The Untold Story of the Opioid Crisis: An Interdisciplinary Approach to Patients with Life-Limiting Complications of Opioid Addiction (TH365)

According to the CDC, in 2016, 62,632 Americans died from drug overdose, with 66% of these deaths related to opioid use. Even with the media's increased attention to the opioid crisis, the stories of patients with recurrent medical complications of addiction remain untold. Medically, these patients are at high risk for recurrent, life-threatening infections, such as endocarditis. Potential survival may entail multiple major surgeries. Surgeons may be reluctant to provide these surgeries, and when surgery is provided, patients suffer post-operative pain that is challenging to control because of patients' opioid tolerance, a challenge compounded when the time comes to transition to outpatient plans for pain management.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research

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CONCLUSIONS: Opiate analgesia can disrupt performance on the Westmead PTA scale in school-aged children resulting in a high false-positive error rate. It is therefore important to record pain medication schedules and interpret results cautiously when opiate analgesia is used following a TBI. Alteration of the method of administration of the memory items should be researched as this may increase the validity of the scale for children with TBI treated with opiate analgesics. PMID: 32497441 [PubMed - as supplied by publisher]
Source: Brain Injury - Category: Neurology Tags: Brain Inj Source Type: research
Conclusion : at long term, the outcome for PRC remains stable despite some series recently reported worsening of the results due to progressive degenerative arthritis. PRC seems to yield comparable clinical results compared to 4CA but a slightly better range of motion than 4CA. PMID: 32490786 [PubMed - in process]
Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research
Authors: De Smet A, Vanhove W, Benis S, Verstraete M, Hollevoet N Abstract Outcomes of 66 Arpe prostheses in 50 patients treated for osteoarthritis of the trapeziometacarpal joint were investigated with a mean follow-up of ten years. Ten-year survival was 87% when failure was defined as implant removal followed by trapeziectomy and tendon interposition. Ten-year survival was 82% when revision of the cup was also considered as failure and it was 80% when replacement of the neck alone was also chosen as an endpoint. Of the 52 prostheses that were not revised mean DASH score was 11, mean pain score 1.2 and mean score ...
Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research
Authors: Verhulst K, Dauwe J, Van Nuffel M, De Smet L Abstract Trapeziectomy with ligament reconstruction and tendon interposition and trapeziometacarpal prosthesis are two commonly used procedures for first carpometacarpal joint osteoarthritis. The purpose of this study is to compare the short-term outcome of trapeziectomy with ligament reconstruction and tendon interposition to trapeziometacarpal prosthesis. Pubmed, Cochrane library and science direct database were searched with adequate search terms. Used parameters were force, pain, mobility, functionality and complication. All papers describing short-term outc...
Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research
Authors: Wautier D, Ftaïta S, Thienpont E Abstract Aseptic loosening of total knee arthroplasty (TKA) components is one of the frequent reasons for early revision together with infection and instability. Aseptic loosening is usually preceded by the observation of radiolucent lines (RLL) on radiographs. Radiolucent lines have conventionally been considered a sign of osteolysis due to particles disease of either polyethylene or cement wear. However, RLL can be observed quite early after TKA, way before wear and osteolysis can even occur. Immediate postoperative RLL are secondary to surgical technique with either...
Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research
Authors: Van Elst C, Caekebeke P, Vandenneucker H, Bellemans J, Scheys L Abstract Partial meniscectomy is a frequently performed treatment strategy for non-suturable meniscal tears. However, the meniscal volume which can be resected without compromising the load-bearing, shock-absorbing function of the meniscus remains a topic of ongoing research. The aim of this study was to calculate the medio-lateral meniscal volume ratio to estimate this volume. In 90 patients (98 pairs of menisci) without meniscal injury, medial and lateral menisci were segmented on MRI imaging and 3D surface models were created to calculate v...
Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research
Conclusion : This study could not confirm the previously reported high complication rate in DAA-THA. The supine positioning without femoral hyperextension is a safe technique, little susceptible by the surgeon's learning curve. PMID: 32490772 [PubMed - in process]
Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research
AbstractPurpose of ReviewThe purpose of this review is to (1) detail the historical context behind the rise of opioid use disorder (OUD) and opioid-related harms in the United States (US) and Canada, (2) describe the epidemiology of OUD in these two countries, and (3) discuss current strategies being employed to address this public health emergency in North America.Recent FindingsOpioid-related overdose has become a leading cause of unintentional injury related death in North America. Deaths have risen in parallel with opioid prescribing and the rising prevalence of unintentional exposure to highly potent synthetic opioids...
Source: Current Addiction Reports - Category: Addiction Source Type: research
As a medical student and resident, I saw many heroin addicts.  We got used to managing right sided endocarditis and overdoses.  That epidemic diminished greatly until recently.  Susan Collins points out the likely source of the current epidemic – Susan Collins cites possible tie between hospital patient surveys, overprescription of opioids. “In the meantime, however, we are concerned that the current evaluation system may inappropriately penalize hospitals and pressure physicians who, in the exercise of medical judgment, opt to limit opioid pain relievers to certain patients and instead rewa...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs
This article blames physicians for opiate addiction – Doctors Play A Role In The Opioid Addiction Epidemic, Study Finds. To begin to figure out how many, a team at the Mayo Clinic, led by pain specialist Dr. W. Michael Hooten, analyzed the medical records of 293 patients given a short-term prescription for opiates for the first time in 2009. These patients were being treated for acute pain — from traumas such as sprained ankles or major surgeries — so their doctors did not expect them to become long-term users of painkillers. Yet just over 1 in 4 of these patients went on to use opioid painkillers for lon...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs
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