Dr. James Laurent Gagne MD

Pain Management Specialist | Pain Medicine

4/5(7)

1809 Verdugo Boulevard Suite 200 Glendale CA, 91208 Show map

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About

Dr. James Gagne practices Pain Medicine in Glendale, CA. Pain medicine is concerned with the prevention of pain, and the evaluation, treatment, and rehabilitation of patients experiencing pain. Pain medicine physicians use a broad-based approach to treat all pain disorders, ranging from pain as a symptom of disease to pain as the primary disease. Dr. Gagne serves as a consultant to other physicians but is often the principal treating physician, providing care at various levels; such as treating the patient directly, prescribing medication, prescribing rehabilitative services, performing pain relieving procedures, counseling patients and families, directing a multidisciplinary team, coordinating care with other healthcare providers, and providing consultative services.

Education and Training

Albert Einstein College of Medicine MD 1973

Albert Einstein College of Medicine - Yeshiva University 1973

Board Certification

American Board of Addiction Medicine

American Board of Internal Medicine

American Board of Pain Medicine

Internal MedicineAmerican Board of Internal MedicineABIM

Provider Details

MaleEnglish 44 years of experience

Dr. James Laurent Gagne MD

Dr. James Laurent Gagne MD's Expert Contributions

My Answers

Do antidepressants cause weight gain?
"Antidepressants" is a large category with about two dozen different medications. Weight gain can be a big problem with many of them, but not all. The worst offenders are tricyclic antidepressants like Elavil (amitriptylene), imipramine, Pamelor (nortriptyline), and especially doxepin. But drugs in this category are now rarely prescribed. Many SRIs (Celexa, Prozac, and especially Paxil) can cause weight gain, while Zoloft (sertraline) does so much less often. Desyrel (mirtazipine) can cause a lot of weight gain. SNRIs like Effexor and Cymbalta vary, but can be a problem. Wellbutrin (bupropion) often helps you lose weight and rarely causes weight gain. A good rule of thumb is that the more sedating any psychiatric medication is, the more likely weight gain will occur. READ MORE
Bump and redness after IV meth injection?
I'll bet your friendly neighborhood drug dealer reassured you that the meth he sold you is sterile, FDA-approved, and pure as the driven snow. Very few addicts would believe him, and nobody should. You have no idea what he cut the meth with. He may have swept up his kitchen floor that morning, picked out the dead flies, and cut your meth with the remainder. The good news is he probably didn't use soiled toilet paper. You'd know it if you had hit an artery, as blood would have come gushing out. Instead, you injected some sort of gunk that caused an infection. Because you injected into a vein (that's the whole point), it's entirely possible the infection is spreading throughout your vascular system, causing total-body sepsis. You most certainly have a localized infection. Get your butt to your primary care physician. READ MORE
Short-term Buprenorphine for Methadone withdrawal?
Your question is a little unclear, but I'll tell you what I know. In many respects buprenorphine and methadone are quite similar. Both are long-acting opioids with proven effectiveness in treating opioid addiction. Buprenorphine is safer and has fewer side effects. If you work with a good addiction medicine MD, it's generally not hard to switch from methadone to buprenorphine. Either medication is highly effective. Because of persistent withdrawal lasting weeks or months, methadone is notoriously difficult to taper and stop, although surprisingly many people do manage to get off it without too much trouble. The hardest part is coming off the last, lowest dose, i.e., 5-15 mg/day. Buprenorphine has similar issues but in general is somewhat easier to stop than methadone. If you worked with a skilled addiction specialist, you could certainly taper and stop buprenorphine. But assume it will take weeks or months. One potential issue is that buprenorphine is usually a pretty good antidepressant, so you may have some depression or anxiety coming off it. People just feel better on buprenorphine. Why in the world do you want to stop methadone?The risk of relapse is extremely high when people stop maintenance therapy with either drug. Both drugs are safe and effective for many years. Often, people decide to stop when they're tired of being sober, or if a friend or relative convinces them maintenance therapy is just another "addiction" and they need to stop (not true!). I've come to regard opioid replacement treatment as something you're on forever, certainly 5-10 years or more. How do you know it's safe to stop taking it? When you've achieved full adult function: stable relationships (ideally including marriage or other long-term committed relationship). You have a career, not just a job. You've bought a house or have a similar stable living arrangement. There's just not a lot of drama in your life. Life is good! READ MORE
How to repair relationships ruined by addiction?
Repairing a marriage after you've spent a while "married" to opioids is tough. Many addicts are abusive, spend money the family doesn't have, sleep around, wind up seriously ill, lie through their teeth, and/or are generally highly undesirable partners. How do you fix this? First, get sober. Second, stay sober for at least a year. Often (but not always), you can repair your marriage by becoming truthful and dependable. Abstinence-based recovery from opioids is possible but usually quite difficult unless your addiction was mild. So many addicts require Suboxone or other brand of buprenorphine-based treatment. This can be hard to find, because a) doctors often believe INCORRECTLY that Suboxone is itself addicting and b) family members frequently revolt. But the science is clear: if you stay on Suboxone or a similar medication long enough, you're likely to get sober and stay sober while taking the medication. But you're committing to many years of maintenance with Suboxone. Detox alone is a prescription for failure. Yes, you'll meet opioid addicts who got sober through abstinence. But you can't talk to all the folks who relapsed and died of an overdose. READ MORE
Can I get addicted to my medication for OCD anxiety and depression?
People keep asking variations of this question, so you may want to read some of my earlier answers. The answer is it depends upon which medication you're taking. Benzodiazepines like Valium, Ativan, or Klonopin are relatively ineffective and have a substantial addiction risk. SRI antidepressants are effective for OCD, anxiety, and depression, and you can't get addicted to them. But you don't want to stop them suddenly, and many people need an extended taper so their original symptoms don't return. READ MORE
How do you stop your addiction to pills?
"Addiction to pills" could mean almost anything, but generally refers to opiates, sedatives, or stimulants. (Few people are addicted to aspirin or vitamins.) Let's stick with those. When you say "addiction," do you mean your doctor prescribed these and you're taking them as prescribed, but are finding it hard to stop? That you're taking many more than were prescribed? You're seeing multiple physicians to get extra prescriptions? You're buying them on the street? Sometimes people who are prescribed a sedative (like Valium or Ativan) or opiate like Norco or Percocet only use them as prescribed, but find they just can't quit. That's not "addiction," but can be distressing. Work with your prescribing physician to address this issue. If you can, it might help to taper these drugs slowly. Some physicians won't prescribe these medications at all, and some insist there's no problem and just to keep taking them indefinitely. One note: if you're on benzodiazepine like Klonopin, Valium, or Ativan, stopping suddenly can cause a flare-up in anxiety. This won't hurt you, but can be annoying. The solution is a very slow taper over many months. READ MORE
Addicted to Diazepam?
Unless you're abusing diazepam, binge using it, or buying it on the street, you're not "addicted." What you describe is physical dependence plus withdrawal if you taper or stop it too quickly. The problem with diazepam is that any kind of rapid taper can lead to an anxiety flare-up that many people find intolerable. This is part and parcel of using diazepam for more than short periods. It doesn't reflect on you in any way. Also, with most drugs of this sort, it's often easier to taper to a lower dose than to taper down and stop from a low dose. So, getting stuck at 6 mg/day is completely understandable. You'll find a variety of slow tapering recommendations on the internet, some better than others. What I'd suggest is cutting the dose by 10% A MONTH. So, take 5-1/2 mg/day for a month, 5 mg a day for a month, 4.5 mg a day for a month, etc. Take your time. In addition, I'd also recommend learning a self-soothing, meditation, or relaxation skill. Mindfulness works well. You'll find mindfulness books and tapes at Amazon and on the internet. A particularly helpful resource may be the Mindfulness Awareness Research Center at UCLA, https://www.uclahealth.org/marc/. READ MORE
What happens after you stop antidepressants?
That's a great question. There are several classes of antidepressants, and each acts a little differently. The most commonly prescribed are SRIs and SNRIs (serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors). Both can cause a withdrawal response if you taper or stop them too quickly. Most common are an upset stomach, maybe some diarrhea, and feeling anxious or jittery. A slow taper should take weeks or months, the slower the better. The larger problem is that you usually can't feel the antidepressants are working, and it's common to decide they aren't doing anything. So, you quit. BAD MOVE! Aside from the withdrawal symptoms noted above, your depression can return in full force, often with a delay of 1-2 weeks or more. The way you can tell the antidepressant is helping is you say to yourself, "I feel terrific! Why am I taking this junk?" So, you stop it, and the depression returns. READ MORE
Why are prescription pills so dangerously addictive?
Unfortunately, your question wildly exaggerates a simple problem into a global castrophe. The vast majority of prescription medications have no addiction risk, just as not all tires blow out and not all children become serial killers. Yes, opiates and sedatives can cause addiction, although the majority of patients use these appropriately. Most overdoses are in people who become addicts and abuse and overuse these drugs. READ MORE
What makes someone addicted to food?
"Binge eating disorder" is a recognized problem. It's not an addiction but is more or less in the same family of problems. Your daughter needs treatment through an eating disorder program. On rare occasion, you can find a psychotherapist with expertise in this area, but more commonly therapists say they treatment eating disorders but have none of the required extra training. A formal program is a better bet. Most likely, she would do fine in an outpatient program, but there's no way to tell what level of care she requires without a formal, person-to-person evaluation. READ MORE
How does psychoanalysis help addiction?
It probably doesn't. Sounds like a false promise unless the therapist is EXTREMELY skilled in specifically treating addictions. Decades ago, analysts claimed to be able to treat anything, but that didn't turn out well. Addiction is caused by a mixture of inheritance and a degree of emotional trauma. Addicts need ongoing emotional support and often a community to turn to. READ MORE
Why do people become addicted to antidepressants?
With one sideways exception, you can't get "addicted" to antidepressants. Medications from the SRI (serotonin reuptake inhibitor) and SNRI (serotonin-norepinephrine reuptake inhibitor) families often have the opposite problem: people don't feel them working right away. When their moods improve, they decide they don't need medications and stop them. The depression slowly comes back. Same story with bupropion (Wellbutrin) and Remeron. That one sideways exception is amphetamines, which are occasionally prescribed for depression but are highly addicting. Addiction is when you crave a medication and take more of it than you intended. When you use it despite repeated adverse consequences. This just doesn't happen with antidepressants. What **can** happen is if you stop an antidepressant suddenly, you can get a withdrawal effect, like an upset stomach. Or your depression can come back. And antidepressants can have side effects, but those aren't addicting either. READ MORE
Is psychotherapy effective for addiction?
Is psychotherapy effective for addiction? Well, yes and no. Most therapists will insist they can treat addiction but fall woefully short. A few have broad experience in addiction treatment and can do quite well. A common scenario is someone finally admits to others he/she has an addiction problem but does NOT want enter into any sort of rehab. So they find a therapist they can string along. Bottom line: usually addiction treatment is best managed by addiction specialists. READ MORE
Is alcohol addiction a genetic condition?
The RISK for alcoholism is in large part genetic. You can tell if you inherited the risk by how you feel after 1-2 drinks. The normal response is, "Yeah, OK, I'm a little more relaxed, but I don't see what all the fuss is about." Having more than 2-3 drinks makes you feel ill. By contrast, those who've inherited the risk feel TERRIFIC and EUPHORIC and HAPPY after 1-2 drinks. The more they drink, the better they feel. Their tolerance for alcohol is much higher than others. The likelihood of inheriting the risk is 25% if one parent or sibling is alcoholic. Your uncle and grandfather were affected, so I would guess your chance of inheriting the risk is lower. But if you use the test in the previous paragraph, it's easy to find out. Note that childhood abuse or extreme isolation or stress can also bring out alcoholic addiction in those who didn't inherit the risk genetically, but this is less common. If you believe you've inherited the risk, the trick is to mostly avoid alcohol, and when you do drink limit the quantity to 1 drink. If you find yourself drinking more, it's time to get help. READ MORE
Clonidine for withdrawal?
Clonidine is a GREAT detox drug for opiate withdrawal. It doesn't completely resolve detox symptoms but helps a lot. If she takes too much, it can drop her blood pressure even to the point of passing out. So she could take more so long as you have a home blood pressure meter to ensure she isn't taking too much. And a single dose of clonidine lasts for 1-2 days. So sure, so long as she's safe, she could take more. You should know that although opiate withdrawal can make you feel completely sick and miserable, it's almost always harmless and medically safe. A lot of experienced addicts take very little detox medication, knowing they'll get through it on their own in a few days. READ MORE
Why am I more likely to abuse drugs if my uncle did?
You're very unlikely to abuse drugs with a low addiction potential like aspirin, and most drugs don't carry an addiction risk. The big three that do are opioids like Norco or oxycodone, benzodiazepines like Xanax, and amphetamines like Adderall. Then there are all the street drugs with high abuse potential. Addiction is largely an inherited disease. You don't inherit the disease per se but the risk. The more affected blood relatives, and the closer they are to you by blood, the greater the risk. So one parent, brother, or sister who's an addict or alcoholic gives you a roughly 25% chance of inheriting the risk for addiction. If your only affected blood relative is your uncle, your likelihood of being at risk is lower. The way you can tell if you've inherited the risk is if you become really euphoric or high when you try a drug. Most of my alcoholic patients learned of the risk when they took their first drink as a young adolescent. They immediately found how much they liked the feeling of alcohol, and most drank heavily that first time. By contrast, if you don't have the risk, you're just apt to feel a little dizzy and wonder what all the fuss is about. Environmental factors can strongly amplify or diminish risk. If you had a relatively happy childhood and have a secure future, addiction is much less likely. If you're having trouble making it or were abused as a child, that greatly amplifies risk. READ MORE
How long does long term depression last?
The duration of "long-term depression," AKA chronic or relapsing depression, depends upon several factors. First, have you ALWAYS been depressed, or did depression arise as a result of things that happened to you? Examples of external factors include childhood emotional trauma, rape, physical or sexual abuse, loss of a relationship, or other adverse events. Drug or alcohol abuse commonly causes depression. Sometimes people become depressed in the winter because there's so little sunlight. Depression also has a strong genetic component. If you study identical twins raised apart (so whatever they have in common is purely genetic), there's a 50% chance that if one twin is depressed, the other twin will also be depressed. If your depression has always been present and you don't have a history of adverse events, then it is a MEDICAL condition that will likely require antidepressants over decades, if not lifelong. Depression due to adverse experiences is a feature of post-traumatic stress disorder, which requires its own treatment. Sometimes you don't know why you're depressed, but it keeps coming back if you stop your medication. Then you simply need to keep taking it. Regardless of the cause of depression, psychotherapy can be extremely helpful. Talk therapy is proven useful, where you work through the events that have haunted you. Even better is cognitive behavioral therapy (CBT), which involves TRAINING you how to turn off depressing thoughts. Many therapists who say they do CBT have never actually been trained in how to do it, so look for someone who specializes in CBT. READ MORE
Can couples therapy make things worse?
Occasionally, attending couple's therapy can help a difficult situation with a drug addicted spouse. Usually that doesn't work, but there IS an effective approach. Go to individual psychotherapy yourself. Within a few weeks or months, you should be a lot clearer on how to proceed. That said, if your husband DOES agree to go to therapy of his own accord (i.e., not because you're insisting or threatening), it may be worth a try. One warning: the quality and competence of therapist varies widely. Please have an initial session with at least two, preferably three therapists and pick the one who seems the most competent, supportive, and aware. If a therapist demeans you or confronts you harshly, run for the door! And yes, if you work with an incompetent therapist, it can make things worse. READ MORE
Why is prescription meds so addictive for people?
Unfortunately, this question is so broad and vague it's hard to answer. It's like what makes cars kill people? Why do people die? In the case of medications, the VAST majority aren't addictive. But a few are. Hopefully, the medications with the greatest addiction risk have such powerful and unique benefits that there are no alternatives. Unfortunately, this isn't always true, as the tragic case of OxyContin shows. READ MORE
Is lithium safe for people with bipolar disorder?
Lithium has some really good news and some really important caveats. You should be sure you're working with a physician skilled in its use who can keep your dose at the right level. Sometimes low-dose lithium is all you need, but most folks require a therapeutic blood level, 0.6 to 1.2 milliequivalents per liter (sorry, that's how it's measured). When properly used, most people find the lithium is highly effective in keeping their moods under control. Overall, it's usually more effective and less risky with fewer side effects than alternative medications for bipolar disorder. But the risk of lithium toxicity is real: levels over 2.0 can make you ill, and much higher levels can be dangerous or even fatal. If you get really dehydrated (too much time in hot weather without drinking enough fluids), that itself can make you toxic. Lithium often interferes with thyroid function, and it's common to require thyroid medication after you've taken lithium for a while. There can be interactions with other medications, especially non-steroidal anti-inflammatory drugs like Aleve and Advil, which you must avoid. READ MORE

Treatments

Opiate Dependence

Dr. James Laurent Gagne MD's Practice location

Practice At 1809 Verdugo Boulevard Suite 200

1809 Verdugo Boulevard Suite 200 -
Glendale, CA 91208

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New patients: 818-790-4300

Fax: 818-790-2816

Mon:09:00 AM - 05:00 PM
Tue:09:00 AM - 05:00 PM
Wed:09:00 AM - 05:00 PM
Thu:09:00 AM - 05:00 PM
Fri:09:00 AM - 05:00 PM
Sat:Closed
Sun:Closed

Dr. James Laurent Gagne MD's reviews

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Patient Experience with Dr. Gagne

4.0

Based on 7 reviews

Dr. James Laurent Gagne MD has a rating of 4 out of 5 stars based on the reviews from 7 patients. FindaTopDoc has aggregated the experiences from real patients to help give you more insights and information on how to choose the best Pain Management Specialist in your area. These reviews do not reflect a providers level of clinical care, but are a compilation of quality indicators such as bedside manner, wait time, staff friendliness, ease of appointment, and knowledge of conditions and treatments.