When treating chronic pain, daily medication is the rule rather than the exception. A variety of medications exist, and accurate diagnosis of both the cause and nature of the pain is critical to choosing the proper medications. For example, nerve pain can be unresponsive to high dose opioid therapy. But, it may respond dramatically to an evening dose of a tricyclic antidepressant such as amitryptiline or nortriptyline.
Considerable controversy exists about the use of opioid medicines for chronic non cancer pain. Opioids have been accepted as appropriate treatment for acute pain and for cancer pain. But, many physicians and healthcare professionals are reluctant to use opioids for patients with chronic non cancer pain because they’re concerned about efficacy, adverse effects, tolerance, and addiction. While studies performed in pain clinics suggest that some patients become psychologically dependent after long-term opioid use, some clinicians and researchers have argued that there is a role for opioid therapy for chronic non cancer pain.
They suggest that the potential for increased function and improved quality of life are the mainstay of therapy.
ISM provides for a comprehensive assessment that weighs the risks against the benefits of increased function. After proper assessment and diagnosis, ISM pain doctors may use opioid medication to treat chronic cancer pain as well as non-cancer pain to a level that a patient becomes stabilized for pain. They also carefully monitor patients for side effects and other concerns.