Harnessing Placebo Analgesia: Another Avenue to Opioid Reduction in Oral Surgery

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 pain with the goal of reducing the need for opioids: a homeopathic recovery kit, intra-socket bupivacaine, preemptive intravenous ibuprofen or acetaminophen, oral bromelain, submucosal tramadol.
Source: Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Authors: Source Type: research

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Depending on what you read, kratom is a dangerous, addictive drug with no medical utility and severe side effects, including overdose and death, or it is an accessible pathway out of undertreated chronic pain and opiate withdrawal. How can the US Drug Enforcement Agency (DEA), medical professionals, and millions of regular kratom users have such divergent views of the same plant? What is kratom? Kratom (Mitragyna speciosa) is a tropical tree from the coffee family native to Southeast Asia, with properties that range from stimulant-like, energizing and uplifting, to opiate-like, causing drowsiness and euphoria. Kratom has d...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Addiction Pain Management Vitamins and supplements Source Type: blogs
After repeated exposure to a piece of information, people will start assuming it’s true, whether or not it actually is, simply because they’ve heard it so many times. Familiarity and repetition can overcome rationality, a phenomenon psychologists call the “illusory truth effect.” In a 24-hour period during the first weekend of August, two mass shootings—one in El Paso, Texas and the other in Dayton, Ohio—left 31 people dead and 53 injured, as of writing. In between “calls for action” and the need for “thoughts and prayers,” legislators across the political spectru...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized health Source Type: news
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]
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
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 ...
Source: Surgical Clinics of North America - Category: Surgery Authors: Source Type: research
CONCLUSIONS: A high level of willingness to wear an overdose detection device was observed in this setting and a range of factors associated with overdose were positively associated with willingness. Since some factors, such as homelessness may be a barrier, further research is needed to investigate explanations for unwillingness and to evaluate real world acceptability of a wearable overdose detection devices as this technology becomes available. PMID: 31269963 [PubMed - in process]
Source: Addiction Science and Clinical Practice - Category: Addiction Authors: Tags: Addict Sci Clin Pract Source Type: research
Conclusions: These findings highlight a vulnerable population of polysubstance users with chronic pain, and indicates the need for more comprehensive assessment and treatment of chronic pain.
Source: Journal of Addiction Medicine - Category: Addiction Tags: Original Research Source Type: research
According to the Centers for Disease Control and Prevention (CDC; 2018), an estimated 68% of the 70,200 drug overdose deaths in the United States (US) in 2017 involved the use of an opioid. In fact, the number of drug overdose deaths that implicated opioids increased six-fold between 1999 and 2017 (CDC, 2018). In the current climate of the opioid addiction epidemic, various stakeholders are calling for tighter opioid access policies, more rigorous prescribing standards, and increasingly tailored patient and community education mechanisms (Christie et al., 2017; National Academies of Sciences [NAS], 2017; National Academy of Medicine, 2017).
Source: Nursing Outlook - Category: Nursing Authors: Source Type: research
By CLAIRE GALOFARO Associated Press The World Health Organization notified U.S. lawmakers last Wednesday that it will discontinue two publications on prescribing opioid painkillers in response to allegations that the pharmaceutical industry influenced the reports. The pledge to remove the guidelines comes a month after U.S. Reps. Katherine Clark and Hal Rogers accused the WHO of being influenced by Purdue Pharma, the American manufacturer of the potent painkiller OxyContin. The lawmakers' report claimed the guidelines, crafted in part by organizations with financial ties to the company, downplay the risk of opioids despite...
Source: JEMS: Journal of Emergency Medical Services News - Category: Emergency Medicine Authors: Tags: News Patient Care AP News Tag Source Type: news
(University Hospitals Cleveland Medical Center) Common antidepressants interact with the opioid pain medication tramadol to make it less effective for pain relief, according to a study published in the journal Pharmacotherapy. These findings have important implications for the opioid epidemic, suggesting that some patients suspected of drug-seeking may in fact be under-medicated and just are seeking more effective pain relief. They also could help explain why some people exceed the prescribed dose of tramadol, increasing their risk of addiction.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
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]
Source: Schmerz - Category: Anesthesiology Authors: Tags: Schmerz Source Type: research
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