Evidence-based pain medicine for primary care physicians.

This article will discuss the role of physical rehabilitation, pain psychology, pharmacotherapy, and procedural interventions in the treatment of chronic pain. Given the current epidemic of drug-related deaths, particular emphasis is placed on the alternatives to opioid therapy. Unfortunately, death is not the only significant complication from opioid therapy, and this article discusses many of the most common side effects. This article provides general guidelines on the most appropriate utilization of opioids with emphasis on the recent Centers for Disease Control and Prevention guidelines, risk stratification, and patient monitoring. Finally, the article concludes with the critical role that a pain medicine specialist can play in the management of patients with chronic pain. PMID: 29686550 [PubMed]
Source: Baylor University Medical Center Proceedings - Category: Universities & Medical Training Authors: Tags: Proc (Bayl Univ Med Cent) Source Type: research

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Raghu S Thota, Seshadri Ramkiran, Rakesh Garg, Jyotsna Goswami, Vaibhavi Baxi, Mary ThomasJournal of Anaesthesiology Clinical Pharmacology 2019 35(4):441-452 The epidemic of opioid crisis started getting recognised as a public health emergency in view of increasing opioid-related deaths occurring due to undetected respiratory depression. Prescribing opioids at discharge has become an independent risk factor for chronic opioid use, following which, prescription practices have undergone a radical change. A call to action has been voiced recently to end the opioid epidemic although with the pain practitioners still strugglin...
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research
Authors: Hussein AI, Bekampis CF, Jermyn RT Abstract The opioid epidemic in the United States is one of the largest modern health crises in the nation's history. The crisis has been cultivated in academic journals, driven by the medical-pharmaceutical complex, and fueled by campaigns representing the most prestigious health care organizations and advocacy groups. Comprehensive guidelines for proper prescribing have been released in addition to state-sponsored prescription drug-monitoring programs (PDMPs) in response to overprescribing habits. When considering opioid treatment for a patient, physicians should docume...
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
Conclusion: Safer prescribing policies may take multiple years to fully implement and need to be employed across the jurisdiction to minimize doctor-shopping and adverse effects on patients with chronic pain. Approaching pain management through the social-ecological model can address potential root causes of addiction and establish a framework for doctors to provide compassionate care, community leadership, and advocacy for these patients. PMID: 31790125 [PubMed - in process]
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
Conclusion: This pilot study demonstrates that increasing residency education in managing chronic pain and opioid use disorder is feasible, and no longer needs to be postponed due to lack of time or faculty expertise. PMID: 31757179 [PubMed - as supplied by publisher]
Source: Substance Use and Misuse - Category: Addiction Tags: Subst Use Misuse Source Type: research
Authors: Kalangara J, Potru S, Kuruvilla M Abstract While opioids represent one of the most common medication allergy labels, these labels are often unsubstantiated in clinical practice. The removal of erroneous opioid allergy labels has a unique importance in the population with acute or chronic pain. The current approach to patients with pseudo-allergy to opioids is switching to an alternative opioid with less histamine release. Thus, allergy labels to relatively lower potency opioids such as codeine may be feasibly result in the prescription of stronger medications like fentanyl that would otherwise not be indic...
Source: Journal of Pain and Palliative Care Pharmacotherapy - Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research
CONCLUSIONS: Chronic pain serves as an important factor in the persistence of drug use in more than one-third of PWID in this sample. The high prevalence of chronic pain with drug use for pain suggests that proper pain management is likely to be an essential component of preventing or regressing injection drug use in PWID, with data needed on effective interventions for this population. PMID: 31704433 [PubMed - as supplied by publisher]
Source: Addictive Behaviors - Category: Addiction Authors: Tags: Addict Behav Source Type: research
The goal of the Acute to Chronic Pain Signatures (A2CPS) program is to develop a set of objective biomarkers that provide"signatures" to predict if chronic pain is likely to develop after acute pain. Such signatures are greatly needed as prevention of chronic pain after an acute pain event is a major challenge in pain management. For most people, acute pain resolves as the injury that caused it heals. Yet in many other people, acute pain from an injury, surgery, or disease persists beyond the initial insult, and lasts for years or throughout life. The number of people who transition from acute to chronic pain aft...
Source: Psychology of Pain - Category: Anesthesiology Source Type: blogs
ConclusionsCollectively, these findings suggest there may be utility in assessing and treating alcohol and cannabis use problems among persons with chronic pain who are using opioids for pain management.
Source: International Journal of Behavioral Medicine - Category: Psychiatry Source Type: research
There remains a growing interest in finding alternative ways of treating chronic pain owing to the current opioid epidemic in the United States. Despite the increase in popularity of spinal cord stimulators (SCS) as a non-pharmacologic treatment for pain management, current spine literature lacks insight on patients' postoperative opioid use behavior.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research
Depending on what you read, kratom is a dangerous, addictive drug with no medical utility and severe side effects, including overdose and death, or it is an accessible pathway out of undertreated chronic pain and opiate withdrawal. How can the US Drug Enforcement Agency (DEA), medical professionals, and millions of regular kratom users have such divergent views of the same plant? What is kratom? Kratom (Mitragyna speciosa) is a tropical tree from the coffee family native to Southeast Asia, with properties that range from stimulant-like, energizing and uplifting, to opiate-like, causing drowsiness and euphoria. Kratom has d...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Addiction Pain Management Vitamins and supplements Source Type: blogs
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