Medication Management
At Pacifica Pain Management Services
we approach chronic pain management
from a non-narcotic perspective.
While some patients may benefit
from enduring opiate therapy,
we treat those who fail to benefit
from this approach for a variety
of reasons. In some instances
this may be due to co-morbidities
such as addiction, depression,
chemical sensitivity, respiratory
depression, and/or cognitive/psychomotor
deficits to name a few. In the
context of an intense, round-the-clock
program we may use medications
in other categories to assist
the patient in controlling pain
and other issues. Those medication
categories may include:
- Anti-depressants
- Anti-convulsants
- Anti-inflammatories
- Channel blockers
- Other medications as
indicated
The list of specific non-narcotic
and non-benzodiazepine medications
available singly or in combination
for use with chronic pain conditions
is extremely large and are considered
at our clinic. Our patients are
usually content managing their
chronic pain without the use
of habit-forming medications
and typically do not report any
particular increase in pain intensity
following detoxification.
Our detoxification process is
slow (usually completed over
12+ days) using a tapering dose
of a long-acting narcotic in
combination with other medications
to control withdrawal symptoms.
Patient reports of satisfaction
with our detoxification protocol
are consistently high. Controlling
sleep deficits, nausea and diarrhea
are on-going challenges.
Once patients complete our program
they fully understand the need
to avoid narcotics for chronic
pain for the indefinite future.
Acute medical needs for narcotics
(ie., post-operatively) are,
of course, the exception. Wherever
possible we work with the referring
physician to keep patients on
the right track. Coordinated
care makes handling patient requests
for opiates in the post-detoxification
phase easier as this can be deferred
to our clinic staff.
Our goal is to titrate most unnecessary
medications and work within a
self-efficacy model in which
the patient's enhanced self-confidence,
physical strength, and determination
work in concert with non-narcotic
medications to defeat syndrome
effects and return the patient
to functional stability.
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