The goal of medication management is to achieve optimal comfort and function with minimal side effects from analgesic therapy. The pain management plan should include treatment of the cause of the pain (if possible), optimal use of analgesic and adjuvant medication, use of non-pharmacologic interventions, and invasive approaches when necessary.
Medications are often the first step in the management of pain because they are effective, relatively low risk, inexpensive, and usually have rapid onset. The following three major classes of medications are used alone or, more commonly, in combination to manage pain.
- NSAIDS: non-steroidal anti-inflammatory drugs. NSAIDs are used primarily to treat inflammation, mild to moderate pain, and fever. Examples include aspirin, ibuprofen, naproxen and diclofenac.
- Adjuvant or co-analgesic medications: these medications are not usually thought of as pain killers, but when given with known analgesics, have synergistic effects or exhibit pain killing activity of their own. For example, anticonvulsants (gabapentin) and antidepressants (amitriptyline) are adjuvant medications used to treat neuropathic pain.
- Opioid Analgesics: suppress your perception of pain and calm your emotional response to pain by reducing the number of pain signals sent by the nervous system and the brain's reaction to those pain signals. Examples include fentanyl, hydrocodone, morphine and oxycodone.
Patients looking to initiate Medication Management at Novocur for the first time should expect to sign an Opioid Agreement that guarantees your compliance with prescription monitoring, urine toxicology procedures, recreational drug use policies and other safety requirements.
Importantly, new medication management patients should not expect to receive a prescription for an opioid/narcotic pain medication on the very first visit. Our staff needs time to verify your opioid prescription history and to receive confirmatory baseline urine toxicology results before the doctor can write your prescription. These controls help guarantee patient safety.