Civilian Casualties Continue to Mount in Governments ’ War on Opioids

I have written  here and here about how patients have become the civilian casualties of the misguided policies addressing the opioid (now predominantly fentanyl and heroin) crisis. The policies have dramatically reduced opioid prescribing by health care practitioners and have pressured them into rapidly tapering or cutting off their chronic pain patients from the opioids that have allowed them to function. More and more reports appear in the pres s about patients becoming desperate because their doctors, often fearing they may lose their livelihoods if they are seen as “outliers” by surveillance agencies, under-treat their pain or abruptly cut them off of their pain treatment regimen.A  story in the July 23, Louisville (KY) Courier Journal illustrates the harm this is causing in Kentucky. “Doctors say the federal raids on medical clinics lead to unintended consequences — patients thrust into painful withdrawals and left vulnerable to suicide or dangerous street drugs,” states the article.  Dr. Wayne Tuckerson, President of the Greater Louisville Medical Society, said, “[When investigators] go in with a sledgehammer and shut down a practice without consulting community physicians, suddenly we have patients thrown loose.” He went on to say, “Docs are very much afra id when it comes to writing pain medications…We don’t want patients to become addicted. An...
Source: Cato-at-liberty - Category: American Health Authors: Source Type: blogs

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Authors: Wietersheim JV, Knoblauch JD, Rottler E, Weiß H, Hartmann A, Rochlitz P, Völker A, Scheidt CE, Beutel ME, Eckhardt-Henn A, Zeeck A Abstract Several therapeutic treatments like individual psychotherapy, group therapy, creative therapies and talks with the nursing staff are components in an inpatient psychosomatic (psychotherapeutic) treatment or a psychosomatic day hospital treatment. In Germany, these therapies have to be documented by the administration with so called OPS-Codes. These codes are reported to the Institute for Reimbursement in Hospitals (InEK). With the data of the INDDEP-study it...
Source: PPmP Psychotherapie Psychosomatik Medizinische Psychologie - Category: Psychiatry & Psychology Tags: Psychother Psychosom Med Psychol Source Type: research
Authors: Priegnitz J, Langheim E, Rademacher W, Schmitz C, Köllner V Abstract An integrative patient-centered care concept is increasingly demanded for treatment of cardiac patients with concomitant mental disorders. The present study aims to investigate the effect of an integrated concept of psycho-cardiac care (PK) versus a monodisciplinary cardiac (K) or psychosomatic (PSO) care. Patients were examined at baseline (T0), at the time of discharge from the rehabilitation program (T1) and after 6 month (T2). General anxiety, depression (HADS), cardiac anxiety (HAF) and quality of life (SF-12) were evaluated usi...
Source: PPmP Psychotherapie Psychosomatik Medizinische Psychologie - Category: Psychiatry & Psychology Tags: Psychother Psychosom Med Psychol Source Type: research
Diagnostic accuracy of troponin T measured ≥6h after symptom onset for ruling out myocardial infarction. Scand Cardiovasc J. 2019 Dec 09;:1-9 Authors: Khoshnood A, Erlandsson M, Isma N, Yndigegn T, Mokhtari A Abstract Objectives: Guidelines recommend a single high-sensitivity cardiac troponin T (hs-cTnT) ≤14 ng/L measured ≥6 h after chest pain onset combined with a GRACE score
Source: Scandinavian Cardiovascular Journal - Category: Cardiology Tags: Scand Cardiovasc J Source Type: research
CONCLUSION: The results of the study confirm the success rates of ankle fusions in the majority of cases. Well defined limitations and residual symptoms can be named on the basis of the available data. PMID: 31820431 [PubMed - as supplied by publisher]
Source: Zeitschrift fur Orthopadie und Unfallchirurgie - Category: Orthopaedics Tags: Z Orthop Unfall Source Type: research
Authors: Togha M, Bahrpeyma F, Jafari M, Nasiri A Abstract BACKGROUND: Cervicogenic headache (CeH) is among the common types of headache which has an undesirable influence on the quality of life. The myofascial trigger point (MTrP) within the sternocleidomastoid (SCM) muscle is one of the most important causes of CeH. OBJECTIVE: The purpose of this study was to compare the effect of dry needling (DN) and ischemic compression (IC) on the headache symptoms as well as MTrP-related features in subjects with CeH originating from MTrPs of the SCM muscle using a sonographic method. METHODS: A total of 29 female su...
Source: Journal of Back and Musculoskeletal Rehabilitation - Category: Orthopaedics Tags: J Back Musculoskelet Rehabil Source Type: research
Publication date: Available online 11 December 2019Source: Physiological and Molecular Plant PathologyAuthor(s): Fangtao He, Lina Zhao, Xiangfeng Zheng, Mandour H. Abdelhai, Nana Serwah Boateng, Xuhua Zhang, Hongyin ZhangAbstractApple is one of the largely grown fruits in China, and it suffers great economic losses caused by Penicillium expansum infection every year. In the present study, we ascertained the efficacy of Meyerozyma guilliermondii enhanced by 200 μmol/L methyl jasmonate (MeJA) in controlling the postharvest blue mold decay of apples and the possible mechanisms involved. The results demonstrated that the ...
Source: Physiological and Molecular Plant Pathology - Category: Molecular Biology 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
Abstract Opioid analgesics are recognized as a legitimate medical therapy for selected patients with severe chronic pain that does not respond to other therapies. However, opioids are associated with risks for patients and society that include misuse, abuse, diversion, addiction, and overdose deaths. Therapeutic success depends on proper candidate selection, assessment before administering opioid therapy, and close monitoring throughout the course of treatment. Risk assessment and prevention include knowledge of patient factors that may contribute to misuse, abuse, addiction, suicide, and respiratory depression. R...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
Conclusion Clinicians should be aware of state laws regarding consent for alcohol and substance use treatment for minors. While family participation is the ideal strategy for treatment, minors can invoke the right of confidentiality to bar clinicians from sharing information regarding substance use with their families. Clinicians should obtain appropriate consent for communications and maintain confidentiality when possible, but above all ensure the safety of the adolescent while providing optimal care. Advice from peers, hospital ethical committees, and/or attorneys is recommended in these situations. Acknowledgment The a...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Child Adol Mental Disorders Commentary Current Issue Ethics in Psychiatry Substance Use Disorders adolescents confidentiality diversion opioids safety Source Type: research
Conclusion Evaluating the potential harms of a commonly used drug—especially a complex substance like marijuana—is a challenging but vital task. Fully informed awareness of both the potential and proven benefits and the potential and proven harms of marijuana are necessary in order to have rational discussions with patients, teens, and decision makers regarding marijuana use. Based on a review of the current literature, we suggest the mnemonic DDUMB (dependence, driving, underachievement, mental illness, and “bad to worse”) as a tool that captures several of the more well-supported, brain-based risk...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Behavioral and Cognitive Neurology Child Adol Mental Disorders Cognition Current Issue Medical Issues Neurologic Systems and Symptoms Psychiatry Psychopharmacology Review Substance Use Disorders Cannabis dependence drug-related har Source Type: research
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