Weekend Doctor: Prescribing opioid medication responsibly for pain 

By Andrius Giedraitis, MD

Pain management has become one of the most challenging aspects of modern medical care. In the wake of the well-publicized opioid crisis, we, as physicians, must balance effective pain treatment with responsible prescribing practices, especially when it comes to opioid medications.

A balanced approach to pain management is essential. While opioid medications play an important role in treating certain types of pain, they represent just one tool in our comprehensive treatment arsenal. Modern pain management incorporates multiple therapeutic approaches, including non-narcotic medications, physical therapy, and interventional procedures.

Before considering opioid medications, we evaluate each patient thoroughly, reviewing their medical history, conducting physical examinations and utilizing screening tools to assess risk factors. This careful assessment helps ensure patient safety and appropriate treatment selection. We also employ state prescription monitoring systems and regular follow-up evaluations to maintain responsible prescribing practices.

For patients who do require opioid medications, we establish clear treatment agreements that outline expectations and responsibilities. These agreements typically include using a single prescriber and pharmacy, participating in recommended therapies and adhering to monitoring protocols. This structured approach helps ensure medications are used safely and effectively.

However, it's crucial to understand that pain management extends far beyond medication. Our comprehensive approach includes physical therapy, aquatic therapy and specialized manual techniques. We often recommend interventional treatments such as therapeutic injections or spinal cord stimulation when appropriate. Additionally, adjunctive therapies like heat therapy, cold therapy and acupuncture can provide significant relief for many patients.

Non-opiate medications often play a vital role in pain management. Medications such as nerve pain modulators, antidepressants and anti-inflammatory drugs can effectively manage various pain conditions with less risk than opioid medications. When combined with other therapeutic approaches, these medications often provide excellent pain relief while minimizing the need for opioid medications.

The goal of modern pain management is to improve function and quality of life while ensuring patient safety. This requires ongoing assessment of treatment effectiveness, monitoring for potential complications, and adjusting treatment plans as needed. We evaluate progress by looking at improvements in daily activities, pain relief and overall function while watching carefully for any adverse effects.

For patients struggling with medication dependence, we maintain strong relationships with addiction specialists and rehabilitation services. While our focus is pain management, we recognize the importance of providing appropriate resources and referrals when needed.

Through this comprehensive approach to pain management, we can help many patients achieve better pain control while minimizing risks associated with opioid medications. It's about finding the right balance of treatments for each individual patient, always keeping safety and effectiveness as our primary goals.

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