Is an opioid really the best medication for my pain?

As physicians, many of our daily practices involve administration of substances that are shrouded in mystery. Certain medications, specifically opioids, have been part of tragic news stories, and have turned young children into orphans, happy spouses into widows and widowers, and once-aspirational youth into memories. The CDC reports that on average, 130 people die each day from an opioid overdose. With such harrowing statistics, why take opioids in the first place? Well, if used appropriately, opioids can significantly improve pain with relatively tolerable side effects. A short-term course of opioids (typically 3 to 7 days) prescribed following an injury, like a broken bone, or after a surgical procedure, is usually quite safe. It’s long-term use that can lead to problems, including the risk of addiction and overdose. National guidelines for physicians recommend the shortest duration of opioids possible for acute pain, as a person’s chances of unintentional long-term use increase with the degree of exposure. One large study found that in first-time opioid users, one in seven people who received a refill or had a second opioid prescribed were on opioids one year later. While widespread overuse of opioids has contributed to increased scrutiny regarding their administration, careful consideration of a variety of factors can help physicians and patients determine whether opioids are the right medication. Here are several important things you may want to discuss with...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Addiction Pain Management Source Type: blogs

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Publication date: Available online 20 July 2019Source: Pharmacological ResearchAuthor(s): Jiasi Wu, Yu Luo, Qing Jiang, Sheng Li, Wenge Huang, Li Xiang, Deming Liu, Yingfan Hu, Ping Wang, Xiaoxia Lu, Guolin Zhang, Fei Wang, Xianli MengAbstractInflammasome mediates the activation of caspase-1, which promotes the secretion of proinflammatory cytokines. In this work, we aimed to investigate whether natural compounds from a Traditional Chinese Medicine prescription called San-Huang-Xie-Xin-Tang exert its clinical efficacy by inhibiting inflammasome activation and the underlying mechanism. The inhibitory effects of compounds on...
Source: Pharmacological Research - Category: Drugs & Pharmacology Source Type: research
ConclusionOur experimental findings offer a promising prospect for the use of HCY2 in the management of obesity through the regulation of AMPK/PGC1 pathways.Graphical Abstract
Source: Phytomedicine - Category: Drugs & Pharmacology Source Type: research
DiscussionWe estimated higher risks of ALL in the offspring of women with pregestational diabetes. These results are consistent with previous findings and compatible with a role of prenatal glycaemic environment in childhood cancer aetiology.
Source: Cancer Epidemiology - Category: Cancer & Oncology Source Type: research
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
This study examined the relationship of living environment (urban vs. suburban vs. small-town/rural) to social anxiety (SA) in a sample of 902 TGNC individuals who participated in the Trans Health Survey. Analysis of variance revealed a significant difference in SA across living environments. Those living in small-town/rural environments reported significantly higher levels of SA compared to those living in urban environments. There was a trend-level difference in SA in suburban compared to urban environments. Linear regression analyses revealed that living environment significantly moderated the relationship between socia...
Source: Journal of Anxiety Disorders - Category: Psychiatry 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
Arbutin protects HK-2 cells against high glucose-induced apoptosis and autophagy by up-regulating microRNA-27a. Artif Cells Nanomed Biotechnol. 2019 Dec;47(1):2940-2947 Authors: Lv L, Zhang J, Tian F, Li X, Li D, Yu X Abstract Arbutin (ARB) has been widely used in skin pigmentation disorders. Nevertheless, the involvements of ARB in diabetic nephropathy (DN) are still unknown. We investigated the functions of ARB in high glucose (HG)-induced cell apoptosis and autophagy in HK-2 cells. Cell viability was examined through CCK-8 in HK-2 cells after disposal with 45 mM glucose and ARB (10-50&th...
Source: Artificial Cells, Nanomedicine and Biotechnology - Category: Biotechnology Tags: Artif Cells Nanomed Biotechnol 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
The objective was therefore to assess insulin and amino acid responses following intake of a high protein meal in healthy horses and those with EMS. Six mature horses diagnosed with EMS and six age-matched control horses without EMS were used. Horses were fed 2 g/kg body mass (BM) of a high protein pellet (31% crude protein) at time 0 and 30 min, for a total of 4 g/kg BM, following an overnight fast. Blood samples collected during a 4 h period were analysed for plasma glucose, insulin, amino acids and urea concentrations.Glucose concentrations were not different between groups (P =&thinsp...
Source: The Veterinary Journal - Category: Veterinary Research Source Type: research
Publication date: Available online 20 July 2019Source: Biochimica et Biophysica Acta (BBA) - Molecular Basis of DiseaseAuthor(s): Tina Hörbelt, Birgit Knebel, Pia Fahlbusch, David Barbosa, Daniella Herzfeld de Wiza, Frederique Van de Velde, Yves Van Nieuwenhove, Bruno Lapauw, G. Hege Thoresen, Hadi Al-Hasani, Dirk Müller-Wieland, D. Margriet Ouwens, Jorg KotzkaAbstractSecreted frizzled-related protein (sFRP) 4 is an adipokine with increased expression in white adipose tissue from obese subjects with type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). Yet, it is unknown whether sFRP4 action contributes ...
Source: Biochimica et Biophysica Acta (BBA) Molecular Basis of Disease - Category: Molecular Biology Source Type: research
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