Frequently Asked Questions
What documentation do I need in order to schedule an appointment for a consultation?
A physician must already have diagnosed you with a painful condition.
Additionally, we will need (1) the progress notes that document your most recent office visits as well as any procedures you have had in an attempt to control your pain (2) a copy of the MRI or CT report that shows your pathology (i.e.: herniated disc, nerve compression, etc.) and (3) a prescription print-out (from your pharmacist) documenting the various medications that you have received in the past year. These items need to be faxed to our office; if you have not spoken to us prior to faxing the information over please include a cover sheet with your name, date of birth, and telephone number.
If you need assistance gathering the above information please contact our office, as we can help you obtain the necessary documentation.
What are the side effects of opioids?
Taking pain medication, over a long period of time, comes with certain problems. However these problems are minimal when compared to quality of life associated with pain. Most of the side effects, such as dizziness and nausea can be treated with over the counter medications, and almost always subside with time. Others, such as constipation and physical dependence are typically unavoidable but can be managed medically.
What is the difference between dependence and addiction?
Physical dependence is not synonymous with addiction. It simply means that if you were to abruptly stop taking your pain medication your body would physiologically react. Symptoms would include sweating, chills, vomiting, dysphoria, etc. However, should a situation ever arise where your pain medications need to be withdrawn (for example if the cause of your pain was removed) the side effects associated with physical dependence can be avoided by gradually decreasing the dosage of your pain medication.
What is the actual definition of pain?
An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. [2]
What is acute pain?
Pain is your bodies response to an adverse chemical, thermal, or mechanical stimulus and is associated with surgery, trauma, and acute illness. It is generally time-limited.
What is the definition of chronic pain?
A pain state which is persistent and in which the cause of the pain cannot be removed or otherwise treated. Chronic pain may be associated with a long-term incurable or intractable medical condition or disease.
What exactly is drug abuse?
A term used in the psychiatric nomenclature to describe a maladaptive pattern of substance use, not related to a therapeutic purpose, resulting in recurrent and significant adverse consequences. Repeated nontherapeutic use of a substance causing harm that can manifest in physical or social impairment but does not meet the criteria of compulsive use despite harm. In common parlance substance abuse may also refer to the use of a substance, including a controlled prescription drug, that is outside of social norms (including the norm of adherence to prescribed drug treatments). [1]
What is addiction?
A primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving. Addiction is considered distinct from, though sometimes interrelated with, tolerance and physical dependence. Neither physical dependence nor tolerance to prescribed drugs is sufficient evidence of addiction. Unlike tolerance or physical dependence, addiction is not a predictable effect of drug exposure but represents an idiosyncratic adverse reaction in biologically and psychosocially vulnerable individuals for which drug exposure is only one of the etiological factors. Simple exposure to opioids does not produce addiction. [1]
What is a psuedoaddiction?
A term used to describe an iatrogenic phenomenon in which a patient with under treated pain is perceived by health care professionals to exhibit behaviors similar to those seen in addiction but is not true addiction. Patients may become focused on obtaining medications, may clock watch,.. or demonstrate behaviors that may otherwise seem inappropriately like drug seeking. The term has been used to describe even such behaviors as illicit drug use and deception, if they appear to be primarily driven by the patients efforts to obtain relief. It is believed that pseudoaddiction can be distinguished from true addiction because the behaviors resolve and do not recur when pain is effectively treated. Clinicians should be aware that abuse or addiction, and pseudoaddiction can co-exist, and a pattern of maladaptive drug-related behaviors could signal the presence of addiction, under treated pain, or both. [1]
What is physical dependence?
A state of adaptation that is manifested by a specific withdrawal syndrome that can be produced by abrupt cessation of dosing, rapid dose reduction, and/or administration of an antagonist. Most patients on long-term opioid therapy develop physical dependence, which is not predictive of addiction. [1]
What is a narcotic?
A legal term that refers to all those substances covered by the Single Convention on Narcotic Drugs, 1961, and the 1972 Protocol amending that Convention, including opiates, opioids as well as cocaine and marijuana. [1]
What is an opioid?
A scientific term that refers to both natural and synthetic drugs whose effects are mediated by specific receptors in the central and peripheral nervous systems, including codeine, morphine, oxycodone, and fentanyl. [1]
What is an opiate?
A substance that is produced from the poppy plant, such as codeine and morphine. [1]
What is tolerance?
Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drugs effects over time. Tolerance often occurs in the absence of addiction, as when drugs are used therapeutically over a period of time, and usually requires increased doses of the drug to produce the pharmacologic effects initially resulting from smaller doses. [1]
Citation 1
[1] American Academy of Pain Medicine, American Pain Society and American Society of Addiction Medicine (2001). Definitions related to the use of opioids for the treatment of pain.
Citation 2
[2] "Standards for the Use of Controlled Substances for Treatment of Pain." Florida Board of Medicine. Rule #64B8-9.013. December 21, 1999.
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