9300 SE 91st Avenue, Suite 400, Portland, OR 97086

Medication Management

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Do you prescribe Suboxone ?

Our practice does not offer Suboxone.

Do you require a referral or can I just call to make an appointment?

New patients typically need to be referred by a primary care physician or other specialist. If you feel you would benefit from our services, ask your physician for a referral or contact our center and we may be able to assist you in obtaining a referral from your provider.

What happens at the first appointment?

At this appointment you will meet with one of our practitioners for a comprehensive exam, where a personalized treatment plan will be developed for you.

**Please be aware that our providers do not prescribe controlled substances at your first visit, and any medication refills you need in the meantime would need to be coordinated with your prescriber.

My previous provider said she/he will not prescribe any more medication. What do I do now?

1) Talk with your previous provider about how to safely taper your medications.

2) If you are already out of medication, talk with them about managing withdrawal symptoms.

3) Unfortunately we cannot take over your prescription medications in an urgent situation like this.

Do you prescribe opioid pain medications?

Opioids can be part of a treatment regimen, but often certain types of pain are not well treated with them and because of their safety profile they are often not the best option in the long term.

Other than opioid medications, how could my pain be managed?

The good news is that medication is only one part of effective pain management. A combination of approaches is often the best way to manage your pain. Our practice uses a multidisciplinary approach to treating pain.  The whole focus of multidisciplinary programs is to get people functioning again. One of the drawbacks of long-term opiate use is many people who take these drugs over a long period of time lose physical function. The goal is to restore physical function and to help people learn that chronic pain does not have to prevent them from living a full, active life.

Will my pain get worse if I am very active?

When you have constant pain it seems natural to avoid doing things like walking, bending and moving around as they can make the feeling of pain worse. However our bodies are designed to move. When we decrease activity, we lose muscle strength – over time this means that even simple daily activities can become more difficult.  Many people with pain fear exercise as they think it will cause more problems. However, regular stretching and exercise can actually decrease pain and increase your ability to function physically.

It is important to remember that chronic pain is not necessarily associated with ongoing damage to your body. This means that hurt doesn’t necessarily equal harm, and if no ongoing cause for the pain is found, you can slowly increase your physical activity despite a certain level of pain. This gradual approach to activity is called pacing.

Should I wait for my pain to go away before I go back to activities I used to do?

Starting to exercise and learning new coping skills are important strategies to help improve your ability to function and reduce the impact of the pain. It is also important not to wait for the pain to be completely gone before starting normal activities, including work.

I want to stop opioids, but I don’t know how, and I’m worried about withdrawal.

Withdrawal is a common effect of stopping opioids.  It is uncomfortable but not life threatening and there are strategies to minimize this and help treat the symptoms.

I’ve been told that there is a difference between physical dependence and addiction to pain medications, but I don’t understand. Can you explain the difference to me?

Physical dependence occurs with any person that takes narcotics at a certain dose for a time, if the medication is stopped abruptly then there may be withdrawal symptoms such as nausea, diarrhea, feeling shaky and sweaty.

Addiction occurs in susceptible individuals, and there are ways to figure out who may be more susceptible.   This may manifest as a craving for the medication and may include escalating dosages and drug seeking behavior.

Why doesn’t the provider prescribe narcotic medications on the first visit?

Initial visits are designed to diagnose and recommend treatments to you and your referring provider.  If you have been prescribed narcotic pain medications previously, that provider must continue to prescribe for you until after we have seen you. In order for us to prescribe subsequently, you must be seen at a return office visit where you will participate in an informed consent discussion, sign an Opioid Treatment Agreement, submit a urine sample, and complete a material risk form as required by the state of Oregon.

What is an Opioid Treatment Agreement?

What is a pain medication agreement? Your health and safety is our primary concern. The pain medication agreement outlines important safety and regulatory issues concerning proper medical use of controlled substances. Among other expectations, we stress the use of one pharmacy and one physician for all of your pain medication prescriptions. We require you to take your medications as prescribed and submit urine specimens for testing on a regular basis. If you are impaired in any way, you must not drive or operate machinery. You cannot give or sell your medications to others, or take someone else’s medications. These and other concerns are a part of our agreement necessary to safely prescribe opioid medications and/or other controlled substances for the management of pain.

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