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The feds say restrict opioid use. Now what?

The federal government has declared, through its major health policy agencies, that the number of pain patients on opioids and the dosages they are on should be severely restricted.  The Center for Disease Control (CDC), Veteran’s Administration (VA) and Centers for Medicare and Medicaid Services (CMS) have all issued new guidelines within the past year to that effect.  Private insurers are following suit, in many cases refusing to pay for high dose opioids. More recently, the American College of Physicians issued new guidelines for the treatment of low back pain that recommend using nonpharmacological therapies before prescribing any medication. They made this recommendation after a review of the research indicated that therapies such as massage, acupuncture, biofeedback and spinal manipulation have greater effectiveness and lower risks than any pharmaceutical. These therapies get to the root of the problem rather than just treating the symptom. It has become clear that opioids are dangerous for many people who take them.  Widespread prescribing of opioids has led to an epidemic of opioid addiction and overdose deaths that has destroyed individuals, families and many communities.  However, this sudden policy shift is highly problematic. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Meds Pain management Source Type: blogs

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Authors: Borenstein DG, Hassett AL, Pisetsky D Abstract The Pain Management Task Force of the American College of Rheumatology published a report in 2010 highlighting pain management as a fundamental aspect of clinical practice, training and research. In the interim, the consideration of pain as a focus of attention of rheumatologists and rheumatology health professionals has become even more challenging than in 2010 because of the epidemic of opiate addiction and overdose death. The characterisation of categories of pain by mechanism (e.g., inflammation, joint degeneration, abnormalities of central pain processing...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
If you teach health law, come to the 40th Annual Health Law Professors Conference, June 8-10, 2017, at Georgia State University College of Law in Atlanta.  Here is the schedule: Thursday, June 8, 20178:00-12:00 AM Tour of the Centers for Disease Control and Prevention (Separate registration is required. Participants meet in the lobby of Georgia State Law to take a shuttle to the CDC.) 9:45 – 11:15 AM Tour of Grady Health System (Separate registration is required. Participants meet in the lobby of Georgia State Law and will walk over to Grady as a group.) 2:00 – 5:00 PM Conference Registration – Henso...
Source: blog.bioethics.net - Category: Medical Ethics Authors: Tags: Health Care syndicated Source Type: blogs
When I was in medical school, doctors only wrote prescriptions for opioid painkillers for terminal cancer patients, surgical patients and critical emergencies. That's because they knew these drugs were lethal. Opioids come from the same poppy plant used to make opium and heroin. And just like those addictive street drugs, the risk of getting hooked on them is extremely high. It's incredible how things have changed since then… What are opioids prescribed for? Today, you're likely to get a prescription for opioids for just about any kind of pain. That includes chronic pain, fibromyalgia, depression, heada...
Source: Al Sears, MD Natural Remedies - Category: Complementary Medicine Authors: Tags: Health Natural Cures Source Type: news
In April, the U.S. Surgeon General, Dr. Vivek Murthy, attended a meeting of the Association of Health Care Journalists. In an exclusive interview with MedPage Today, he shared his mounting concerns about two matters: the impact of burnout on physicians and our society’s current opioid crisis. Dr. Murthy stated that he views physicians as being an essential part of the solution to the epidemic of drug overdoses, which have exceeded motor vehicle accidents as one of the leading causes of death. Dr. Murthy correctly linked the well-being of health professionals with that of the general public, stating, “As I think...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Addiction Behavioral Health Health care Pain Management Source Type: news
"Please, I need my Oxycodone! " my patient, M, pleaded with me. My eyes met his. I observed every fleeting facial expression, hoping to gauge his intentions. The discussion about whether to continue to prescribe this medication was one I 'd had too many times with too many patients over the past few months. "My arthritis is always worst in the winter, " he said, rubbing his lower back. It was a snowy afternoon in clinic, and M and I were in the midst of a debate. Oxycodone is an opioid medication, and, like other painkillers such as Oxycontin, Percocet, and Vicodin, it carries...
Source: Psychology of Pain - Category: Anesthesiology Source Type: blogs
"Please, I need my Oxycodone!" my patient, M, pleaded with me. My eyes met his. I observed every fleeting facial expression, hoping to gauge his intentions. The discussion about whether to continue to prescribe this medication was one I'd had too many times with too many patients over the past few months. "My arthritis is always worst in the winter," he said, rubbing his lower back. It was a snowy afternoon in clinic, and M and I were in the midst of a debate. Oxycodone is an opioid medication, and, like other painkillers such as Oxycontin, Percocet, and Vicodin, it carries a significant risk of ...
Source: Psychology of Pain - Category: Anesthesiology Source Type: blogs
Like many others, Bill suffered lower back pain. He was prescribed hydrocodone and then methadone, and an overdose killed him at age 33. Lance was prescribed opioids for a root canal, after which the Army veteran became addicted. He died in a Texas hotel room of an overdose at age 26. Michael was prescribed hydrocodone for Crohn's Disease when he was 18 and, after almost three years of escalating dosages, he took his own life with a shotgun after being unable to find a treatment program. The stories of Bill, Lance, and Michael are horrifying ones, all of them beginning with a seemingly benign prescription from a doctor. ...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
The nation has seen a four-fold increase in opioid deaths in the last decade, according to the Centers for Disease Control and Prevention (CDC)—and physicians stand on the front lines of this national health crisis. During the 2015 AMA Interim Meeting, physician experts recently discussed actions you can take now to help combat the opioid epidemic and improve patient care. Rethinking prescribing practices, effectively using PDMPs CDC Director Thomas Frieden, MD, was among a panel of experts who offered actionable solutions to help curb the nation’s high rate of opioid overdoses. He noted that the rise in opi...
Source: AMA Wire - Category: Journals (General) Authors: Source Type: news
During a recent campaign stop, presidential candidate Hillary Clinton promised to make the "quiet epidemic" involving heroin and prescription opioids an important part of her presidential campaign -- and, presumably, of her presidency, should she be elected. She mentioned the issue of substance misuse again in her highly publicized speech on criminal justice reform last week. As someone intimately familiar with the devastating impact of this public health crisis on individuals, families and communities, I was very pleased to hear this, and thought of several ways she could make good on her pledge. Here are fi...
Source: Science - The Huffington Post - Category: Science Source Type: news
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