Non-Opiate Pain Management – After Detox

Dr. Scanlan has extensive experience in treating chronic pain with non-narcotics. 

Opiates are not the only option for treating chronic pain

Dr. Scanlan will perform a comprehensive pain assessment for patients complaining of chronic pain. Please bring any old radiology reports from CT scans or MRIs to first appointment.  The assessment will examine the origin and the nature of the pain.  The nature of the pain entails whether the pain is noiceptive or neuropathic. 

Nociceptive pain occurs when the nervous system is working as it should. Pain is a signal that something is wrong. Pain is caused by a stimulus such as injury, infection, or inflammation. The pain signal is sent to your spinal cord and then to your brain. Your brain then interprets the pain and acts on it. Your brain can release substances such as your own natural opioid-like endorphins to calm the initial pain signal down and help you deal with it. The pain intensity is usually related to the degree of injury and amount of actual tissue damage.

Neuropathic pain is caused by a nervous system that isn’t working right. Think of it as irritable nerve cells that react for no reason. The pain can arise from the central nervous system (spinal cord or brain) or from the peripheral nervous system such as in the legs, arms, skin, and so on. Insults such as trauma, inflammation, or diseases such as shingles, diabetes, and HIV can cause it. Neuropathic pain can be constant or episodic (comes and goes). It is often described as burning, streaking, lightning, tingling, or pins and needles. Neuropathic pain serves no known purpose. It is not related to the degree of injury or disease. Neuropathic pain is meaningless outside the amount of suffering it causes. Most often more than one drug is needed to control neuropathic pain.

Screener and Opioid Assessment for Patients with Pain

Once more information is obtained about your pain other treatment options can be discussed.  There are a number of different non-narcotic medications that may be right for you.  Just some of the possible medications are the following:

NSAIDS – Ibuprofen, Voltaren, Celebrex, and Indocen
Acetaminophen – Tylenol
Anticonvulsants – Lyrica, Neurontin, Topomax, Depakote
Muscle Relaxants – Baclofen, Flexeril, Skelaxine, Robaxin, Zanaflex
Anti-Depressants – Elavil, Cymbalta
Topical Agents – Lidocaine patch, capsacin cream

Chronic pain is a devastating phenomenon that exacts not only a physical toll on a patient, but an emotional one as well.  Years of dependency on prescription pain medication can often intensify the pain. It can make it difficult for patients to distinguish which pain is from the initial injury and which pain is from the use of the pain medications.  A few weeks after a patient has been detoxified and all pain medications have gotten out of the body, our patients often report that their pain has lessened more than when they were using opiates. The patient’s body will restart producing endorphins – the body’s natural painkillers – because the patient has stopped taking opiates.   A few weeks after detoxification it is finally possible to make a true assessment of pain and to adjust treatment with non-narcotic medications. Furthermore, if pain continues then referrals to pain doctors who specialize in treatment of pain without narcotics can be made for further options (nerve blocks, acupuncture, and physical therapy).