Introduction to Pain Medications

Pain medications are just a very small part of what we do at IPCA.  We do not prescribe pain medications unless it is clear that they are helpful and are causing no or minimal harm - and we prescribe pain medications only to patients who responsibly manage their health care and who participate actively in improving their health in general and in optimizing recovery from the illness that is causing pain.

Pain medications, including opioids (narcotic medication like morphine, hydrocodone, oxycodone, codeine, etc) can be an important part of pain treatment.  They are certainly important in treating acute pain, such as pain after surgery.  They can at times be very helpful in managing pain from painful ichronic llnesses such as arthritis, nerve pain like peripheral neuropathy, back pain, headaches, and cancer. 

• For selected patients, opioid medications do have a role as a part of the treatment of chronic pain.  Some people can do more, be more active, think more clearly, and sleep better because of the medication they take for pain. 
• However, the great enthsiasm for treating chonic pain with opioids that existed 10 - 20 years ago has been tempered by experience, which has taught us that these medications are like any other - they often they do not help enough by themselves, and for some the pain medication actually causes more problems than it solves. 

The decision to use opioid medications to treat chronic pain is no different from using medications to treat high blood pressure - if a medication provides benefit without causing harm it is worth continuing at the lowest effective dose. 

However, there are unique "harm" concerns when it comes to opioids. 

• The possibility that the patient will use the medication for non-medical reasons ("addiction")
• The possibility that the medication will be diverted to people other than the patient, for profit, etc.

Consequently, a doctor prescribing opioid has to make an effort to pay attention to possibilities that do not exist with most other medications.  The additional effort/cost/risk of this effort, plus these other factors, has discouraged many providers from prescribing potent pain medication:

• Providers know that their medical training did not train them well enough to assess a patient taking pain medication
• Real and perceived and social pressures that surround opioid treatment

This is unfotunate, because many people who would be able to function better, contribute more, and suffer less if they had access to properly prescribed and monitored potent pain medication do not have access.

IPCA staff work with our patients, regulatory agencies, law enforcement, non-profit groups, and the medical community to disseminate good information on pain medications, to reduce unreasonable fears, and to educate regarding their role in treating pain.  When appropriate, we use potent pain medications carefully and judiciously as part of pain treatment.