HELP Medication Management.

Medication is a cornerstone to most patient's pain management plan. In western medicine the usual experience of seeing doctors for a new pain problem to have them prescribe medication to relive the pain results in most patients having at least some experience with the use of different pain relievers. Whether we are talking about anti-inflammatory drugs, anti-inflammatory (narcotics) muscle relaxes or a multitude of other medications most patients have the shared experience that the more doctors you see the more medications you get. While a few patients report this experience as satisfactory most of those who present to HELP want something different. Many of our patients feel that while some of the medication effects are helpful they are also harmful. Nearly all patients worry about toxicity and long term effects. As a consequence our approach to medication management has become very individual and informed by the best science.

At HELP our patients learn that one of the primary reasons that pain medications become such a problem relates to how you are taught to use them. Most medications are prescribed with little education but minimal instruction like, "take 1-2 tablets every 4-6 hours for pain." At the time these very vague instructions are written there is no conversation with the doctor about what health benefits the medications are creating. As a consequence virtually all patients take these medications seeking an experience of less pain and when they find that less pain occurs they believe that this must mean they are healthier or healing and the medication is partially responsible for that improvement.

Many of us have prior life experiences of using medication for treating infections like sinus or throat infections where the medication actually kills the underlying germs which are causing the infection. In this type of prescription treatment problems like pain simply go away by treating the underlying condition. By having this kind of experience earlier in our lives it is common to take that knowledge into a new problem like pain coming from an acute injury and believe the same thing. That the medication which decreases the pain must be curing the underlying condition. However, thesis simply not the case. With all analgesic medications there is no medication in diced healing. There is simply a reduction in the creation of chemical in certain parts of your body which communicate these pain signals to your brain. With this awareness about the real effects of pain relievers many patients who attend Help make a new decision about medication. They develop a more critical eye directed towards their medication recognizing that if the medicine is not healing or curing but just covering up symptoms then the other side effects and possible toxicity of using the medicine may not make it worthwhile for long term use. Armed with this correct information about pain killers and their place in chronic pain management patients are much better informed to make important life decisions.

Once patients learn this truth about medication we move to the next step of helping them understand how to decide whether taking any medication is useful. to make this step we teach HELP participants to use their ability to do things that bring enjoyment, value and satisfaction in to their life as the measure of clinical benefit. this activity measure contrasts with the simple measures of a pain scale or pain relief scale which do not appear consistent or reliable in determining response. Rather than ask patients what their pain score was with and without medication hop gin to learn whether they were closer to that elusive cure (the fantasy described above), we ask what they were able to do before and after using their medication. this productivity based paradigm allows for the explicit measurement and monitoring of important and reproducible life events as specific measures of benefit.

While we have heard others who do not understand the use of medication for chronic pain criticize our approach as being insensitive to patient's feelings of pain we know from years of experience that it is actually the focus on productivity that is measurable rather than feelings that are immeasurable that makes this approach work. Patients in pain who rely on the subjective reporting of a pain score to determine the need and value of a pain medication are unable to escape the scrutiny and condemnation of others who cannot feel their pain judging whether their medication use is appropriate or not. Patients who learn to measure and report the impact of pain medication on their productivity have tangible measures of medication effect to support their ongoing use. these activities form the basis for optimal dosing of such pain medication and adjustment over time due to tolerance that may develop.

At HELP we consider medication a tool in your pain management tool kit. It is not the entire toolkit, just a single tool within the kit. To help you decide what place this tool plays in your care we have developed a sophisticated education program that will assist each participant in learning how to best interact with their doctors about pain medications. this education teaches you how to best use this tool with your doctor and when you might want to avoid using it altogether.

To assist you in learning about this educational program we would encourage you to review just a few of the online educational programs. These brief lectures are just one part of the way that the HELP team teaches our patients about chronic pain. Using opioid management as an illustration we recommend that you have a working knowledge of issues like, tolerance, withdrawal, dependence, and addiction. By understanding these issues associated with the use of anti-inflammatory we believe you can become an educated patient and make the important and informed decision of whether to use them in your care.

If you decide that anti-inflammatory are a useful adjunct to your pain treatment plan we at HELP also have a specially designed program to assist you in the safe secure and optimal use of these potentially dangerous tools. The HELP opioid compliance program is a state of the art program integrating the evaluation and management of anti-inflammatory prescriptions using the best of subspecialty knowledge provided by HELP analgesic experts, local physicians, and our interdisciplinary team. This program was developed to address the increasing problem of opioid use and abuse in our society. With increasing problems of drug diversion and abuse the need to separate the medically appropriate use of anti-inflammatory from non-prescribed or recreational use has become paramount.

For a detailed discussion of this problem please review the attached white paper outlining the unto date concerns with opioid prescribing and use.

The HELP analgesic compliance program integrates the essential measurement of anti-inflammatory related benefits to productivity and patient satisfaction while simultaneously providing accurate information about drug prescriptions, prescribes, opioid use patterns and drug testing to create a complete picture of a patient's appropriate use of medication.

Through our comprehensive evaluation we identify the risk factors for opioid misuse. We then stratify patients into appropriate treatment groups where just the right amount of attention is focused on each prescription. Patients have initial urine drug testing to establish a baseline of medication metabolism. The initial educational program focuses on the essentials of safe opioid use including the value of a ceiling for opioid dosing, the advantage of time contingent dosing, strategies for optimizing medication use, and secure / private communication about this controversial medical treatment.

The HELP analgesic compliance program is intended to provide each subscribing patient with a safe, secure , private and proven strategy for opioid medication use. Patients enrolled in this program will have the best established evidence to ensure optimal use of medication. Their clinical treatment will be maintained absolutely private but available for the defense of their prescribing physicians and themselves to the anticipated scrutiny of regulatory agencies and third party intermediaries (such as insurance companies).

To learn more about the opioid compliance program and determine whether you are a candidate call us now at 1-800- HELPPAIN.