Frequently Asked Questions
Here are some answers to the most frequently asked questions. If you would like to email general questions to us, the most common ones may be posted here.
Q: What is different about pain management from other medical
specialties?
A: This is a complex question. There are several answers, all
interesting. Four reasons are (1) standard of care, (2) risks of
treatment, (3) law enforcement issues, and (4) public perception.
There are many others as well.
(1) Standard of Care: If you look at another specialty, like cardiology (heart doctors), there is a clear standard of care: if you have a heart attack, chances are that the same treatments will occur no matter where you go or who you see. This is not the case with pain management. Because there is no standard of care clearly established, one pain doctor may have a treatment that is very different from another pain doctor. That makes it hard to determine which treatment is the "right one."
(2) Risks of Treatment: Also, the medications used in pain management can cause addiction and death; although any medication could be fatal, this is especially true in pain management where patients often take extra medication while not realizing the danger.
(3) Law Enforcement: Pain management is the only field of medicine where the doctor not only has to abide with medical rules but also with legal rules; the heart doctor is not likely to be arrested for prescribing a blood pressure medication, but the news is full of pain doctors who are arrested for prescribing pain medications. Pain physicians do need to consider diversion and abuse when prescribing medications.
(4) Public Perception: A big difference relates to public perception: some people believe pain builds character while some believe pain causes misery. Some believe that only certain people with certain diseases deserve pain treatment and some believe that physicians should help relieve all suffering. In essence, everyone believes a heart attack needs to be treated, but NOT everyone believes pain should be treated.
Pain management is a very different field and is not simply another branch of medicine.
Q: Will I become an addict if I take
pain medication?
A: This is the most common general medication question. The answer
is somewhat complex. Currently, scientific research suggests that
the potential for addiction is mostly genetic and only partly
social/environmental. As such, it is believed that pain medications,
used properly for pain, are not likely to cause addiction. They do
result in dependence, just like many medications (like some blood
pressure medications), however, but dependence is not the same as
addiction. Addiction is an abnormal behavior associated with taking
the medication for purposes other than what was intended and
involves behaviors such as continuing to take the medication even
after suffering harm from the medication. Dependence is a normal
phenomenon meaning that your body is expecting the medication and if
it is stopped, the body has an odd withdrawal syndrome because it
has to readjust. Certain blood pressure medications, diabetes
medications, seizure medications, muscle relaxants and others cause
dependence, not just pain medications.
Q: How do I obtain
medication refills?
A: The good news is that they typically are not necessary from our
office. At the time of the office appointment, we typically provide
enough medication (with refills if appropriate) to last until the
next scheduled appointment. Your pharmacy does not need to fax or
call us for any refill authorizations; your pharmacy does
NOT need our permission or authorization to provide the prescribed
medication. Avoiding telephone or faxed refills not only
provides better service for our patients, but also reduces the
chance of medication errors because of bad telephone connections or
blurry faxes.
Q: I am having side effects or a new
problem. What do I do?
A: If you are not sure whether you are experiencing an emergency,
please call 911 or go to the nearest emergency room (if you can
travel). If you are absolutely sure that you are not having an
emergency, please call our office. If we are unable to return your
call in a reasonable amount of time, there will be an on-call
physician available for you, 24/7, 365 days per year.
Q: More questions coming!
Email us some questions!
A: [under construction!]