What medication management is
Medication management is the ongoing part of a written pain plan where a physician chooses, adjusts and monitors the medicines you take for pain. At each appointment the doctor looks at how much relief you are getting, what it is costing you in side effects, and whether the dose can come down or the medicine can be stopped.
We start with non-controlled options wherever we can: anti-inflammatories, muscle relaxants, nerve pain medicines such as gabapentin or duloxetine, topical creams and patches, and short courses around an injury or a procedure. For many patients that is enough, especially alongside trigger point or joint injections and nerve blocks.
Controlled medication, including opioids, has a place for some patients with severe or long-standing pain. When it is used, it is prescribed at the lowest effective dose, for a defined purpose, and with the monitoring that Florida law requires.
How our physicians manage it
- A full review first. Your pain history, what you have tried, every other medicine you take, and any kidney, liver, heart or stomach problems that change what is safe.
- Non-controlled before controlled. A controlled medication is considered only when simpler options have been tried or are unsuitable, and the reason is written into your plan.
- Lowest effective dose. We aim for the smallest amount that lets you sleep, work and move, then hold or reduce it rather than escalate.
- Medication alongside procedures. Injections, nerve blocks and, at Davie, StemWave shockwave therapy often mean less medication is needed over time.
- A naloxone conversation. If an opioid is prescribed, the doctor talks with you about naloxone (Narcan), the rescue medicine that reverses an overdose, and whether you should keep it at home.
Does insurance cover it? Yes. Medication management appointments are billed as regular office visits, so Medicare, Medicare Advantage, Aetna, Blue Cross Blue Shield and Cigna cover them the same way as any doctor's visit, with your usual copay. The cost of the medicine itself depends on your pharmacy benefit. Urine screening ordered as part of monitoring is generally covered when medically necessary. Read more about insurance and self-pay.
Florida's rules for controlled medication, in plain language
Florida sets clear requirements for prescribing controlled pain medication. They exist to protect patients, and we follow them at both clinics.
- A physical exam on the same day. Whenever a controlled medication is prescribed, the doctor examines you at that visit. This is why these prescriptions cannot be issued over the phone.
- A prescription database check. Before prescribing, the doctor checks Florida's prescription drug monitoring database, which lists the controlled medicines you have filled anywhere in the state.
- A signed treatment agreement. You and the doctor sign an agreement covering how the medicine is to be taken, that you use one prescriber and one pharmacy, and what happens if the agreement is not kept.
- Periodic urine screening. A urine test at intervals confirms the medicine is being taken as prescribed and nothing unexpected is present.
- How often you are seen. When a Schedule II medication (this includes most opioids) is prescribed, you are seen every month. For other controlled medicines, follow-up is at least every three months.
- Electronic prescribing. Controlled prescriptions are sent electronically to your pharmacy rather than written on paper.
| What it treats | Chronic back, neck, joint and nerve pain; pain after injury |
|---|---|
| Visit length | About 30 to 45 minutes for the first consultation, 15 to 20 minutes for follow-ups |
| Typical course | Ongoing; monthly visits on a Schedule II medicine, otherwise at least every three months |
| Downtime | None |
| Coverage | Covered as office visits by Medicare and in-network plans |
What to expect
- Before you come in, we verify your insurance and ask you to bring photo ID, your current medication bottles or an up-to-date list, your pharmacy details and any records from a previous pain doctor.
- At the consultation, the doctor examines you, goes through your history and explains every option, not only medication.
- You leave with a written plan that names the medicine, the dose, the goal it is meant to achieve and the date it will be reviewed.
- Follow-up is monthly or every three months depending on what is prescribed. Refills are timed to those visits.
Will I be prescribed opioids at my first visit?
Not usually. The first visit is about finding the source of the pain and starting the safest option that fits. If a controlled medication is appropriate, it is prescribed after an exam, a database check and a signed agreement.
Can I get refills without coming in?
Non-controlled medicines can sometimes be refilled between visits. Controlled medicines cannot: Florida requires an exam on the day of each prescription, so refills are tied to your scheduled appointments.
I am already on pain medication from another doctor. Can I transfer my care?
Yes. Bring your records and current bottles. The doctor reviews the prescription database, confirms what you are taking and decides with you whether to continue, adjust or reduce it. Nothing is stopped abruptly.
What if I want to come off pain medication?
Tell us. Tapering is planned and gradual. For patients who have become dependent on opioids, Dr. Escarria leads an office-based, outpatient medication-assisted treatment program at both clinics.
Which clinic offers medication management?
Both. Davie serves Broward County and Boynton Beach serves Palm Beach County, and the same physicians and the same rules apply at each.
Is medication management covered by insurance?
Yes, as a standard office visit under Medicare, Medicare Advantage, Aetna, Blue Cross Blue Shield and Cigna. Self-pay is available if you are uninsured. When you book, the front desk confirms your coverage before your first appointment.