For Patients with Chronic Pain


What You Should Know About Pain Medication

at OHSU Family Medicine at Richmond


We care about your pain and we want to evaluate and treat it appropriately, with your help.  This means:


·         The safety of our patients and the community is important to us.


·         We have many ways to help with painful conditions.  Much of our help will NOT involve prescription medications.


·         “Opiate” pain medicines (sometimes called “narcotics”) like Vicodin, Oxycodone, Morphine, Tramadol, and Methadone can cause much harm.


·         Use of these opiate pain medications is especially dangerous when combined with other sedatives such as Alcohol, Promethazine, and Benzodiazepines (e.g. Xanax, Klonopin).


·         Other community clinics in the area follow the same basic policies.


Our clinicians, not management personnel, have the final decision-making authority and responsibility on all prescriptions they write.  Generally, they will not write a prescription for opiate pain medication:

·         At your first visit,

·         Without records from your prior clinician’s office,

·         If pain medication was stopped by another primary care clinician,

·         If you are taking Xanax, Valium, Ativan, Klonopin, or are seen at a Methadone clinic,

·         If your clinician thinks the potential harms outweigh the potential benefits, especially improvement in function,

·         If you have a history of “diversion” (passing your opiates on to another person),

·         If you are at high risk for misusing medications (by use of a standard tool),

·         If you have unstable mental health,

·         If you have active substance use or abuse,

·         Use of medical marijuana


If you are prescribed opiates for chronic pain:


·         We will require ongoing behavioral health services,

·         Non-medication therapies must be used (e.g. physical therapy, exercise, yoga, chiropractor, acupuncture, relaxation techniques),

·         Long-acting pain medications will be preferred,

·         Random drug tests, and pill counts will be required,

·         The state prescription report will be checked,

·         Maximum total daily doses will not be more than:   120mg of Morphine,   80 mg of Oxycodone, or   60 mg of Methadone