Pain Management Conference Focuses On Changing Doctors' Behavior

Pain management physicians had a role in creating the opioid crisis and some of those doctors are now working to solve the problem.

When the Florida Academy of Pain Medicine meets to discuss opioids this weekend, the agenda will include discussions on responsible prescribing, and alternative treatments, such as physical therapy, massage and acupuncture.

The method for prescribing medication has evolved from just a few years ago when physicians believed that they could solve patients’ chronic pain with opioids alone, said Dr. Abraham Rivera, chief medical officer at Physician Partners of America, which operates several pain clinics in Central Florida.

“Unfortunately that is a road full of pitfalls and the pitfalls of that is called addiction and dependency,” Rivera said.

At the conference, pain specialists will preach caution with opioids. Rivera says treatments like injections, nerve blocks and corrective surgery should be considered first.

“It’s a behavior changing conference,” Rivera said. People will leave with a list of 10 things that they can do differently that will create change.”

Some like prescription limits for opioids and participation in the statewide prescription drug monitoring program are required by a new law signed by Gov. Rick Scott last month.

Others may be more controversial. Rivera says his practice requires patients who get opioid prescriptions to submit to drug tests so doctors can see if there are other drugs in their systems.

Patients who are prescribed opioids should also get a prescription of Naloxone, the drug that reverses fatal overdoses, according to conference material.

Rivera also says patients should sign a prescription drug agreement, promising to use the drug only to treat their condition and not to share it.

Finally, the use of alternative treatments in conjunction with, or instead of, opioids has gained popularity, Rivera said.

Evidence shows opioids are no longer effective at treating pain after a patient uses them for more than two years, he said.

“There has been a resurgence, rethinking of alternative medicine,” Rivera said. “There is plenty of evidence-backed literature that defends the use of things like physical therapy, acupuncture, message, meditation therapy, cognitive therapy. These things can be used and there is science behind it.”

The next hurdle, he said, is getting insurance companies to cover the treatments.

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