Medication Management

Unfortunately all medications can have deleterious side effects on the human body. That is why at Cleaver Medical Group we make every effort possible to optimize treatment of the underlying cause of pain, while minimizing the risks to our patients. Our pain management services are currently offered at our Cumming location.

Chronic pain is pain that has persisted for greater than a three month time period. This type of pain can be related to:

• Previous injuries

• Underlying medical conditions

• Cancerous pain causing damage to the body.

The aim of medication management in the treatment of chronic pain is to provide symptomatic relief and to help progressively increase an individual’s daily level of functioning and activities. Due to advances in modern medicine over the years, there are now many types of safe and effective medications that can help with just this. Medications used depend on the type of chronic pain that each patient is experiencing and can be non-narcotic and narcotic in nature. Some examples of medication classes that are non-narcotic include:

• Non-steroidal anti-inflammatories
• Anti-depressants
• Acetaminophens
• Muscle relaxants
• Anti-convulsants

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.