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All posts by Integrated Pain Associates

CVS Pharmacy Will Limit Prescriptions for Opioids

With the 64,000 deaths from opioid overdoses last year alone, the medical community is struggling to contain the out-of-control opioid epidemic. Now, CVS, one the nation’s largest pharmacy benefit managers that oversees prescription drug benefits for 90 million people through its CVS Caremark plan, is attempting to address opioid abuse by no longer reimbursing opioid prescriptions beyond the first week for people filling these prescriptions for the first time.

Beginning in February, the company announced, it will adhere to the Centers for Disease Control and Prevention’s (CDC) guidelines for prescribing opioids that limit doses and duration of the drugs prescribed by doctors. The CDC recommends prescribing the painkilling narcotics, which can be highly addictive, in as low a dose as possible for as short a time as needed. Not only will CVS Caremark only reimburse for seven days of prescriptions, but for first-time opioid prescription-fillers it will also dispense short-acting, rather than extended release, versions of the drugs for these patients.

Read More: http://time.com/4952176/cvs-pharmacy-opioid-epidemic/

Source: Time.com

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National Pain Awareness Month

Pain Awareness Month was created to increase awareness about the effect of pain and to educate citizens about the advanced treatment options available to help alleviate pain.

September is Pain Awareness Month.
This busy month is marked by a variety of different initiatives and activities all with the goal of promoting education, advocacy and awareness about chronic pain in order to break down the barriers to effective pain management.

Undertreated chronic pain significantly impairs quality of life, and can be severely physically, psychologically, and socially debilitating.
• Pain affects more Americans than diabetes, heart disease and cancer combined.
• Workers lose an average of 4.6 hours per week of productive time due to a pain condition.
• An estimated 20 percent of American adults report that pain or discomfort disrupts their sleep a few nights a week or more.
• 80 percent of people in the United States will experience back pain at some point in their lives.
• Besides the common cold, back pain is the number one reason people visit their family doctors.

The adoption of pain as the “fifth vital sign” in 2001 has helped increase the legitimacy of pain as not just a symptom but a serious detriment to quality of life, requiring proper medical attention. It also helped further the notion that every person has a right to timely and effective pain management.
Pain does NOT mean pills — There are many interventional pain management options available.
A major aim of Pain Awareness Month is to foster partnerships among individuals and organizations, with a common goal of effecting positive change in the state of pain management. By promoting education, awareness and advocacy, the goal is to recognize and address these barriers to pain management.
In recognition of Pain Awareness Month, there are a variety of different ways that Integrated Pain Associates can promote pain education and awareness – among patients, other providers, and the general public.
Education and awareness are two prominent themes of Pain Awareness Month, and they both undeniably represent a key component of improving the state of pain management. Pain Awareness Month serves as a powerful means to convey the compelling message that millions of people continue to suffer from something that deserves proper management. It is an opportunity for those who suffer from an “invisible” illness to finally have their voices heard, and incite much-needed change.

Interventional Pain Management Techniques
The basis of interventional pain management is to block the production and/or transmission of pain signals to the brain through methods including nerve blocks, spinal steroid injections, radio-frequency ablations, spinal cord stimulation or injection of an anesthetic.
Goals of these interventional techniques include pain reduction, improving and maintaining mobility, and minimizing medication use. The administration strategies enable pain management specialists to selectively target injured and painful body regions while minimizing complications such as infection, bleeding, further injury, and sympathetic crisis.

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Integrated Pain Associates

Wheelchair Bound to the Highway Hog: a Story of Recovery

The missions of Integrated Pain Associates are to help people in the communities we serve fight chronic pain and help patients so they can get back to enjoying everyday life. With pain management offices in Killeen, home to Fort Hood, one of the largest military bases in the country, we help a large number of veterans with chronic pain from injuries during their service.

It brings us great joy to help those who have served our country overcome chronic pain and find happiness in their everyday lives. But in some cases, we’re seeing turnarounds far more life-altering. Mr. Brown thought he was bound to his wheelchair for the rest of his life, only dreaming for a chance to have the first dance at his daughter’s wedding. After coming to the pain doctors at IPA, Mr. Brown received specialized care and worked hard to make his dreams become reality.

Mr. Brown was generous in sharing his story with us.

Q: Thank you Mr. Brown for taking the time to share your story with everyone today. Can you please tell us a little bit about your background and what type of pain you’ve been experiencing?

A: I was very athletic growing up, even before the military. Before joining the military I’d broken my right ankle and then after joining I broke my ankle 8 times, shattered my left ankle and blew up the tendons simultaneously.

After being deployed to Bosnia, I lifted weights to keep my strength up before going into combat, and guess I had too much weight on the bench & the bench broke, messing up my left shoulder.

Shortly thereafter I was trying to avoid another accident, and took a fall on my right shoulder and really tore it up. I developed carpal tunnel on the nerve which needed treatment, then while in the military I threw my back out which put me out of service for two weeks.

In my location at Fort Hood Texas, I was on very limited light duty for my career. In the company because of overcrowding I couldn’t get on to Fort Hood healthcare, so I was seeing Dr. Charles Mitchell, who recommended me to go to a pain management doctor.

I started seeing Dr. Irvine back in 2006 or 2007. He is an awesome physician, and I love his bedside/chairside manner, so easy to communicate with. This is before Integrated Pain Associates came into fruition.

We established a great rapport immediately, a great physician/patient relationship because he was so easy to talk to. You know how some physicians ask questions like, “Are you okay, what is bothering you, how did this happen?” And you clam up, you don’t want to communicate. But he made it easy for me to say what was going on with me.

So he said, “Let’s start you on this exercise program on your own, try to strengthen some of the muscles & joints,” which were compensating for the pain. From there he said “Okay, we will have to increase your medication, but have you ever heard of a nerve stimulator?” I said, “Yes I’ve heard vaguely about it, a patch you put on,” so we started out with stimulators we could put on my knees, back, & wherever I had pain. But it wasn’t enough.

So he said, “Have you ever heard about a neuro stimulator?” and I said “No, what is it?”

“We put leads down in your vertebrae.” I said “What? I don’t want anyone messing with my spine.”

He said, “We won’t mess with the spinal cord, it goes down inside and with a battery pack, and you can decide whether to put on abdomen or buttocks.” I chose buttocks, we used Medtronic’s, at the time, the best thing out there about 6 years ago.

It helped even more, so I said, “Hey! I’m doing ok, it kept me out of a wheelchair,” but I still wasn’t able to do as many activities as I would like to. He also changed my medication and recommended some after-surgery treatment, but I wasn’t getting the relief I needed. That’s what I liked about him. He’s always looking for better ways to take care of his patients.

Then, recently he asked if I’d be willing to try a new stimulation that works on a higher frequency. Fortunately for me I already had the leads in so we didn’t have to install those, it could just be attached to the leads.

They attached the medical stimulator and it’s a lot less bulky, a lot more comfortable, and it’s kind of dangerous, because I started to feel like when I was a teenager (my lower extremities). It was like I virtually didn’t have any pain.

So I started to jog! I don’t know why. But then I kind of hurt myself, and he chastised me, “What were you thinking? Why would you do something like that?” And I said, “Because I didn’t hurt anymore” (laughing)…

Do you know how long it’s been since I felt like this? I felt amazing!”

Now I’m taking my time, I’m able to move my daughter in Lubbock from 2nd floor apartment to Glendale, Arizona for veterinary school, and I didn’t have to lay down, didn’t have to rest. It was amazing to have the energy to do the things that a normal 55 year old should be able to do.

It has changed my life. My wife is asking, “Have you taken your pain medication?” Because she knew when I was grumpy, I was in excruciating pain. It has greatly improved our relationship. I’m a lot more enjoyable to be around for her.

Even for life things, for instance, the doctor was asking, “What are your goals”, and to be honest, “Well I really want to be able to do the father-daughter dance at my daughter’s wedding,” and before the treatment I could never have done that.

He went ahead and did the order for me on the nerve that went down the back of my legs, and I was able to dance. Understand that I have two daughters, and I have been able to dance at both daughters’ weddings. You don’t know what that means to me.

It’s like a total transformation. I thought I’d end up in a wheelchair for the rest of my life.

Where I was to where I am now, is unbelievable.

Q: Did you ever think it could be possible?

A: I was convinced that I would be in a wheelchair for the rest of my life. The VA offered me one of those power electric wheelchairs. However I don’t need it, and instead I can play with my grandbabies and dance at my daughters’ weddings. It was all unbelievable to me prior to meeting Dr. Irvine.

Q: Did all of the other doctors you visited not understand what kind of pain you were in?

A: They had no concept of my pain. Dr. Mitchell is on the board of directors in Metroplex, he said, “There’s nothing more I can do for you, let’s try this pain management system.” Ever since then I feel I’ve given Dr. Mitchell a lot of feedback and I’m sure he recommends other people to Integrated Pain Associates.

I’ve seen Dr. Lowry and he’s awesome. The first stimulator they put in was at Seton Medical Center in Round Rock. The St. Jude’s neurostimulator they did right there at Integrated Pain Associates in their outpatient surgical center, right there onsite. I’ve seen three of the four physicians that work there, and they are fantastic.

Anyone I see with a cane, a walker, a wheelchair that will listen to me, I tell them you need to see my physicians, and I call them my own physicians because I love them, at Integrated Pain Associates. I know the people at the hospital, a lot of them I’ve known for a while, they are saying, “Where’s your cane?”, and I say, “Oh, I have no idea, but I don’t need that thing anymore”.

Q: When you had to use a cane, wheelchair, or walker, what were the activities you missed the most and are most glad to get back to?

A: Fishing, hunting, riding my motorcycle. I’ve always wanted a large Harley-type of motorcycle, but when I retired from the military, I put my daughters’ educations first, put them through college, and the Harley dream went to the wayside. As a matter of fact, my wife wanted to surprise me one year with a motorcycle but she said with my condition, she wouldn’t get it.

After that I was talking to Dr. Lowry about it, kind of depressed and let down. It wasn’t that I couldn’t afford it, but that I couldn’t ride it. But on December 30, 2015 my wife said, “Hey I need you to take me for a ride early in the morning,” and I said, “Can’t you just go, go by yourself or with someone else?” It wasn’t that I couldn’t, I just didn’t want to.

But I got up, we got in the truck, and she said, “You are taking me to work.” I started driving that way, and went past an Indian motorcycle dealership, and she said, “Just turn in there”. And I said, “I don’t want to look at a bike, I don’t like to shop for things unless I know I’m going to buy.” We walked in there and I saw my name on a motorcycle.

It was spinning in the air, on the handlebar, on a brand new Indian Chieftain. I said, “Why does it have my name on it, did you get that? Stop playing?” She said, “No I didn’t.” “So why does it have my name on it and a ‘sold’ tag?”

We walked in and my dream bike was there, black and storm grey, I said “Stop playing!”

I could not believe it. I sat on that bike, she did the paperwork, I didn’t sign have to sign anything. It was a dream come true.

She said “Let’s get out of here,” and I rolled away, and I’ve been riding ever since.

It was a dream come true. It’s just under a 1000 pounds, and I’m able to ride it like it was made for me.

And it’s something that would never have happened had I never met Dr. Irvine on that first day. I’m convinced.

Q: Incredible! And how are you feeling now?

A: Fantastic! I feel awesome! And as a matter of fact, normally this morning I’d be riding. So, upon completion of this interview, I’ll be going for a cruise.

Q. Sounds great.

A: If it wasn’t for them, that’s the other thing, nurse practitioners and everyone at the clinic; they are like my extended family. They have wonderful personalities. I’ve been a lot of places and seen a lot of physicians in my life.

I’ve had 41 surgeries and I shouldn’t be able to do anything except be bedridden or in a wheelchair, but here I am walking around upright without assistance other than what Dr. Lowry has put in me.

And now I can go deep sea fishing, a cruise with my wife – things that were unimaginable.

That’s why I share with each and every person that I know is suffering and in pain. It’s nice to know you don’t have to live like that anymore.

I don’t know how long pain management physicians have been around, but there needs to be more just like Integrated Pain Associates. The personalities of the doctors, nurses, nurse practitioners, they are great! They are made for that job.

They make it easy for you to deal with them. When you are in pain, it’s hard to talk to people. It’s hard to be pleasant, but they help you get through that.

I definitely want to make sure that all the supporting staff is to be commended also. I’ve been around the world, throughout my military career, and the civilian side, and I’ve never met a complete staff like I have at Integrated Pain Associates.

Q: I’m with you because a lot of the time you are talking to the staff as much as the doctor.

A: They are like my extended family. I love every single one of them. I’ve never met anyone within that organization that, if they have their own personal problems, they don’t bring it to work.

Everyone is so happy and everyone enjoys working in that organization.

And I’ve told Dr. Irvine, “God put you in my life. God intended me to come here and meet you so you could take care of me.”

Q: Absolutely. Do you have any advice for our U.S. armed service members who may have been injured, and how to persevere and get through the way you did?

A: I would tell them, sometimes it’s inevitable that during your military career that you could get injured…but if you do, especially if you are in Fort Hood, call Integrated Pain Associates. They will help you get back on your feet so you can enjoy your family, and help you get back in society, and seek employment after your military career.

Q: I think a lot of people don’t know what pain management options are available to them.

A: I know they don’t. Like I said, I’ve seen a lot more physicians than most. Still, the word is not out there. I know that if more people knew about it, especially military soldiers, they need to see all the doctors and the crew. They are all great.

Q: You are helping us out by spreading that message.

A: I know. In fact, a friend of mine at church, a retired first sergeant, called me up the other day, and said, “Did you mention a neuro stimulator?” And now he is going to Integrated Pain Associates, I recommended them.

I know with him, he lumbers around and it is labor intensive to even move if you are in that much pain. We met in physical therapy up at the VA, and I told him he had to go to Integrated Pain Associates, they will take care of you, get the St. Jude neurostimulator, and you’ll be just like me.

Be careful when you get it, you’ll feel so good that you’ll want to do crazy things, but take it easy and slow it down. You can condition yourself over time.

I can’t even begin to tell you how long it’s been since I’ve been without excruciating pain. Pain started to define me, and no-one should live like that. If we can get the word out more about pain management then I guarantee Dr. Irvine will have to build a giant hospital to take care of all the patients. Because there is a better way to go through life than to suffer every day and every night.

I couldn’t sleep at night because of the pain, and so much that I couldn’t do. And I was putting such a burden on my wife. What a strain it is to not be able to do “manly” things around the house and instead watch the wife do it.

After meeting Dr. Irvine, I’m able to mow the grass with a push mower for exercise, and help around the house, all because of Pain Management. I’m doing things I never thought possible, there is an answer and that is Pain Management.

Q: You have an incredible story, thank you for sharing with us.

A: That’s my story and that’s the truth. I’m a Christian man. As God as my witness, that is the truth.

Q: It seems like you’ve come a long way and I understand that pain can consume your life. We are trying to get the message out that people don’t understand what people are going through, and they feel kind of hopeless because of that. So that’s why we are looking for people with similar stories to them, to show them, here…it’s hard for somebody who doesn’t have chronic pain to know what it’s like.

A: Can you imagine having people seeing me that I haven’t seen in awhile? Even at the grocery store. And I’m a friendly kind of guy, I love people. Well the people at my grocery store ask, “Where have you been?”

And they see me now, and say, “I saw you last week, with no wheelchair or walker!” And I told them you need to go see Integrated Pain Associates. I keep cards in my pocket, I hand them out, and I tell everyone, “These people can help you,” that’s how much I believe in them.

Q: That’s great and I’m glad they were able to help you with your recovery so much.

A: I don’t know where I’d be without them, well, yes I do. I appreciate that you guys are getting the word out there, you guys are the message deliverers. The more people that can be reached, the more that can be helped and able to do for themselves.

Q: That’s exactly what we are aiming to do.

A: You will reach other people with hope, who were suffering like I was. You don’t have to suffer so much, and in some cases you can be almost 100% pain free.

Q: We can’t make those promises, but the ideas are there. You can get back to doing the things that make life special to you. Thank you for sharing your story with us.

A: Well thank you for getting the message out so that other people can be helped. As a five time combat veteran, I really am glad we have people out there that care about us and want to give us some resemblance of a normal life.

I’m glad it’s in Killeen so they can focus on the military vets.

Q: Thank you again for sharing your story. Now go enjoy your ride.

Are you or someone know you know in pain? Begin your road to recovery and contact us today!

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Waco – New Location


The IPA Waco clinic will be moving locations. Starting Aug 7th, 2017, we will be at the following address:

7030 New Sanger Rd
Suite 204
Waco, TX 76712


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Holding hands to comfort loved ones does help reduce pain

Holding hands to comfort loved ones does help reduce pain, US study shows

Holding the hand of a loved one to comfort them really does help reduce pain, a US study has shown.

Dr Pavel Goldstein, a postdoctoral pain researcher in the Cognitive and Affective Neuroscience Lab at the University of Colorado Boulder was inspired to conduct the research after witnessing the birth of his daughter four years ago.

He said: “My wife was in pain, and all I could think was, ‘What can I do to help her?’ I reached for her hand and it seemed to help.

Source: The Telegraph

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FDA wants opioid painkiller pulled off market

(CNN)The US Food and Drug Administration said Thursday that drugmaker Endo Pharmaceuticals must remove its powerful opioid painkiller Opana ER from the market. The agency says this the first time it has asked that an opioid pain medication be pulled due to “the public health consequences of abuse.”

“We are facing an opioid epidemic — a public health crisis — and we must take all necessary steps to reduce the scope of opioid misuse and abuse,” FDA Commissioner Dr. Scott Gottlieb said. “We will continue to take regulatory steps when we see situations where an opioid product’s risks outweigh its benefits, not only for its intended patient population but also in regard to its potential for misuse and abuse.”
Source: CNN
Read Full Story Here: http://www.cnn.com/2017/06/08/health/fda-opioid-opana-er-bn/index.html
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FDA Joint Committee Votes Opana ER Risks Outweigh Benefits

The benefits of oxymorphone hydrochloride extended-release tablets (Opana ER, Endo Pharmaceuticals) do not outweigh its risks to public health, according to a joint FDA advisory committee.

Members of the Anesthetic and Analgesic Drug Products Advisory Committee and the Drug Safety and Risk Management Advisory Committee held a two-day meeting and voted 18-8—with one abstention—that the drug’s risk–benefit ratio has changed for the worst. Most of the panelists agreed that the drug should be removed from the market due to its high potential for IV abuse and misuse: Several outbreaks of HIV, hepatitis C and vascular issues were related to IV abuse of the drug.

“This formulation of oxymorphone has unintended consequences that deserve its removal from market,” said Charles Emala, MD, professor of anesthesiology at Columbia University in New York City, one of the panelists who voted against the drug, MedPage Today reported.

Endo presented efficacy data during the meeting, including postmarketing data on abuse and misuse compiled from the National Addictions Vigilance Intervention and Prevention Program and the RADARS System Drug Diversion Program. The company reported that the increases in oxymorphone-related death and overdose rates were associated with the introduction of the abuse-deterrent formulation of oxycodone (OxyContin ADF; Purdue Pharma) in August 2010, and decreased after the introduction of the oxymorphone reformulation.

Many panelists acknowledged a lack of data, but believed there was enough to conclude that oxymorphone carried increased risks related to injection abuse.

The drug has had a difficult regulatory history with the FDA. It earned a reputation for severe abuse when it originally came to the market in 1959, and was removed in the 1970s.

Source: PainMedicineNews.com
Full Article: FDA_Opana

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#PainStopsHere Facebook Challenge

Integrated Pain Associates #PainStopsHere Facebook Challenge

Starting June 1, Integrated Pain Associates has a new challenge for you. We want to see how treatment at Integrated Pain Associates has improved your quality of life and helped you get back to enjoying your favorite activities. We call it the #PainStopsHere Facebook Challenge and all you’ve got to do is put on a (free!) shirt, snap a picture of yourself showing off your improved quality of life, and let the world know on Facebook.

Here’s how it works!

  1. Jump onto Facebook or Yelp and leave a review of Integrated Pain Associates while you’re at one of our two clinics in Killeen or Waco.
  2. Show the receptionist the new review on your mobile device and you’ll get a free #PainStopsHere t-shirt on the spot.
  3. Snap a picture of yourself showing-off your improved mobility and quality of life while wearing your #PainStopsHere t-shirt.
    • This can be big things like playing golf or working out at the gym.
    • Or little thing like opening a jar of pickles, sewing or cooking with ease.
  4. Post your Photo to Facebook, tag @IPACLINIC and include the hashtag #PainStopsHere.

By posting your photo, you’ll be entered into our monthly contest, where we’ll be giving away all kinds of prizes that will help you go on pain free adventures or enjoy some well earned relaxation. Follow us on Facebook to see each month’s prize!

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Guidelines for Prescribing Opioids

CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.

For the Full Article, see the below link.
Guidelines for Opioids – CDC

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