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Guest column series by Scott Fitzpatrick, Dipl.O.M., RES

According to the State of Tennessee, we have a pervasive, multi-dimensional problem facing our population regarding the use and misuse of prescription medications.  Sadly, this is not unique to our state; however, the numbers suggest a higher incidence in Tennessee compared to most other states.  The problem is so incredibly complex, but when broken down into manageable parts, positive things can be accomplished.

I have unfortunately had the experience of losing a young family member and a few patients due to prescription drug overdose.  The sadness cannot replace the need for education and intervention.  My wish is to introduce patients, parents, loved ones, and all other interested parties to the differences and choices available when dealing with pain syndromes.  The following information will help differentiate between Integrative Pain Medicine clinics versus Pain Medicine clinics (a.k.a. Pill-Pushers).

As a standard rule, there are some very specific criteria to expect when searching for reputable pain medicine clinics.  First, do not let the name fool you.  Some clinics uses catchy terms and phrases like “Best, Loving, Alternative, Professional, etc.,” which does not indicate the level of care they do or do not provide.  The patient must look inside and find the types of services offered and all of the necessary licenses obtained by the clinic.  In a perfect setting, the clinic would be an “Integrative” Pain Medicine clinic.

A true “Integrative” Pain Medicine clinic would include many, if not all, of the following options designed to treat complex pain syndromes.  The list would include:

  1. Anesthesiological therapies (epidurals, facet injections, radiofrequency ablation);
  2. Behavioral and lifestyle change therapies with Psychologist or Therapist;
  3. Acupuncture therapies (standard and electrical, cupping, Tui-na, manipulations);
  4. Medicine therapies (prescription, Chinese, Naturopathic and Homeopathic);
  5. Physical therapies (movement, strength-building and stretching techniques);
  6. Nutritional therapies (effectively influencing pain levels through dietary changes);
  7. Surgical therapies;
  8. Neurostimulation therapies.

The seamless integration of these therapies can provide the patients and the providers with a number of wonderful options that can be tailored specifically for each individual.  Other modalities that can also be extremely useful would include: Yoga, Chiropractic, Reiki, Massage, Hypnosis, Biofeedback, Quantum Biofeedback, and Prayer therapies.  Each of these treatments can be efficacious and work well with the other regimens when used appropriately.

Signs that a Pain Medicine clinic may be a “Pill-Pusher” or “Pill Mill” and may be more motivated by money than patient care are pretty obvious.  Indicators that a Pain Medicine clinic might be a “Pill Mill” could include: lack of professionalism consistent with other medical practices (including staff and exam areas), if the facility recently opened, has only one provider or the doctor is at another location, has no therapeutic options available, does not accept payment other than cash (which is illegal in the state of Tennessee), encourages the use of pain medications, is protected by armored guards, or any other indicator that just doesn’t seem right.   Certainly, this list is for reference and is not intended to imply that any or all of these traits guarantee a clinic is a “Pill-Pusher,” but should serve as a warning to patients in search of reliable help.

Most importantly, when dealing with pain syndromes, one must follow a very simple path.  Get a proper diagnosis, a manageable plan, a helpful support system, and a provider that knows how to negotiate this difficult problem, integrating a variety of appropriate treatment modalities.

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