associated with opioid use: dependence. There are two main types of drug dependence–psychological and physiological, wherein the body reacts to discontinued use with harmful physical effects, such as a magnification of the condition treated. A painful condition may be perceived as much worse in the absence of opioid administration, due to physical dependence.
We take addiction very seriously at Access Pain Solutions. We understand that oral medications are at the heart of the opioid epidemic happening in our communities. For this reason, our medical providers are trained in addiction medicine. Their extensive training as a Substance Abuse and Mental Health Services Administration Suboxone provider allows us to provide medication assisted therapy to those seeking addiction treatment.
Addiction is the same as being chemically dependent to an opiate or similar drug. Some of these drugs include Vicodin, Oxycontin, morphine, Dilaudid, heroin, etc. Another way to put it, if you crave more of any drug or simply feel like you need it to function, you are likely addicted. Suboxone therapy can be effective way to free anyone from the chains of addiction. Suboxone treatment works to deter addiction to drugs used for pain relief.
Suboxone is specifically designed for the treatment of opiate dependence. Suboxone helps to curb cravings almost immediately, and nobody can tell you’re using it. In other words, you can work, interact socially, drive, and function normally while taking Suboxone.
If you or a loved one is addicted to an opiate, chances are you probably already know it. However, sometimes it can be difficult to admit it to yourself – and especially others. Suboxone works by taking the place of opiates in brain receptors, helping to suppress any withdrawal symptoms or cravings for your chosen opiate drug. Despite the absence of cravings, patients may choose to relapse. However, while Suboxone is the in system a patient will not retain any effects from the opiate. This helps prevent patients from relapsing, as well as gives them a chance to stop using again without the impending withdrawal.
Deciding to use Suboxone to treat your opiate problem does not mean you have chosen to replace one drug with another. Suboxone does not create a euphoric sensation when taken. No matter how much Suboxone you take, it will never result in getting high. It simply restores balance to your life.
There are three stages of Suboxone treatment:
Suboxone induction is the process of stopping the opiate medication that was being taken. After the adequate time has passed off of the abused substance, suboxone medication will be started. The Suboxone will help combat cravings and withdrawals.
The road to sobriety and defeating opiate addiction is a long process. During this maintenance phase, you will see your clinician at Access Pain Solutions regularly to monitor your progress. During this time, your provider will adjust your dosage if necessary and address any questions or issues you may have. At Access Pain Solutions, our care providers don’t stop there. We will continue to help you throughout your journey by providing support and ongoing counseling in order to minimize your risk of relapse.
Access Pain Solutions prides itself on our successful Suboxone program and our doctors who specialize in the use of Suboxone treatment for opiate addiction. Call us for an appointment today or simply fill out the appointment form and we’ll start the process of freeing you from your opiate addiction.