Doctors can change opioid prescribing habits. Incrementally.

When they started practicing medicine, most surgeons say, there was little or no information about just how many pain pills patients needed after specific procedures. As a result, patients often were sent home with the equivalent of handfuls of powerful and addictive medications. Then the opioid crisis hit, along with  studies showing one possible side effect of […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Meds Pain Management Source Type: blogs

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Publication date: Available online 7 September 2019Source: Neuroscience LettersAuthor(s): Shibin Du, Corinna Lin, Yuan-Xiang TaoAbstractSickle cell disease (SCD) is one of the most common severe genetic diseases around the world. A majority of SCD patients experience intense pain, leading to hospitalization, and poor quality of life. Opioids form the bedrock of pain management, but their long-term use is associated with severe side effects including hyperalgesia, tolerance and addiction. Recently, excellent research has shown some new potential mechanisms that underlie SCD-associated pain. This review focused on how transi...
Source: Neuroscience Letters - Category: Neuroscience Source Type: research
Fibromyalgia (FM) is associated with debilitating pain and a reduced heart rate variability (HRV), reflecting decreased emotional adaptability and resistance to stress. Common pharmacological treatments are ineffective, and opioids are highly addictive and cause an estimated 15,000 overdose deaths per year. Effective recommendations include patient-centered interventions like physical activity, cognitive behavioral therapy, and biofeedback. Heart rate variability biofeedback (HRVB) may be effective in improving HRV, thus increasing stress resistance and emotional adaptability and reducing pain.
Source: Pain Management Nursing - Category: Nursing Authors: Tags: Review Article Source Type: research
Schedule II opioids have long been a common analgesic option for postoperative pain following third molar extractions. Despite their efficacy in treating moderate-to-severe pain, opioids have a high potential for addiction and abuse. Dental surgeries are a prominent source of unused opioids.1 In light of the current opioid epidemic, it is imperative that providers reduce excess opioid prescriptions, especially in adolescent patients. Use of non-opioids and weaker opioid agonists rather than the traditional schedule II opioids could reduce the risk of addiction and secondary exposure.
Source: Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Authors: Source Type: research
Abstract 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 recomme...
Source: The Medical Clinics of North America - Category: General Medicine Authors: Tags: Surg Clin North Am Source Type: research
Abstract The opioid epidemic continues to be a serious public health concern. Many have pointed to prescription drug misuse as a nidus for patients to become addicted to opioids and as such, urologists and other surgical subspecialists must critically define optimal pain management for the various procedures performed within their respective disciplines. Controlling pain following penile prosthesis implantation remains a unique challenge for urologists, given the increased pain patients commonly experience in the postoperative setting. Although most of the existing urological literature focuses on interventions pe...
Source: Asian Journal of Andrology - Category: Urology & Nephrology Authors: Tags: Asian J Androl Source Type: research
Abstract BACKGROUND: As opioid abuse and addiction have developed into a major national health crisis, prescription of opioids for pain management has become more controversial. However, opioids do help some patients by providing pain relief and improving the quality of life. To better understand the addictive properties of opioids under chronic pain conditions, we used a conditioned place preference (CPP) paradigm to examine the rewarding properties of morphine in rats with persistent nociception. METHODS: Spared nerve injury (SNI) model was used to induce persistent nociception in rats. Nociceptive behavior...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
Opioid abuse has become a critical threat to individuals and communities in the U.S. Unfortunately, physicians and other health care providers may unintentionally be contributing to the epidemic, as prescription opioid use often precedes opioid misuse, abuse, and addiction. Adequate pain management, however, remains an integral component of patient-centered care, particularly for surgical procedures. The purpose of this study is to characterize opioid prescription patterns among Mohs surgeons, to analyze how these practices may vary based on procedural volume, and to compare these practices to those of nonsurgical dermatol...
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Authors: Koller G, Schwarzer A, Halfter K, Soyka M Abstract Introduction: Opioid addiction is a worldwide disease with a significant impact. A multitude of physical and mental comorbidities are associated with opioid addiction, pain being one of the most relevant. Insufficient pain management may lead to a disruption in medical treatment, self-medication, and subsequent harm to patients. Areas covered: In this review, the authors provide a general overview of opioid addiction. A literature search for pain management and opioid maintenance treatment was conducted. Different settings of acute or chronic pain and situ...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
It seems that no amount of data-driven information can get policymakers to reconsider the hysteria-driven pain prescription policies they continue to put in place.I can understand lay politicians and members of the press misconstruing addiction and dependency, but there is no excuse when doctors make that error. Yet National Public Radio  reports that surgeons in 18 Upstate New York hospitals have agreed on an initiative to limit the amount of pain medicine they will prescribe to postoperative patients discharged from the hospital. The reporter says that researchers “now know” that patients prescribed...
Source: Cato-at-liberty - Category: American Health Authors: Source Type: blogs
Today’s guest is Okpara Rice, CEO of Tanager Place, a mental health facility for children in Cedar Rapids, Iowa.  Unlike adults, children are not in control of their own environment, and anything that affects a child will affect their families, and vice versa.  So, what is the best way to help these kids?  Join us as Okpara and Gabe talk about the importance of a holistic approach to mental illness in children, approaches which may or may not include medication. SUBSCRIBE &REVIEW   Guest information for ‘Children’s Mental Health’ Podcast Episode Okpara Rice joined Tanager...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Children and Teens Mental Health and Wellness Relationships The Psych Central Show Treatment Source Type: blogs
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