Dishing out more drugs won ’t stop the pain. Doctors need new tools | Ann Robinson

As a GP, I know opioids have their place. But we shouldn ’t be complacent about a US-style crisis happening in BritainGrowing concern about the prescription of drugs that cause dependence has been backed up by a recent report from Public Health England (PHE). The agencydiscovered that in 2017-18, 13% of adults in England received at least one prescription for opioids such as morphine or oxycodone (although this represented a slight downturn in prescribing after a long upward trend). Other drug classes were implicated too, with 25% of adults prescribed one or more of the following drugs: benzodiazepines (such as Valium), z-drugs (sleeping pills such as Zopiclone), gabapentinoids (gabapentin or pregabalin, prescribed for neuropathic pain) or antidepressants.The fear is that the UK is following in the footsteps of the US, where overprescribing is said to have led to a full-blown “opioid crisis”. But where does this leave those who live with severe or chronic pain and are dependent on opioids to function day-to-day? GPs, like me, and pain specialists need lots of time and a toolbox of interventions to properly treat those who suffer. But in the current cash- and time-poo r environment, is it any wonder that they dole out prescriptions instead?Continue reading...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Opioids GPs NHS Doctors Health Society Drugs policy Politics Science UK news Source Type: news

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CONCLUSION: The implementation of this questionnaire may reduce the incidence and morbimortality of opioid misuse among chronic pain patients and should improve chronic pain treatment in Portugal. PMID: 32238240 [PubMed - in process]
Source: Acta Medica Portuguesa - Category: General Medicine Tags: Acta Med Port Source Type: research
Abstract INTRODUCTION: Migraine is a frequent and debilitating primary headache. Pain catastrophizing is a negative set activated in response to anticipated or actual pain. The anticipatory fear of pain, one of its characteristics, has been associated with a greater prescription and use of analgesics. AIM: To explore the pain catastrophizing in relation to analgesic overuse and the headache impact on quality of life in patients with chronic migraine. PATIENTS AND METHODS: An observational cross-sectional analytical study was performed. Patients older than 18 years with chronic migraine were included, who...
Source: Revista de Neurologia - Category: Neurology Authors: Tags: Rev Neurol Source Type: research
This study investigates the incidence of long-term consequences in survivors of critical illness 6 months after ICU care. A retrospective analysis of the risk factors was also completed. METHODS: A mixed-method design was used. A qualitative design was used in the questionnaire study (phase 1), and a quantitative design was used for the retrospective study (phase 2). RESULTS: 116 patients were interviewed. Forty-eight patients (41.4%) reported at least one long-term consequence 6 months after ICU discharge. The most frequent consequences were anxiety (n = 33, 28.4%), depression (n = 32, 27.6%) and chronic pain (n =...
Source: Annali dell Istituto Superiore di Sanita - Category: General Medicine Tags: Ann Ist Super Sanita Source Type: research
CONCLUSIONS: Evaluative studies on organizations that support Veterans are useful to gauge the effectiveness and impact. Through this study, Veterans expressed perceived strengths and weaknesses of the program so further development and appropriate services will be provided. Similar studies on the impact of non-profit organizations are encouraged. Vet TRIIP significantly impacts the lives of many through stress and pain reduction, potentially preventing suicide. PMID: 32236440 [PubMed - as supplied by publisher]
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Conclusions: CRF denervation of the SIJ can safely elicit pain and disability relief, and reduce opioid use, regardless of intervention success. Future studies may support CRF denervation as a dependable therapy to alleviate opioid use in patients with SIJ-derived LBP and show that opioid use measurements can be a surrogate indicator of pain. PMID: 32235019 [PubMed]
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Conclusions: The calcium-mediated cerebral process occurs after peripheral injury in CRPS, and there can be a relationship between the cerebrum and the pathogenesis of CRPS. PMID: 32235013 [PubMed]
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Authors: Sato KL, Sanada LS, Silva MDD, Okubo R, Sluka KA Abstract Background: Transcutaneous electrical nerve stimulation (TENS), manual acupuncture (MA), and spinal cord stimulation (SCS) are used to treat a variety of pain conditions. These non-pharmacological treatments are often thought to work through similar mechanisms, and thus should have similar effects for different types of pain. However, it is unclear if each of these treatments work equally well on each type of pain condition. The purpose of this study was to compared the effects of TENS, MA, and SCS on neuropathic, inflammatory, and non-inflammatory ...
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Authors: Isagulyan E, Slavin K, Konovalov N, Dorochov E, Tomsky A, Dekopov A, Makashova E, Isagulyan D, Genov P Abstract Chronic severe pain results in a detrimental effect on the patient's quality of life. Such patients have to take a large number of medications, including opioids, often without satisfactory effect, sometimes leading to medication abuse and the pain worsening. Spinal cord stimulation (SCS) is one of the most effective technologies that, unlike other interventional pain treatment methods, achieves long-term results in patients suffering from chronic neuropathic pain. The first described mode of SCS...
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Conclusion: LIS is still the gold standard for the treatment of chronic anal fissure when the physicians would like to avoid recurrence and obtain the best pain relief.
Source: Nigerian Journal of Clinical Practice - Category: Rural Health Authors: Source Type: research
We report here a 41-year-old lady suffering from bilateral heel pain without trauma history. Her complaining did not respond to analgesics and stretching exercises of plantar fascia. In her past medical history she reported ongoing carbamazepine (CBZ) use over 8 years for trigeminal neuralgia. She had had low bone mineral density; defined as osteopenia. Both calcaneus MRI revealed bilateral stress fractures of calcaneum. She had been advised immobilization for 6 weeks, vitamin D and calcium supplements. CBZ has been stopped by neurology specialist and she had undergone microvascular decompression surgery for intractable pa...
Source: Nigerian Journal of Clinical Practice - Category: Rural Health Authors: Source Type: research
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