Prescription monitoring programs: Helpful or harmful?

The crushing toll of the opioid crisis is daily news, including stories about ways to “fix” it. A wide array of initiatives has been brought forward in an attempt to curb this epidemic and the damage it causes. Prescription monitoring programs (PMPs) are one of them. The goal of PMPs is a good one — to identify patients who are being prescribed multiple medications by multiple clinicians. It is a means to introduce some stewardship for preventing overuse and misuse of prescription drugs. How prescription monitoring programs work Prescription monitoring programs are state-based electronic databases that provide a way to track prescriptions, specifically controlled substances including opioids, benzodiazepines, and amphetamines. They are intended to support access to legitimate medical use of these drugs, and to help identify and deter drug misuse and diversion (when medications are not used by the person for whom they were prescribed). Currently 49 states, the District of Columbia, and Guam have PMPs, and in many states providers must access the PMP before prescribing a controlled substance. PMPs have had some success, with several states demonstrating an overall decrease in prescription opioid overdose after implementation. At the same time, there are several challenges hindering effective use of prescription monitoring programs, including issues of lag time, state to state variability, and important privacy concerns. These issues need to be addressed as thi...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Addiction Drugs and Supplements Health Source Type: blogs

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Authors: Gentile E, Ricci K, Delussi M, Brighina F, de Tommaso M Abstract Previous studies indicated changes of motor cortex excitability in fibromyalgia (FM) patients and the positive results of transcranial stimulation techniques. The present study aimed to explore the metabolism of motor cortex in FM patients, in resting state and during slow and fast finger tapping, using functional Near-Infrared Spectroscopy (fNIRS), an optical method which detects in real time the metabolism changes in the cortical tissue. We studied 24 FM patients and 24 healthy subjects. We found a significant slowness of motor speed in FM ...
Source: Pain Research and Treatment - Category: Anesthesiology Tags: Pain Res Treat Source Type: research
Conclusions: Through simulations, we determined that among the studied environmental factors, precipitation showed the strongest correlation with the transmission dynamics of influenza. Moreover, the SIR+P+T model is the most efficient for simulating the behavioral dynamics of influenza in the area of interest. PMID: 30788178 [PubMed]
Source: Healthcare Informatics Research - Category: Information Technology Tags: Healthc Inform Res Source Type: research
The indications for cryoablation in pediatric patients has been slowly growing over the last few years. Vascular anomalies and solid tumors are being treated with this modality. However, cryoablation can be associated with local complications. This is of high relevance in children due to smaller body surface area, more compact anatomy and less subcutaneous fat. Additionally, these patients have lower tolerance to pain and inflammation. It is critical to understand these factors when using cryoablation to treat pediatric patients.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 5: You ’ve Got To Be Kid-ing Me (Pediatric IR) Source Type: research
The American Society of Anesthesiologists (ASA) standards were updated in 2011 to recommend end-tidal carbon dioxide (EtCO2) monitoring during moderate sedation, which is now common practice in IR. Studies show EtCO2 monitoring improves detection of respiratory depression and hypoxemia. The purpose of this study was to evaluate the incidence of respiratory depression and hypoxemia from oversedation during IR procedures before and after implementation of EtCO2 monitoring.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 4: Step Up Your Game Source Type: research
Knee OA is a common cause of pain and disability, with many patients relying on chronic pain medications and/or joint injections. These options unfortunately result in short-term relief, or have associated increased morbidity, and knee replacement surgery may ultimately be performed. Researchers have postulated that synovial neovascularity develops as a result of inflammation and subsequently leads to knee pain. While previous overseas reports of success with GAE have been published, we present our final results from a prospective US multicenter clinical trial.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 3: Not Your Run-of-the-Mill Embolization Source Type: research
The objective of this compound is to decrease the rate of rectal toxicity related to radiation therapy, by creating a gap between the prostate and rectum. Secondary benefits include decreased urinary complications and improved sexual quality of life. The hydrogel spacer maintains space for approximately 3 months, and is absorbed in about 6 months.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 43: Follow Your Gut Source Type: research
To evaluate the efficacy and clinical impact of 3 Tesla in-bore trans-rectal magnetic resonance-guided biopsy (3T MRGB) for prostate cancer (PCa) detection based on PIRADSv2 in patients with either suspected prostate cancer or under active surveillance.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 43: Follow Your Gut Source Type: research
With all the news media accounts and reports from governmental health organizations about the opioid epidemic, including the 70,237 drug overdose deaths in 2017, a newly emerging threat is gaining attention: use and misuse of benzodiazepines, opioid drugs and Z-drugs. Specifically, combining these three drugs can create a deadly combination that snuffs out lives. Benzodiazepine Overdose Deaths on the Rise Benzodiazepines, a class of sedative narcotic drugs including Xanax and Valium used to treat anxiety, insomnia and other disorders and classified as Schedule IV under the Controlled Substances Act by the Drug Enforcement ...
Source: Psych Central - Category: Psychiatry Authors: Tags: Addictions Substance Abuse Suicide Source Type: news
This past week, Governor John Kasich of Ohio issued an executive order limiting the amount of opioids doctors and dentists can prescribe to no more than a 7 day supply. Failure to comply could result in disciplinary action, including loss of license. Exceptions exist only for patients with cancer or those enrolled in hospice programs. For all the rest, it represents a hard full stop. No longer will the chronic pain sufferer, the woman status post lumbar back fusion x 3, be able to get a prescription for a month's supply of oxycodone with 3 refills.On the surface this appears to be a reasonable initiativ...
Source: Buckeye Surgeon - Category: Surgery Authors: Source Type: blogs
"If you do not change direction, you may end up where you are heading." -- Lao Tzu Over the last few weeks, the CDC, the U.S. Department of Health and Human Services (HHS), and the president of the United States have all separately hit the emergency button over the subject of chronic pain treatment and opioid pain killers. Concerns over the rising tide of pain killer addiction, accidental overdose deaths, and a carryover effect causing a steep rise in heroin use have made this a "code blue" emergency for Washington. President Obama has made it clear that addressing the opioid epidemic is now an administ...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
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