Non-Surgical Medical Treatment of Chronic Pain - Pain Management Partners

Specializing in Non-Surgical Treatment of Chronic Pain

Welcome to Pain Management Partners!

Serving Lane County, we offer multifaceted pain management, quality service and in-depth knowledge. Pain Management Partners, LLC in Eugene, Oregon specializes in non-surgical medical treatment of intractable pain. Our nationally recognized medical practitioners emphasize comprehensive care with a multidisciplinary perspective. We offer thorough evaluation, treatment recommendations, coordination of care, and alternative approaches when usual options fail.

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Lee Porter: New NP, CNS Joins PMP

Lee Porter, NP, CNS

Lee Porter, NP, CNS joined PMP this May. Lee is licensed and nationally certified as an adult nurse practitioner (NP) and also as a clinical nurse specialist (CNS) in psychiatry and mental health. He has more than 25 years of clinical experience in a variety of practice settings, from supporting clinical research at the National Institutes of Health to providing direct patient care at his own integrative medicine practice in coastal North Carolina, working primarily in psychiatry, neurology, and functional medicine.

Mr. Porter's perspective on patient care is via a holistic, whole person or bio-psycho-social approach, as consistent with the nursing paradigm; and he incorporates this approach to patient wellness and healing. As a clinical specialist, he applies this integrative perspective to health care via direct patient care, offering counseling and psychotherapy, patient and peer education, research, and patient advocacy, in addition to the medical services he provides as a nurse practitioner with prescriptive privileges.

Mr. Porter's clinical interest is in the mind-body aspects of pain, respiratory and stress physiology, mood and cognition, and patient self-empowerment in pain treatment. Lee works with patients using the most clinically effective therapies, including non-pharmaceutical therapies or standard medications.

A graduate of Franklin and Marshall College, Lee also received a BSN from Johns Hopkins University, an MSN from George Mason University in the George Washington University Medical Center collaborative nurse practitioner program. He then completed the national certification requirements as a clinical nurse specialist (CNS) in psychiatric and mental health nursing and a post-graduate internship in psycho-pharmacology at the University of Virginia. Lee also earned BCIA certifications in general biofeedback and in EEG neurofeedback.

Most recently from 2006-2015, Lee provided outpatient care at his practice, Allied Psychophysiology, in Wilmington, N.C., which focused on the care of patients with stress-related medical disorders, chronic pain conditions, brain injuries and post concussion syndrome, attention disorders, and anxiety and trauma. The clinical focus of the practice was neurological and psychiatric disorders, and medical and psychological disorders with a mind-body linkage. He also consulted in clinical and legal case management, health policy and administration, and provided continuing education and professional mentoring.

Lee appreciates the family atmosphere among staff and warmth shown to patients at Pain Management Partners, and he is honored to work with PMP patients on best managing their mind-body health and wellness.

New Federal Guidelines For Opiod Prescribing: Does This Affect You?

By James R. Morris, M.D.

There is quite a bit in the news lately about changes to Federal guidelines for opiate prescribing. Just as new information can lead to new medications and new therapies, it can lead to a change in the therapies and medications we already have. In this case it has led the CDC (Centers for Disease Control) to make several recommendations for chronic pain treatment and opioid use. Perhaps the most reported part of those recommendations is that for chronic pain, opiate prescriptions should be written for a Morphine equivalent of 50mg per day or less. If you take opiates, at your next appointment you are welcome to ask how your prescriptions compare to CDC recommendations. If your medication needs to be adjusted you and your practitioner can make a plan for how best to do this. The CDC has also strengthened its recommendation to avoid taking opiates and Benzodiazepines on the same day. When it’s unavoidable, close monitoring should be used. There are many benzodiazepines, such as temazepam (Restoril), diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax) and others. Most of the CDC recommendations are already things you likely do regularly, such as regular urine testing, education and discussion, setting goals for pain treatment and improved function, using non opiate medications, exercise and counseling. We look forward to seeing you at your next appointment! If you would like to read more here are some links:

  https://www.cdc.gov/drugoverdose/pdf/guidelines_a...

https://www.cdc.gov/drugoverdose/pdf/guidelines_fa...

http://www.nejm.org/doi/full/10.1056/NEJMp1515917?rss=mostViewed&#t=article

Pain Management Partners, LLC, is committed to marketplace ethics and meets the Better Business Bureau's  Code of Business Practices. Pain Management Partners, LLC, maintains honest and reliable business practices. We make a pledge to be transparent, be responsive to customers, advertise honestly, honor promises and act with integrity.

Feature Article: PMP Policy on Medical Marijuana

By James R. Morris, M.D.

At PMP, our goal is to promote the best welfare of our patients. Medical marijuana (cannabis) and recreational marijuana are controversial topics. Medical marijuana is regulated by law in the state of Oregon and has gained substantial popularity. As of 2015, recreational marijuana is available and state regulated. Yet marijuana remains illegal and largely unavailable by federal law.

At PMP, we support the concept of research, evidence-based clinical trials, and pharmaceutical grade cannabis preparations for FDA approval and appropriate federal regulation. We agree with Dr. Ethan Russo that a pharmaceutical, cannabis-based medicine must:

  • Be standardized, consistent and display a quality equal to any new chemical entity.
  • Possess a practical and suitable delivery system that minimizes patient risk, including intoxication, other aspects of drug abuse liability or serious adverse events (e.g., pulmonary sequela).
  • Have a supply chain that ensures security and distribution to its intended target patients.
  • Be accessible, meaning available and affordable.
  • Have evidence-based safety and efficacy.
  • Available as preparations that physicians may prescribe with confidence, that pharmacists endorse and supply.
  • Be prescriptions that government health services and third-party payers will cover.

Currently available "medical marijuana," despite contrary claims of the budding marijuana industry, cannot provide these assurances. It is difficult to recommend medical marijuana to our patients without these assurances, unless the patient has a terminal illness or severe condition known to respond to marijuana treatment. Examples: Metastatic cancer, Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease), progressive Multiple Sclerosis, HIV/AIDS wasting syndrome, and others.

Even so, some patients may wish to try marijuana as an alternative to pharmaceuticals and other treatments for their non-malignant pain. Under what circumstances will PMP support this trial?

1. Patient must have conditions supported by medical marijuana use laws, such as severe debilitating pain, muscle spasms, nausea/vomiting from chemotherapy, etc.

2. Patient cannot use other controlled substances for pain control, such as opiate narcotics or benzodiazepines.

3. Patient must not have contraindications to use (examples: COPD for inhaled marijuana, severe allergy to cannabis, substance use disorder/addiction, etc.)

4. Patient must not consume other intoxicating substances, such as alcohol, barbiturates, etc, and drive or operate machinery.

5. Patient must understand the side effects, adverse effects and potential consequences of marijuana use, such as weight gain, fatigue, impaired judgment, paranoia, bronchitis, immune suppression, infertility, fetal effects, accidental overdose, psychosis, etc.

6. Patient must understand the legal ramifications of use. Some examples of activities governed by law and liability -- driving, accidents, fault determination, restrictions on production, growth or distribution of marijuana, costs of obtaining state sponsored medical marijuana card, the difference between recreational and medical marijuana uses, etc.

For patients taking chronic opiates or narcotics as prescribed from our practice, a choice needs to be made. Bottom line: As of this date (August 2016), it’s either “your drug” or “our prescription medicine” but not both. We cannot prescribe controlled substances such as opioids when you use any form of marijuana, including CBD, for chronic, non-malignant pain. For questions and further discussion, see your provider.

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Feature Article: Medical Marijuana FAQ

Medical Marijuana Frequently Asked Questions:

  • I use Hydrocodone for my back pain but it doesn’t work so well. Will you prescribe medical marijuana in addition?

o No. It’s either your drug our ours, not both. And we cannot “prescribe” marijuana – that’s illegal.

  • If the marijuana doesn’t work, can I use the morphine you prescribed in addition?

o No. You need to decide on one or the other, not both.

  • What if I’m in a car accident and it wasn’t my fault, but they find marijuana in my urine or blood?

o Even if you haven’t used marijuana for days or weeks, it still shows up in your urine. You could be held liable for the accident based on presumed impairment.

  • Will you write a letter to my employer excusing me from drug testing at work?

o No. Your employer sets their policy about drug testing, not us.

  • If I have a medical marijuana card, does that protect me being fired from work for a positive drug screen?

o No, not in Oregon, but it is the employer’s decision or policy that determines the result (a zero-tolerance policy would result in automatic dismissal).

  • I’m taking opiates but I want to wean off and try marijuana. Will you help?

o Yes, in most cases we can recommend marijuana. We can determine a weaning schedule for you to reduce withdrawal symptoms. We can also support your application for an Oregon Medical Marijuana Program card, if you meet the criteria.

  • If the medical marijuana trial fails, can I go back on my opioid analgesic medications?

o If you stop using marijuana, we can again prescribe opioid analgesics as long as that is the best medical option for you.

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Willamette Medical Center
2401 River Rd, Suite 101
Eugene OR 97404
Hours: M-F 9 am to 4 pm

Business Office: 541-431-0631
Pharmacy Line: 541-393-0061
Scheduling: 541-344-8469
Fax: 541-687-8631

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