Risk Assessment and Monitoring of Patients with Cancer Receiving Opioid Therapy.

Risk Assessment and Monitoring of Patients with Cancer Receiving Opioid Therapy. Oncologist. 2019 May 22;: Authors: Paice JA Abstract The primary objective of this article is to assist oncologists and advanced practice prescribers to safely and effectively minimize risk when providing opioids for cancer pain relief. The majority of people with cancer are unlikely to misuse or divert opioid medications, yet the prescriber is often unaware of those who are at risk for these behaviors. To provide skillful pain management to each patient in the oncology setting, while limiting harm to the community, all prescribers must consider the potential for risk of misuse, addiction, or diversion. To minimize this risk to the greatest degree possible, it is imperative to include a thorough risk assessment when conducting a comprehensive pain evaluation. This information is then used to triage pain relief interventions based upon the degree of risk, including whether or not to incorporate opioids into the plan of care. Risk mitigation strategies, incorporating universal precautions, are implemented to assess, monitor, and reduce the potential for opioid misuse. Universal precautions include strategies such as the use of urine toxicology, state prescription drug monitoring programs, and agreements. Ongoing monitoring is conducted with the goal being to identify aberrant behaviors early so that they can be addressed and managed appropriately. Referral to addiction special...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Oncologist Source Type: research

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For many years, health care providers like me were told that we were undertreating pain and that pain was a vital sign that needed to be measured. Concurrently, we were reassured that opioids were a safe and effective way to treat pain, with very little potential for development of abuse. As a result, opioid prescriptions in the United States skyrocketed. A common way to compare opioids is to calculate their strength relative to morphine, called morphine milligram equivalents, or MMEs. In 1992, our country dispensed 25 billion MMEs of prescription opioids; by 2011, that number had reached 242 billion. Meanwhile, opioid-rel...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Addiction Pain Management Risks and Prevention Source Type: blogs
Ryan R. Kelly1,2†, Lindsay T. McDonald1,2†, Nathaniel R. Jensen1,2, Sara J. Sidles1,2 and Amanda C. LaRue1,2* 1Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States 2Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States The significant biochemical and physiological effects of psychological stress are beginning to be recognized as exacerbating common diseases, including osteoporosis. This review discusses the current evidence for psychological stress-associated mental health disorders as risk factors for os...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
This study was performed by the MPN Quality of Life Study Group. A survey was designed by a team of MPN investigators experienced with MPN symptomatology. Patients completed the MPN-10, a 10 item survey of MPN symptoms completed on a 0 (absent) to 10 (worst imaginable) scale (Blood. 2011 Jul 14;118(2):401-8). Other surveyed tools included the Opioid Risk Tool (ORT) as well as DSMV criteria for Opioid Use Disorder (OUD). The survey was posted on high-traffic MPN-related webpages focused on patient education and advocacy (MPN Forum, MPN Net, MPN Research Foundation, MPN Voice)for a total of 28 days. Patients currently receiv...
Source: Blood - Category: Hematology Authors: Tags: 634. Myeloproliferative Syndromes: Clinical: Poster III Source Type: research
Publication date: May–June 2018Source: EXPLORE, Volume 14, Issue 3Author(s): Heather Tick, Arya Nielsen, Kenneth R. Pelletier, Robert Bonakdar, Samantha Simmons, Ronald Glick, Emily Ratner, Russell L. Lemmon, Peter Wayne, Veronica Zador, The Pain Task Force of the Academic Consortium for Integrative Medicine and HealthABSTRACTMedical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action ...
Source: EXPLORE: The Journal of Science and Healing - Category: Complementary Medicine Source Type: research
Gun control advocates like to accuse legislators of being “afraid of the NRA,” implying that reason and principle have nothing to do with their legislative decisions. In the same way, Jackie Kucinich, in a column in The Daily Beast, suggests that the failure of Congress to pass CARA 2.0 (Comprehensive Addiction and Recovery Act) is due primarily to the lobbying clout of the American Medical Association, pointing to its status as the “seventh highest lobbying spender in 2017.”  The article quotes opioid reform advocate Gary Mendell as saying “the AMA will resist anything tha...
Source: Cato-at-liberty - Category: American Health Authors: Source Type: blogs
House of Representatives member Representative Susan W. Brooks recently introduced the ADAPT Act of 2018. The ADAPT Act (Abuse Deterrent and Prescriber Training Act of 2018) is an attempt to require training for prescribers of controlled substances. The bill would amend the Controlled Substances Act to include a requirement for all practitioners who are licensed under State law to prescribe controlled substances in Schedule II, III, IV, or V, a written certification that the practitioner has completed 3 hours of training under a specific training program, in all registration or renewal requests. The training program will...
Source: Policy and Medicine - Category: American Health Authors: Source Type: blogs
Publication date: Available online 1 March 2018 Source:EXPLORE Author(s): Heather Tick, Arya Nielsen, Kenneth R. Pelletier, Robert Bonakdar, Samantha Simmons, Ronald Glick, Emily Ratner, Russell L. Lemmon, Peter Wayne, Veronica Zador Consortium Pain Taskforce White Paper Summary Evidence-based Nonpharmacologic Strategies for Comprehensive Pain Care Supplementary information can be found in the online version at https://doi.org/10.1016/j.explore.2018.02.001. Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addict...
Source: EXPLORE: The Journal of Science and Healing - Category: Complementary Medicine Source Type: research
Purpose of review The primary cause of overdose death in the United States is related to pharmaceutical opioids. A few particular populations that struggle with adverse outcomes related to opioid abuse are those in palliative care, those with chronic pain, and those receiving pain treatments secondary to cancer or chemotherapy. Recent findings There have been massive efforts to decrease the use of opioid abuse in patient care in a gestalt manner, but palliative care provides unique challenges in applying these reduction tactics used by other specialties. Summary We explore behavioral interventions, provider educati...
Source: Current Opinion in Supportive and Palliative Care - Category: Palliative Care Tags: PAIN: CANCER: Edited by Anthony H. Dickenson and Paul Farquhar-Smith Source Type: research
(TRENTON, N.J.) — New data show that the number of prescriptions for opioid painkillers filled in the U.S. fell dramatically last year. They showed their biggest drop in 25 years. The decline comes amid increasing legal restrictions and public awareness of the dangers of addiction. A health data firm released a report Thursday showing a 9 percent average drop nationwide in the number of prescriptions for opioids filled by retail and mail-order pharmacies. All 50 states and the District of Columbia had declines of more than 5 percent. The U.S. is estimated to consume roughly 30 percent of all opioids used worldwide. ...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized healthytime medicine onetime Source Type: news
Publication date: Available online 1 March 2018 Source:EXPLORE Author(s): Heather Tick, Arya Nielsen, Kenneth R. Pelletier, Robert Bonakdar, Samantha Simmons, Ronald Glick, Emily Ratner, Russell L. Lemmon, Peter Wayne, Veronica Zador Medical pain management is in crisis: from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care has prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC. There is pressure for pain...
Source: EXPLORE: The Journal of Science and Healing - Category: Complementary Medicine Source Type: research
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