Medication Policy

CHRONIC PAIN: Narcotics/Opioids (Lortab, Oxycodone, Codeine, etc.)

Opioids, morphine and it’s relatives, are generally my last choice for ongoing pain. In most circumstances, addressing underlying health issues, non-opiate medications, manual medicine techniques (physical therapy, rehabilitation, massage, acupuncture, etc.) and lifestyle changes (diet, exercise, sleep, etc.) can significantly reduce and manage chronic pain.

Long term or frequent use of narcotic medications comes with significant risk – including escalating dosing, dependence, withdrawal, and functional decline. There are certain severe medical conditions that may require extended use (more than 1-2 weeks) of narcotics for pain. I reserve the right to prescribe opiates only when I see appropriate on a case-by-case basis after review of history and records. There are a few conditions for which I will NOT prescribe long-term opioids, including . . .

  • Chronic back pain due to most cases of “degenerative disc disease”, muscle spasms or non-specific causes.
  • Headaches; primary types including migraine and tension-type.
  • Fibromyalgia or other central-pain syndromes.

If you have further questions, please feel free to call to discuss.


ANXIETY, PANIC ATTACKS: Benzodiazepines (Xanax, Valium, etc.)

Benzodiazepines (also known as “benzos”) are a class of medications used for a variety of purposes – including anxiety and “panic attacks”. Long-term or frequent use of benzos comes with significant risk of dependence, increasing tolerance, abuse, mental function and adverse effect on physical/mental health. These issues are particularly profound with shorter-acting agents, such a alprazolam (Xanax and Ativan).

For long-term control of anxiety disorders, several classes of non-benzo medications, therapies and psychology techniques have proven to be effective and safer than benzodiazapines. I will not recommend or prescribe regular use of these medications.

If you have further questions, please feel free to call to discuss.