Personalized Medicine Consultants New Pain Management Protocol


Personalized Medicine Consultants recognizes the need for adequate pain control to help improve function and enhance quality of life. There are many potential avenues one can explore to help manage pain. Some of these include, mindfulness meditation, cognitive behavioral therapy, yoga, physical exercise and physical therapy. Patients may also use a variety of pharmacologic interventions including anti- inflammatory medications, muscle relaxers, anti seizure medications, opioids and others.


Opioids are powerful painkillers but come with several ominous side effects such as abuse and addiction, as well as respiratory depression that may lead to death. Despite these concerns, opioids are an important tool in the appropriate patient in the management of moderate to severe pain associated with various disease states.


We are currently in the midst of an opioid epidemic here in the United States, and despite a variety of state and federal interventions, we are faced with major drug abuse issues and a rising overdose death rate. There are no entirely safe opioids, just as there are no completely safe medications. Patient education, along with a judicious approach to multi disciplinary pain therapy is paramount. If opioids are considered, they must be used for the appropriate patient at the lowest possible effective dose that allows reasonable pain relief and functional improvement. At Personalized Medicine Consultants, we encourage the use of opioid medications with a lower potential for addiction and respiratory depression. We believe that safety is an integral part of any opioid therapy program.


To this end, Fiaz Jaleel, MD at Personalized Medicine Consultants has collaborated with compounding pharmacist Steven Mougeot, Pharm.D of Thrive Pharmacy in Jacksonville, FL to utilize compounded buprenorphine for select patients with moderately severe pain. Buprenorphine is a Schedule 3 partial opioid agonist that has been traditionally employed to treat opioid abuse and addiction but can also be used to effectively treat pain. Buprenorphine is a potent pain killer with a lower risk for abuse and psychological dependence, it also carries a lower risk of respiratory depression and overdose death. At the appropriate dose, it helps manage pain, decreases symptoms of opioid withdrawal, suppresses craving and reduces illicit opioid use.


If someone with chronic pain, on highly addictive Schedule 2 medications, such as oxycodone, hydrocodone, hydromorphone or morphine wishes to step down to a less addictive medication without withdrawal symptoms, then buprenorphine is an excellent choice. Buprenorphine can also be used in a tapering dose as a bridge to a non-controlled medication for pain and perhaps may lead to a pain medication free life in select patients with adequate social and psychological support.


If you will like to learn more about sublingual buprenorphine troches and how it can help manage pain, please contact Dr. Jaleel at (904) 744-7474 in Jacksonville or (407) 673-8999 in the Orlando area.