Toward a Healthy Relationship with Opioids

In the June 14thWall Street Journal, Johns Hopkins University bioethicist Travis Rieder, in an excellent  essay, shared with readers his battle with pain resulting from a devastating accident, the effectiveness of opioids in controlling the pain, and the hell he went through when he was too rapidly tapered off of the opioids to which he had become physically dependent. Like most patients requiring long term pain management with opioids, he developed a physical dependence, which is often  mistakenly equated with addiction by policymakers and many in the media. The aggressive schedule launched me into withdrawal, and I learned viscerally, firsthand, what the absence of opioids can do to someone whose brain has become accustomed to them. Those symptoms include  increased sensitivity to the very pain that the opioids counteract, as well as extreme flu-like symptoms, insomnia and crippling depression. I came to understand why people sometimes go back onto deadly dangerous drugs: because the alternative is such profound suffering that it makes you want to die.I have criticized policymakers for their ham-handed approach based upon a misinterpretation and misapplication of the guidelines on pain management with opioids, released in 2016 by the Centers for Disease Control and Prevention,  here,  here, and  here. As  explained in an article I co-authored in the Journal of Pain Research in February 2019, this blunt reaction is based...
Source: Cato-at-liberty - Category: American Health Authors: Source Type: blogs

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Publication date: Available online 20 July 2019Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): Mark R. Jones, Matthew B. Novitch, Sudipta Sen, Nadia Hernandez, Johanna Blair De Haan, Rebecca A. Budish, Christopher Bailey, Joseph Ragusa, Pankaj Thakur, Vwaire Orhurhu, Ivan Urits, Elyse M. Cornett, Alan David KayeAbstractSurgeries and chronic pain states of the upper extremity are quite common and pose unique challenges for the clinical anesthesiology and pain specialists. Most innervation of the upper extremity involves the brachial plexus. The four most common brachial plexus blocks performed in clin...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
Publication date: Available online 20 July 2019Source: Neuroscience &Biobehavioral ReviewsAuthor(s): Lily R. Aleksandrova, Yu Tian Wang, Anthony G. PhillipsAbstractIn order to expand the prospects of developing novel antidepressants for treatment-resistant populations, animal models should incorporate not only various stress-induced behavioural, neurochemical and endocrine parallels to major depressive disorder (MDD), but also aspects of heightened stress susceptibility and resistance to conventional drugs. This review focuses on the available literature supporting the Wistar-Kyoto (WKY) rat as a model of endogenous st...
Source: Neuroscience and Biobehavioral Reviews - Category: Neuroscience Source Type: research
Conclusion: Our findings might indicate that the comorbidity of SeAD with SAD may increase the risk of the severity of AvPD and current depression. PMID: 31322453 [PubMed - as supplied by publisher]
Source: Nordic Journal of Psychiatry - Category: Psychiatry Tags: Nord J Psychiatry Source Type: research
This study investigated the prevalence of depression and explored fatigue, QOL, and pain that is associated with depression in patients on first admission to a hematologic oncology unit. METHODS: This descriptive study measured depression, QOL, and fatigue with the Patient Health Questionnaire-9, the Functional Assessment of Cancer Therapy (FACT)-General, and the FACT-Anemia scale, respectively. Pain levels were examined with a numeric rating scale. FINDINGS: 58 patients participated; 17 reported moderate to severe depression, which highly correlated with fatigue, QOL, and pain. Among all factors, multivariate an...
Source: Clinical Journal of Oncology Nursing - Category: Nursing Authors: Tags: Clin J Oncol Nurs Source Type: research
Publication date: Available online 20 July 2019Source: Progress in Biophysics and Molecular BiologyAuthor(s): Anna Di Bona, Veronica Vita, Irene Costantini, Tania ZagliaAbstractIt is well appreciated that autonomic neurons have a central role in the homeostatic regulation of organs and systems and participate to the pathogenesis of several disease conditions. As such, the function and signalling pathways activated by sympathetic neurons (SNs) in different cell types and organs have become a matter of intense investigation throughout the years of modern biomedical research. This review is focused on the methods used to addr...
Source: Progress in Biophysics and Molecular Biology - Category: Molecular Biology Source Type: research
Publication date: 15 October 2019Source: Journal of Alloys and Compounds, Volume 805Author(s): Subhranu Samanta, Xiao Gong, Panpan Zhang, Kaizhen Han, Xuanyao FongAbstractStep bias (VSTEP) modulated bipolar resistive switching (BRS) and neuromorphic characteristics are observed at very low current level (sub-μA) in a novel Ni/SiOx/W 2 × 2 μm2 cross-point resistive random access memory (RRAM) structure. Device microstructure and thickness of the switching dielectric layer are exposed by TEM/HRTEM images. Elemental composition of Ni/SiOx/W structure and switching matrix (SiOx) are confirmed by EDS and XPS a...
Source: Journal of Alloys and Compounds - Category: Chemistry Source Type: research
CONCLUSION: Microvascular decompression may be more effective than radiofrequency thermocoagulation for patients with classical trigeminal neuralgia with concomitant persistent facial pain. PMID: 31321761 [PubMed - in process]
Source: Acta Neurologica Taiwanica - Category: Neurology Tags: Acta Neurol Taiwan Source Type: research
Authors: Poduval G PMID: 31321949 [PubMed - in process]
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Conclusions: Very young
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
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