At Flamingo Pain Specialists, patient safety is our highest priority. Many of the medications used to treat acute and chronic pain have very serious and even potentially life-threatening side effects. Caution and vigilance on the part of both patient and physician are required to minimize the risk of complications. The lowest effective dose of medication must always be used to in order to lessen the possibility of side effects and minimize the risk of respiratory depression. Pharmacologic therapy should be only part of a comprehensive pain management program that includes Non-Pharmacologic Interventions. Both the pain physician and patient must regularly evaluate the risk versus benefit of continuing pharmacologic therapy. Of course no matter how carefully a pain management program is developed and implemented, the small risk of a serious complication or death can never be completely eliminated.
Opioid Pain Medications for the Treatment of Chronic Pain
Opioids for chronic pain are usually indicated only after conservative therapy has failed and other classes of medication alone are insufficient. If opioids are indicated for your condition, several important patient safety strategies are in place at Flamingo Pain Specialists that help to minimize the risk of a poor outcome. Flamingo Pain Specialists practice according to “Model Policy on the Use of Opioid Analgesics in the Treatment of Chronic Pain.” This document was developed by the Federation of State Medical Boards in July 2013 and subsequently adopted by the Nevada State Board of Medical Examiners (NSBME) in 2015. As they govern the practice of medicine by physicians in Nevada, NSBME regulations have the force of law and must be followed.
At Flamingo Pain Specialists, opioid medications are prescribed cautiously and only for indicated medical purposes. The pain physician formulates a plan that is based on a documented medical cause of the patient’s pain. The risks and benefits of any intervention are carefully weighed by the physician and discussed with the patient. Your Flamingo Pain Specialists physician will conduct a thorough evaluation and use assessment tools to evaluate the risk of prescribing opioid medications to you, if such medications are indicated. Your Flamingo Pain physician will evaluate the effect of pain on your physical and psychological functioning. Any personal or family history of alcohol or other substance abuse will be evaluated. All pain patients are screened for depression. Flamingo Pain Specialists will obtain relevant medical records from your other providers.
The Nevada Prescription Monitoring Program
Nevada is fortunate to have a centralized electronic prescription monitoring program administered by the Nevada State Board of Pharmacy. This database records any and all prescriptions filled by patients in Nevada. The database is linked to databases in other states and information is shared. The Nevada Prescription Monitoring Program is an extremely useful tool and it is utilized very frequently by Flamingo Pain Specialists.
If controlled substances are indicated for your pain diagnosis or associated conditions, your Flamingo Pain Specialist will ask you to sign an informed consent form before initiating therapy. This document will outline the risks associated with the initiation and maintenance of pain management with controlled substances.
Opioid Contract Agreement
One of the most important ways to avoid medical errors is to ensure that there is a clear understanding as to which of your physicians is prescribing which medications. If opioids are indicated for your medical condition, we will ask you to sign an agreement that you obtain prescriptions for your opioid medications only from Flamingo Pain Specialists. This helps to minimize the possibility that two physicians in two separate practices will write for medications in the same class and potentially put the patient at risk.
Coordination and Collaboration With Your Local Pharmacist
Your pharmacist is an extremely important member of your pain management team. Pharmacists constantly monitor patients for medication interactions and extremely knowledgeable about the effects of all drugs on the human body. Physicians at Flamingo Pain Specialists frequently communicate and consult with pharmacists regarding the use of controlled substances, if indicated. It is very important for pain patients to consistently fill their prescriptions at the same pharmacy location each month. This ensures a continuity of care and keeps your pharmacist up to date on medication changes helps to minimize the risks of adverse drug events.
Close Pain Management Follow-Up
The laws and regulations governing pain management physician practices are constantly changing. Most prescriptions for controlled substances can no longer be called or faxed to pharmacies. Prescriptions for pain medication are hand-delivered to patients by the office staff after each follow-up visit. Follow-up visits must occur at least once per month and prescriptions are never refilled without an office visit assessment by the pain physician.
Periodic Drug Testing
In order to ensure that medication is taken as prescribed, the standard of care now requires that pain physicians order periodic drug testing on patients receiving prescriptions for controlled substances.
Consultation With Other Specialists
When indicated, Flamingo Pain Specialists physicians will refer patients to other specialties such as psychiatry or addiction medicine if substance abuse or mental illness is suspected.
Discontinuing Opioid Therapy
Various painful conditions rarely remain exactly the same over time. Physicians at Flamingo Pain Specialists will regularly evaluate whether opioid therapy continues to be indicated. The decision to continue or discontinue such therapy is a collaborative one made between the physician and the patient in order to maximize the health and wellbeing of the patient.
Flamingo Pain Specialists are meticulous about medical record keeping. We will usually obtain the medical records relevant to your pain diagnosis from other providers. Similarly, we carefully document the care you receive at Flamingo Pain Specialists. Your medical records are maintained in electronic format only and retained for the duration required by the applicable state and local laws.
Compliance with Controlled Substance Laws and Regulations
Flamingo Pain Specialists abides by all state and federal laws related to the prescribing of controlled substances.