Pain and Symptom Management for People with Serious Illness in the Context of the Opioid Epidemic
Nov 29, 2018. The Keck Center, Washington, DC. Sponsored by National Academies of Sciences, Engineering, and Medicine
Conclusions: Effective MMA strategies have paved the way for OFA approaches to postoperative pain management, with goals to reduce opioid prescriptions, improve patient recovery, and reduce overall healthcare resource utilization and costs. However, institution-wide deployment and adoption of OFA is still in early stages and will require personalization and better management of patient expectations. PMID: 31315466 [PubMed - as supplied by publisher]
The current opioid crisis has raised awareness of the risks of misuse, addiction, and overdose with opioid prescribing for pain management in the perioperative and nonoperative care of surgical patients. Despite these risks, it is essential for surgical providers to provide safe and adequate functional pain control to enhance recovery. The purpose of this review is to outline the relevance of the US opioid crisis to surgical prescribing, describe strategies for opioid reduction using a stepwise therapy approach, and provide recommendations for improving the safety of opioid prescribing. Additional recommendations for risk ...
A plethora of statistics and claims exist concerning the rise in prescription opioid use and the increase in opioid-related deaths. Eleven misperceptions were identified that underlie some of the growing national concern and backlash against opioid use. Misperceptions include the number of opioid overdose deaths, the quality of government-sponsored data and guidelines, the impact of opioid dose escalation on overdose risk, postoperative opioid use associated with long-term use, and the link between prescription opioid use and heroin initiation.
While encouraging early signs suggest the United States opioid epidemic may have peaked, our eyes have been opened to the tremendous risks of subsequent abuse and addiction for the young patient exposed to opioids. This makes avoiding opioids especially important for the typical high school or college third molar patient. The 2017 AAOMS White Paper on opioid prescribing and pain management encouraged a multimodal approach to pain management; recommending NSAIDs for first-line analgesic therapy. In early 2019, the Journal of Oral and Maxillofacial Surgery describes numerous adjuncts for treating postoperative third molar pa...
This article will aim to provide an overview of the pain pathway in relation to the therapeutic targets for providing analgesia, commonly used NAOs and their brief introduction.
Opioids are the mainstay of pain management after burn injury. The United States currently faces an epidemic of opioid overuse and abuse, while simultaneously experiencing a nationwide shortage of intravenous narcotics. Adjunctive pain management therapies...
ConclusionAlthough clinicians should endeavor to offer alternative pain management strategies to all patients, those who are younger, are male patients, and report a history of or current substance use or mental health diagnoses were associated with a greater risk of developing opioid misuse. Clinicians should consider prioritizing alternative pain management strategies for these higher-risk patients.
CONCLUSION: The epidemic of opioid misuse has shown that there is a lack of fundamental knowledge about the characteristics and management of chronic pain, that conflicts of interest and validity of models must be more intensively considered in the context of drug development and that novel analgesics with less addictive potential are urgently needed. Currently, the most promising perspectives appear to be augmenting endogenous opioid actions and the selective activation of peripheral opioid receptors. PMID: 31222410 [PubMed - as supplied by publisher]
Conclusion: PVBs are a regional anesthesia technique which may aid in pain management in the breast reconstructive setting. Evidence suggests that PVBs aid in controlling acute postoperative pain, reduce opioid consumption, and improve patient length of stay. However, some conflicting findings demonstrate a need for continued research in this area of pain control.
Opioid use disorder (OUD) has become a public health crisis in the United States. OUD has been shown to have worse outcomes in patients with chronic conditions. Although opioids are widely used for pain management in acute conditions such as acute pancreatitis (AP), the impact of OUD on outcomes in patients with AP remains unknown. We aimed to evaluate the prevalence, trends and impact of OUD on outcomes in hospitalized patients with AP.