An individual with chronic disabling pain will naturally request pain killers, so why are some physicians reluctant to prescribe narcotics?
Opiates can cause multiple problems. We have highlighted some of the complications associated with opiate therapy in the sections that follow on addiction, tolerance, hyperesthesia and hyperalgesia, immune and hormonal changes, withdrawal and detoxification.
We may ask you to undergo psychological or psychiatric evaluation and/or counseling sessions because of your chronic pain. Chronic pain affects not only the body, but also the mind. It is beneficial to have someone to whom you can talk about the pain and its impact on your life. The therapist provides information to the pain management physician on the psychophysiological effects of the chronic pain. We provide psychophysiological therapy, family therapy, group and individual psychotherapy to assist in controlling and coping with the pain. Depending upon the cause and type of pain, as well as the type of therapy, we also sponsor community support groups in the St. Louis region. If you are considering a permanent implantable device, such as a Dorsal Column Stimulator (DCS) or Intrathecal Pump, we will require you to have psychological screening, to make certain you fulfill the criteria for implantation. Patient’s who have pre-existing psychiatric conditions such as bipolar disorder, borderline personality, schizophrenia, major depression, or any history of substance abuse should notify us immediately upon patient intake. Successful treatment of chronic pain in these particular patient groups depends upon a coordinated approach, especially in these specific conditions.
Pain medications are an important part of you care. We want to ensure that you are on an appropriate medication regimen for your specific pain. All patients who are prescribed narcotic pain medication must sign a narcotic agreement with The Center for Interventional Pain Management. This agreement is to ensure that we are the only physicians prescribing you pain medication, and that all narcotic pain medications are filled at a designated pharmacy. This will provide greater relief from the pain and also help prevent possible serious drug interactions. If you break this agreement, you will no longer be prescribed narcotic pain medication from the Center for Interventional Pain Management. The Center for Interventional Pain Management does not view running out of pain medication to be an emergency. You are responsible for taking your medication in the manner in which it is prescribed. No refills or medication changes will be given after hours, on weekend or holidays. Narcotic pain medications will not be refilled without physically seeing you in the office, on at least a monthly basis. Please remember, it is your responsibility to monitor your medication usage and to plan for your follow-up visit if you need a refill.