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Interventions for the reduction of prescribed opioid use in chronic non-cancer pain.

CONCLUSIONS: There is no evidence for the efficacy or safety of methods for reducing prescribed opioid use in chronic pain. There is a small number of randomised controlled trials investigating opioid reduction, which means our conclusions are limited regarding the benefit of psychological, pharmacological, or other types of interventions for people with chronic pain trying to reduce their opioid consumption. The findings to date are mixed: there were reductions in opioid consumption after intervention, and often in control groups too. PMID: 29130474 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research

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Conclusions With comprehensive treatments, 27.9% of patients had successful opioid tapering with opioid abstinence for over a year. The use of mirtazepine, topiramate, or likely bupropion was associated with successful opioid tapering in the medication assisted treatment with temporary use of methadone. Opioid tapering may be a practical option and should be considered for managing prescription OUD. Implications For patients with OUD, indefinite opioid maintenance treatment may not be necessary. Considering the ethical values of autonomy, nonmaleficence, and beneficence, clinicians should provide patients with OUD the opti...
Source: Scandinavian Journal of Pain - Category: Anesthesiology Source Type: research
Follow me on Twitter @RobShmerling It’s a question that has challenged generations of patients and their doctors. The answer has changed over the years. When I was in medical school in the early 1980s, bedrest for a week or more was often recommended for severe back pain. This sometimes included hospital admission. Then, research demonstrated that prolonged bedrest was actually a bad idea. It was no better (and often worse) than taking it easy for a day or two followed by slowly increasing activity, including stretching and strengthening the back. Medications, including pain relievers, non-steroidal anti-inflammatory...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Back Pain Complementary and alternative medicine Health Injuries Pain Management Source Type: blogs
Low back pain, the scourge of mankind: it is the second leading cause of disability here in the United States, and the fourth worldwide. It’s also one of the top five medical problems for which people see doctors. Almost every day that I see patients, I see someone with back pain. It’s one of the top reasons for lost wages due to missed work, as well as for healthcare dollars spent, hence, a very expensive problem. Looking at two kinds of back pain Let’s talk about the most common forms of back pain: acute (which lasts less than four weeks) and subacute (which lasts four to 12 weeks). Most of these cases ...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Back Pain Managing your health care Pain Management Source Type: blogs
by Tom QuinnIn case you didn’t notice, the US Centers for Disease Control published their long-awaited (dreaded?) “CDC Guideline for Prescribing Opioids for Chronic Pain.” It made a pretty big splash: Five editorials plus the full Guideline in the online Mar 15 JAMA, front page New York Times feature article, the first hour on NPR’s “Diane Rehm Show,” (Mar 17) and multiple others. It is specifically aimed at primary care prescribers, who write about half of the scripts for opioids in the US. It is intended to “support clinicians caring for patients outside the context of active can...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: CDC ethics opioids pain quinn The profession Source Type: blogs
Abstract: Available systematic reviews showed uncertainty on the effectiveness of using acupuncture and related therapies for palliative cancer care. The aim of this systematic review and meta-analysis was to summarize current best evidence on acupuncture and related therapies for palliative cancer care. Five international and 3 Chinese databases were searched. Randomized controlled trials (RCTs) comparing acupuncture and related therapies with conventional or sham treatments were considered. Primary outcomes included fatigue, paresthesia and dysesthesias, chronic pain, anorexia, insomnia, limb edema, constipation, and h...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Systematic Reviewand Meta-Analysis Source Type: research
By: Allie Ondrejcak, Communications Intern Do you first think of medication, surgery or vaccinations when thinking about the field of medicine? If so, you are thinking of conventional medicine. This system of medicine, used by medical doctors and other health professionals, is a medical model of evidence-based practice used to treat symptoms and diseases. In the United States, conventional medicine is considered the mainstream approach. If you did not think of medication, surgery or vaccination, did you think of acupuncture, supplements or nutrition? These unconventional approaches to medicine fall under the umbrella ...
Source: Life in a Medical Center - Category: Universities & Medical Training Authors: Tags: Integrative Medicine Source Type: blogs
It makes sense that the primary goal of pain treatment should be to reduce pain. However, a recent editorial in The New England Journal of Medicine makes a strong case for looking beyond pain intensity when evaluating what is “successful” pain management. The “balancing act” of managing chronic pain Here is the problem: For people with chronic pain, the pain affects nearly all aspects of their lives. But at the same time, treatments to relieve chronic pain also have the potential to influence many aspects of a person’s life. Our best pain-relieving drugs have lots of unpleasant side effects. E...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Health Addiction Arthritis Back Pain Cancer Migraines Pain Management Behavioral Health chronic pain managing pain Source Type: news
CONCLUSIONS: There is insufficient evidence to judge whether acupuncture is effective in treating cancer pain in adults. PMID: 26468973 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
Too many doctors refuse to think outside the narrow confines of the mainstream medical establishment – especially when it comes to chronic back pain. Back pain is one of the most common reasons Americans go to the doctor, which explains why it’s also one of America’s biggest businesses. But I never cease to be astounded when patients come to my wellness clinic with back pain and tell me they’ve already had a barrage of dangerous Big Pharma prescriptions pushed at them. These drugs include highly addictive opiates like Vicodin, Percocet and OxyContin. Meanwhile, big bucks are also made when doctors p...
Source: Al Sears, MD Natural Remedies - Category: Complementary Medicine Authors: Tags: Anti-Aging Source Type: news
Whenever I read or write about the overuse of so-called opioid painkillers it is with mixed feelings. As a lifelong back-pain patient who once depended on them for pain relief, I appreciate the challenge posed by opioids to people in pain and their doctors. People in agonizing pain want it to stop, but opioids are often a poor long-term solution. Doctors want to help their patients, so they may prescribe opioids for extended periods despite well-founded reservations. At the same time, the epidemic of abuse of these painkillers has led to numerous deaths. Like many Americans, I know people whose lives were destroyed—w...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Addiction Drugs and Supplements Pain Management hydrocodone opioids oxycodone Source Type: news
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