Why does the pain management clinic want to know my psychiatric care and psychological assessments?
May 13th, 2009 | by Michael |
CC Curious asked:
What does that have to do with car accidents and degenerated vertebrae and other areas of pain?
I have been desparate enough to be willing to be put on a mental pill, but that didn’t work out, and a lot of physical pain can cause depression and frustration. And the pain has been bad enough I have thought about being willing to try again. I have also been diagnosed in the past with depression.
Why are they not also asking other questions like all of my history, especially history related to what drugs I should not be on for medical reasons (physical contraindications such as blood pressure, heart and liver, and drug interactions)?
And why doesn’t the physical therapist and the physicians who will or have seen me more often not require All this same information? But 2 physicians do have a history of me on file, just not the same way (I have to fill pages of permission and names of people out for information to be transferred to this place and it’s tedious).
JAMAL
What does that have to do with car accidents and degenerated vertebrae and other areas of pain?
I have been desparate enough to be willing to be put on a mental pill, but that didn’t work out, and a lot of physical pain can cause depression and frustration. And the pain has been bad enough I have thought about being willing to try again. I have also been diagnosed in the past with depression.
Why are they not also asking other questions like all of my history, especially history related to what drugs I should not be on for medical reasons (physical contraindications such as blood pressure, heart and liver, and drug interactions)?
And why doesn’t the physical therapist and the physicians who will or have seen me more often not require All this same information? But 2 physicians do have a history of me on file, just not the same way (I have to fill pages of permission and names of people out for information to be transferred to this place and it’s tedious).
JAMAL
6 Responses to “Why does the pain management clinic want to know my psychiatric care and psychological assessments?”
By heatishellinflorida on May 13, 2009 | Reply
Look, in a nutshell, Doctors are a JOKE! They must cover their own when prescribing meds. Obviously you are considering pain meds and yes it is essential they know what your brain is like, for Example they are not going to prescribe you Oxycontin if you have had a history of overdoses. Now they are wanting to substitute opiate based narcotics for anti-depressants and the BAD thing is one, anti-depressants can make you feel suicidal and depressed, not too mention if you stop taking them you might wish you were dead.They have no idea how a pill is going to react on you, they only know what their patients tell them and me, I think it is insane to want to give anti-depressants for pain, while opiates work the best. Is this LONG term? if so I would love to talk to you, there IS a LOT and I mean a lot you need to know and I was a pain management patient for years and know pharmaceuticals like the back of my hand, be careful! It seems like this is a place that wants to experiment with Anti-depressants for pain, to me this is insane. Thank all the nuts that abused Oxycontin for this, Don’t be a guinea pig.
By Niki on May 14, 2009 | Reply
You’re right… they should not have to ask you about your psychiatric care. But, in this world today, I think that they feel a moral obligation to ask such things.
I believe they think that many times when someone is not psychologically stable… they have a higher chance of abusing the prescribed narcotics. Or, even selling them.
Many times, people that are depressed or suffering from other mental illnesses self medicate… and I can vouch for that. When there is no other way to turn for your mental anguish, and you don’t have an anti-depressant to take… the next best thing is a narcotic.
Now don’t get me wrong. If you are truly in pain, they should give out the medications. I have been to a pain clinic and have found that they are overly cautious. If the medications are taken correctly and exactly as prescribed, there is next to no chance of addiction. But there is a chance of chemical dependence… big difference: one is mental/psychological and the other is physical.
So… I don’t think it is right that they judge people on their psychological past or present. But I don’t blame them… people are just so hard to trust these days.
By Booklover37 on May 15, 2009 | Reply
I work in a hospital and the main purpose I can think of is because pain clinic doctors get quite a lot of drug seekers in their offices, so perhaps they are trying to weed out anyone who may be just trying to get narcotics or opiate drugs, and those people generally end up with psychiatric stays, etc. So that may be the reason.
By mistify on May 15, 2009 | Reply
Pain management is a very holistic approach (or at least it should be). This is because pain is very often not a cause and effect type of relationship. In other words, your x-rays which show “X” amount of _________ will not always result in “Y” amount of pain. For instance, degree of vertebral/disc degeneration as shown on x-ray has almost no correlation with someone’s pain levels. As an example, about 30% of the pain-free population has at least one degenerative disc by the age of 30…as we approach 60, that number nears 100%. It doesn’t mean that degneration cannot be a cause of your pain, just that there are many factors that relate to this. (see below)
Pain is mediated by several factors including mechanical nocioception (the physical input of pain as a direct result of “damage”), chemical mediation of the pain receptors (levels of neurotransmitters, etc), mediation in the brain (hence the need to know your pscyhiatric history), and mediation and the spinal cord level. This is why pain management addresses you as a whole…both your physical and emotional needs.
The sensitivity of these mechanisms can be altered by many things including whether you smoke, your diet, weight, presense of psychological disorders such as anxiety and depression.
It’s good that you are willing to try things that do not necessarily seem to have a linear relationship, because many people are turned off by the thought of taking an anti-depressant or a “mental pill.” (BTW, try not to think of it like that…think of it as a way to manage a chemical imbalance in your pain control response). However, not one pill works for everyone. Several may need to be tried to find one that works for you.
Furthermore, part of pain management is learning how to cope effectively. Many people have adapted poor pain coping mechanisms that further propegate the problem. Cognitive behavioral therapy is often incorperated to help address these issues.
As far having to fill out repated information, this is standard because people who have chronic pain issues have frequent changes in medication and new interactions can happen at anytime. Therefore, it’s necessary to review this information when you meet a new provider. Although I do agree, drug interactions should be included…it will help prevent having you try a drug that gave you bad results in the past.
Hang in there!
By deltaqueen on May 15, 2009 | Reply
I am a pain management patient and went through the phyciatric questions as well. I am worried about the clinic that you are going to if they are focusing on it though.
I was told that the reason they ask is for information on past medications and if I had had a history of depression I would be watched a little more closely because the pain meds that I was to recieve could cause depression.
I took it more as them understanding that pain and having your life turned upside down because of it is depressing enough and they need to know my history to make sure that I am on the right medications and they have not unintentionally given me something that would heighten my depression.
We also went througn my complete medical history as far as heart, liver and kidneys,etc. We talked about what my goals where now that I was using the clinic, and just what I do on a daily basis. They did ask about my life at home and if I had stress or a good support system. I don’t know that they send my history to anyone else (other docs) but I doubt it.
So you see, I think that your clinic is a little bit differant than the ones I have heard of and the one I go to.
I **** to hear that you are upset because I look at my Pain Mangement Clinic as a blessing and you should be able to as well. It’s finally somewhere that I know that they believe that I am in pain and not just looking for drugs.
Is there any other Clinics in your area?
By Mandy VZ on May 16, 2009 | Reply
They want to know if you have a history of substance abuse so they can treat you with the proper medications. They also want to weed out drug-seekers. They also want to know if you’ve been treated for depression, etc. for the reasons you mentioned: pain can cause depression.
They don’t ask medical history questions in-depth because you should be providing them with a copy of medical records from the diagnosing doctor. It has your allergies in it as well as the in-depth infor they need to know about past treatments, etc. A lot of the information they will ask you about in person, as well.