The medical professionals at Colorado Pain Care understand that acute or chronic pain is a disruptive experience that requires timely medical intervention. Drawing on our extensive professional experience treating pain in our patients, our physicians, advanced practice providers and allied health professionals are committed to finding the most appropriate pain management program for every patient we treat.
We have adapted many of the most powerful and effective pain therapies developed by modern medicine for our patients. This includes interventional procedures, physical therapy, behavioral management*, pharmacological therapies as well as other treatment modalities.
Among the most popular but risk-heavy pain treatments in U.S. health care is opioid medication. We recognize that opioid medications do offer potent benefits for certain patients exhibiting acute or chronic pain symptoms, but we have established some rigid guidelines for their use due to the serious risks of misuse, abuse, overdose, physical dependency, and even death.
Based on our interventional and multi-modal pain management approach, we consider opioid medications only one component of a multi-dimensional strategy that involves a broad spectrum of medical and pharmacological therapies. Generally speaking, only when more promising treatment options with less attached risks have proven ineffective will we consider potentially harmful therapies that involve opioid pain killers.
Colorado Pain Care generally adheres to all federal and state regulations and guidelines regarding opioid medication prescribing, patient monitoring and governmental reporting. We work hard to maintain the profession’s highest ethical standards and incorporate the best practices currently available.
Patient safety is one of our highest priorities.
Prerequisites for Opioid Treatment
To minimize risk to our patients, we generally only authorize opioid medication use if the following conditions are met:
- Patient exhibits moderate to severe pain which requires aggressive intervention
- Other non-opioid treatments have been tried and failed
- Clear and verifiable treatment goals have been developed in collaboration with the patient, including reduction in pain symptoms
- A detailed medical and psychological evaluation has been performed that examines patient risk factors including past substance abuse
- A thorough risk analysis has been performed in which any potential benefits are compared to risks including
- Opioid abuse
- Addiction
- Overdose
- Long-term health effects
- Death
- Sound patient-doctor relationship has been established in which the patient is expected to promptly communicate any health or behavioral changes
- Patient complies with urine drug screen and definitive testing requirements
- Signed “PATIENT RESPONSIBILITY AND CONTROLLED SUBSTANCE AGREEMENT” has been obtained from the patient
Prescribing Guidelines for Nonmalignant & Chronic Pain
To minimize risk to our patients, we generally adhere to the following guidelines:
- Initial dosages of opioid medications should be at minimum effective strength
- Prescriptions will be for immediate-release forms rather than extended-release pills
- Only a minimal number of opioid pills to remedy pain symptoms will be prescribed
- Continuous monitoring of patient symptoms will be maintained
- Routine, periodic re-evaluation of pain condition and opioid effectiveness
- Physician adheres to prescription drug monitoring program in accordance with law
- If pain symptoms abate, opioids will be reduced accordingly
Grounds for Discontinuation of Opioid Therapy
The following are several reasons in which opioid therapy may be discontinued or a patient may be discharged from the practice, as warranted by the circumstances:
- Failure to attend monthly medical appointments
- Lack of open, honest communication with therapeutic team
- Obtaining opioid prescriptions from more than one provider
- Misuse of medication or noncompliance with opioid policy
- Non-compliance with any state or federal laws regarding opioid possession or use
- Early refills or diversion of meds
- Behavior issues
* Although Colorado Pain Care does not currently provide behavioral health services in-house, we consider cognitive behavioral therapy (or CBT) an important prong of a multimodal approach, and we collaborate closely with outside behavioral health specialists and practitioners in this regard.