Should I go to a pain clinic like my doctor said? Im kinda nervous.?

My doctor has had me on all kinds of medications that simply don't work. I have had cluster migraines since I was in the 6th grade (I'm nearly 21 now), I've had arthritis in my shoulder, and in 4 of the columns in my lower back, syatic (how ever you spell it) nerve damage in my back, and one of the columns in my lower back is not lining up with the others like its suppose to (it's sticking out way further than the rest). My doctor wanted to put me on the Butrans patch, but I refused to use them becuase I find them really dangerous. That's when he said "we might have to get you into a pain clinic". So my questions are.. what happens in a pain clinic? How often do you have to be seen? What kind of pain medications would the be most likely to give me for my problems? Do pain clinics accept Medicaid? And are the doctors at pain clinics pretty easy going? (For example, do they just automatically assume everyone is a drug seeker?) I'd rather be shot dead than thought of somebody that only wants drugs for the hell of it.