Medication Safety

Prescription Drug Safety Information from Blue Ridge Pain Management Associates

The pain management physicians of Blue Ridge Pain Management Associates create an individualized treatment plan for each patient. We look at all available treatments that target a particular diagnosis or condition. It is important to be comprehensive since pain has such an enormous impact on the quality of life.

Prescription pain medications are used for a variety of acute and chronic pain conditions. These medications can be an effective component of pain management but must be used with caution and safeguarded from inappropriate use by others.

There are a variety of medications and categories of pharmacologic therapies available to help individuals with both acute and chronic pain. These categories include:

Anti-inflammatory medications
Muscle relaxants
Anti-depressants
Anti-convulsants
Analgesics

Analgesics (medications whose primary function is to relieve pain) are divided into two main subgroups, i.e., opioids (narcotics) and non-opioid forms. Opioids are currently the most potent, and in some instances the most effective, analgesic used to treat both acute and chronic pain. However, not all musculoskeletal pain syndromes require opioid medication, either because the severity of the pain does not justify the use of narcotics or in some instances the pain syndrome may simply be unresponsive or poorly responsive to opioid medication.

In our view, a prescription for opioid medication must be considered as part of the overall pain management plan, including interventional pain management techniques when applicable and other pharmacologic approaches.

The hallmark of opioid therapy is the need to individualize treatment for each patient. In so doing, we follow a number of important steps and guidelines:

Define the indication for opioid treatment.
Need for aggressive intervention for moderate to severe disabling pain.
Failure of non-opioid therapy.
Comprehensive assessment and treatment.
Define diagnosis to be treated.
Evaluate risk factors (psychosocial factors, mood, history of substance abuse, among others).
Obtain a signed “opioid contract” or prescribing agreement.
Review potential side effects – constipation, drowsiness, nausea, etc.
Explain grounds for tapering or discontinuing opioid medications altogether.
Set goals of treatment with opioids focusing on pain reduction, improved functioning and enhanced ability to cope with pain.
Provide overdose education to high risk patients and their families and prescribe naloxone.
Maintenance and follow-up (appointments for prescription refills are at least every 3 months).

Aberrant drug behaviors are grounds for discontinuation of opioid therapy and may lead to dismissal from our practice. These include obtaining prescriptions from multiple providers or from non-medical sources. It also includes non-approved dose escalation by the patient, lost or stolen prescriptions (these will not be replaced), forged prescriptions, and impulsive drug use. Opioid therapy will be discontinued at any time if the risks outweigh the benefits of continued therapy

We follow the standards set forth by the Commonwealth of Virginia Department of Health Professions Prescription Monitoring Program.

Opioid Overdose Recognition and Treatment

In collaboration with Project Lazarus, Blue Ridge Pain Management Associates has pioneered the most comprehensive and cost effective chronic pain treatment and prescription medication safety program in the country.

The purpose of this program is to educate our patients, their families and the Southwestern Virginia region on the proper use, risks and strategies to decrease the personal and societal risk of prescription pain medications.

Medical Treatment for opioid dependence and opioid-weaning options/information: