Pain expert: Judge the opioid treatment, not the patient

With medications that carry significant risks, such as opioids, appropriate prescribing practices are critical to patient safety. One physician in Boston lives by a mantra that puts patients first: Judge the treatment, not the patient. We need to start re-conceptualizing chronic pain as a chronic disease, said Daniel P. Alford, MD, associate professor of medicine at the Boston University School of Medicine and director of the Safe and Competent Opioid Prescribing Education (SCOPE of Pain) program. “Acute pain is a symptom, and it’s life-sustaining—and you need to feel acute pain in order to survive,” Dr. Alford said. But “there is no advantage to chronic pain. Chronic pain really is a malfunctioning of the nervous system and requires, like other chronic diseases, a multimodal approach.” Assessing whether opioids are the appropriate course of treatment Many potential physical, psycho-behavioral, procedural and pharmacologic options exist for managing chronic pain. Dr. Alford follows a process that helps him to make the appropriate clinical judgment regarding whether or not opioids are an appropriate course of treatment for each individual patient: 1.  Determine whether the patient has a pain process that is likely to respond to opioid therapy. For a lot of chronic pain disorders, opioids are probably not the answer, Dr. Alford said. “For example, chronic migraine headaches, fibromyalgia and back pain … tend t...
Source: AMA Wire - Category: Journals (General) Authors: Source Type: news

Related Links:

"The first doctor who saw me told me to go home and die," says a pancreatic cancer survivor who hopes one day no one else will have to hear those words
Source: Health News: CBSNews.com - Category: Consumer Health News Source Type: news
Authors: Koehler LA, Hunter DW Abstract Axillary web syndrome (AWS) is a frequently overlooked problem that causes morbidity in the early post-operative period following cancer surgery with axillary lymph node removal (1-3). AWS, also known as “cording” was first described in 2001 by Moskovitz as “a visible web of axillary skin overlying palpable cords of tissue that are made taut by shoulder abduction” (1). Over a decade has passed since Moskovitz’s seminal article was published, and we still lack a good understanding of AWS. This condition has been suboptimally studied using widely d...
Source: Lymphology - Category: Internal Medicine Tags: Lymphology Source Type: research
Authors: Iwakiri K, Sotoyama M, Takahashi M, Liu X, Koda S, Ichikawa K Abstract Many care workers at elderly care facilities in Japan suffer occupational low back pain (LBP) despite the utilization of welfare equipment. When introducing welfare equipment such as hoists and sliding boards, education on appropriate care methods using welfare equipment is usually conducted, but the effect of education diminishes with time. This intervention study aimed to examine the effect of re-education on appropriate care methods using welfare equipment on the prevention of care workers' LBP at an elderly care facility. At the int...
Source: Industrial Health - Category: Occupational Health Tags: Ind Health Source Type: research
Authors: Bozat-Emre S, Marshall SG, Zhong C, Reimer J Abstract The Government of Manitoba launched the provincial Take-Home Naloxone Program in January 2017. By the end of September 2017, there were over 60 sites operating in Manitoba. These sites distributed 765 kits to people at risk of opioid overdose, and 93 of these kits were replacement kits used in overdose events. Most of these events occurred among males (60.2%) and in a private residence (72.0%). Fentanyl and carfentanil were the most common substances reported during overdose events. Take-Home Naloxone Program data provide important information about the...
Source: Health Promotion and Chronic Disease Prevention in Canada - Category: International Medicine & Public Health Tags: Health Promot Chronic Dis Prev Can Source Type: research
Authors: Ye X, Sutherland J, Henry B, Tyndall M, Kendall PRW Abstract We quantified the contributions of leading causes of death and drug overdose to changes in life expectancy at birth over time and inequalities by sex and socioeconomic status in British Columbia. From 2014 to 2016, life expectancy at birth declined by 0.38 years and drug overdose deaths (mainly opioid-involved) contributed a loss of 0.12 years of the decrease. The analysis also demonstrated that the higher drug overdose mortality among males and among those in lower socioeconomic status communities contributed to a differential decrease in life e...
Source: Health Promotion and Chronic Disease Prevention in Canada - Category: International Medicine & Public Health Tags: Health Promot Chronic Dis Prev Can Source Type: research
Authors: Skowronski M, Risør MB, Andersen RS, Foss N Abstract Little is known about how people living in the aftermath of cancer treatment experience and manage worries about possible signs of cancer relapse, not as an individual enterprise but as socially embedded management. One-year ethnographic fieldwork was conducted in a coastal village of under 3000 inhabitants in northern Norway. Ten villagers who had undergone cancer treatment from six months to five years earlier were the main informants. During fieldwork, the first author conducted qualitative, semi-structured monthly interviews with them, and par...
Source: Anthropology and Medicine - Category: International Medicine & Public Health Tags: Anthropol Med Source Type: research
Authors: Norum J, Balteskard L, Thomsen MW, Kvernmo HD Abstract Rough weather conditions in the subarctic areas of Norway may influence on the risk of wrist fracture. We implemented data from the Norwegian System of Patient Injury Compensation (NPE). All claims due to wrist surgery, performed at the public hospitals in Northern Norway, during 2005-2014 were analyzed. We employed the ICD-10 classification codes S52.5 (fracture of distal end of radius) and S52.6 (fracture of distal end of radius and ulna). Treatment was defined by NCSP codes. 84 patients (0.3%) complained. Females complained four times more often tha...
Source: International Journal of Circumpolar Health - Category: International Medicine & Public Health Tags: Int J Circumpolar Health Source Type: research
CONCLUSIONS:   In participants reporting HxLBP, TrA thickness modulations were lower and both tabletop and seated thickness modulations were able to distinguish reported HxLBP status. These findings suggest that TrA muscle function may be altered by HxLBP. PMID: 29912568 [PubMed - as supplied by publisher]
Source: Journal of Athletic Training - Category: Sports Medicine Tags: J Athl Train Source Type: research
Supplementation with Robuvit® in post-mastectomy post-radiation arm lymphedema. Minerva Chir. 2018 Jun;73(3):288-294 Authors: Belcaro G, Dugall M, Cotellese R, Feragalli B, Cianchetti E, Cesarone MR Abstract BACKGROUND: Post-mastectomy lymphedema is one of the most significant, non-life-threatening complications following breast cancer surgery and radiotherapy. Post-mastectomy post-radiotherapy (PMPR) lymphedema is related to damages to lymphatics and/or veins during/after axillary surgery and radiotherapy. The management of this condition is very challenging; the comprehensive decongestive therapy...
Source: Minerva Chirurgica - Category: Surgery Tags: Minerva Chir Source Type: research
NEW YORK (CBS Local/CBS News) – Smoking in the U.S. has hit another all-time low. About 14 percent of U.S adults admit to being smokers last year, down from about 16 percent in 2016, government figures from the CDC show. There hadn’t been much change the previous two years, but it’s been clear there’s been a general decline and the new figures show it’s continuing, according to K. Michael Cummings of the tobacco research program at Medical University of South Carolina. “Everything is pointed in the right direction,” including falling cigarette sales and other indicators, Cummi...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Health News Local TV Smoking talkers Source Type: news
More News: Acupuncture | Addiction | Back Pain | Boston University | Cancer | Cancer & Oncology | Chronic Pain | Education | Emergency Medicine | Fibromyalgia | General Medicine | Headache | Migraine | Overdose | Pain | Rural Health | Universities & Medical Training