Managing Opioids, Including Misuse and Addiction, in Patients with Serious Illness in Ambulatory Palliative Care: a Qualitative Study (S710)

Pain and opioid management are core ambulatory palliative care skills. Existing literature on how to manage opioid misuse/use disorder excludes patients found in palliative care settings, such as individuals with serious illness (e.g., cancer) or those near the end of life.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research

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Buprenorphine is widely used as a treatment for patients with opioid use disorders, but has also been shown to be an effective treatment for cancer and neuropathic pain, with unique pharmacologic properties that give it several advantages over traditional opioids. Buprenorphine is associated with less analgesic tolerance, and is less likely to cause respiratory depression and constipation than other opioids. Buprenorphine also does not cause immunosuppression, sphincter of Oddi dysfunction, or hypogonadism like traditional opioids.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Conclusions: Indian medical practitioners felt the need for formal pain management training. There is a lack of consensus on how to manage the pain using opioid analgesics. Tough regulations on medical and scientific use of opioids are the most commonly reported barrier to prescribing them.
Source: Indian Journal of Palliative Care - Category: Palliative Care Authors: Source Type: research
AbstractCancer pain is a common symptom experienced by patients, caused either by the disease or its treatment. Morphine remains the most effective and recommended treatment for cancer pain. However, cancer patients still do not receive appropriate management for their pain, and under-treatment is common. Lack of knowledge and negative attitudes towards cancer pain and analgesia among professionals, patients and family caregivers are reported as one of the most common barriers to effective cancer pain management (CPM). To systematically review research on the nature and impact of attitudes and knowledge towards CPM, a syst...
Source: Journal of Cancer Education - Category: Cancer & Oncology Source Type: research
Opinion statementAlthough clinical evidence supports the use of opioids for cancer-related pain, doing so amidst the current opioid crisis remains a challenge. A proportion of opioid-related deaths in the USA are attributable to prescription opioids, which implicates health care providers as one of the major contributors. It is therefore even more important now for all clinicians to follow safe and effective opioid prescribing practices. Oncologists are often in the frontline of cancer pain management. They are encouraged to use validated tools to screen all patients receiving opioids for high risk behaviors. Those identif...
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research
By COLIN KONSCHAK, FACHE and DAVE LEVIN, MD  Dave Levin Colin Konschak The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. Part one of the series proposed a strategic framework for evaluating and pursuing technical solutions. A Framework for Innovation In part one of our series, we declared the opioid crisis an “All Hands-On Deck” moment and made the case that health IT (HIT) has a lot to offer. Given the many different possibilities, h...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Tech Access to care Colin Konschak Dave Levin Divurgent Health IT Sansoro Health Source Type: blogs
This study was performed by the MPN Quality of Life Study Group. A survey was designed by a team of MPN investigators experienced with MPN symptomatology. Patients completed the MPN-10, a 10 item survey of MPN symptoms completed on a 0 (absent) to 10 (worst imaginable) scale (Blood. 2011 Jul 14;118(2):401-8). Other surveyed tools included the Opioid Risk Tool (ORT) as well as DSMV criteria for Opioid Use Disorder (OUD). The survey was posted on high-traffic MPN-related webpages focused on patient education and advocacy (MPN Forum, MPN Net, MPN Research Foundation, MPN Voice)for a total of 28 days. Patients currently receiv...
Source: Blood - Category: Hematology Authors: Tags: 634. Myeloproliferative Syndromes: Clinical: Poster III Source Type: research
House of Representatives member Representative Susan W. Brooks recently introduced the ADAPT Act of 2018. The ADAPT Act (Abuse Deterrent and Prescriber Training Act of 2018) is an attempt to require training for prescribers of controlled substances. The bill would amend the Controlled Substances Act to include a requirement for all practitioners who are licensed under State law to prescribe controlled substances in Schedule II, III, IV, or V, a written certification that the practitioner has completed 3 hours of training under a specific training program, in all registration or renewal requests. The training program will...
Source: Policy and Medicine - Category: American Health Authors: Source Type: blogs
Purpose of review The primary cause of overdose death in the United States is related to pharmaceutical opioids. A few particular populations that struggle with adverse outcomes related to opioid abuse are those in palliative care, those with chronic pain, and those receiving pain treatments secondary to cancer or chemotherapy. Recent findings There have been massive efforts to decrease the use of opioid abuse in patient care in a gestalt manner, but palliative care provides unique challenges in applying these reduction tactics used by other specialties. Summary We explore behavioral interventions, provider educati...
Source: Current Opinion in Supportive and Palliative Care - Category: Palliative Care Tags: PAIN: CANCER: Edited by Anthony H. Dickenson and Paul Farquhar-Smith Source Type: research
Opioids are an essential class of drugs used in pain management. In recent years, complex mechanisms pertaining to their abusive use have prompted a deadly crisis which is unfolding in the United States. The U.S. Centers for Disease Control and Prevention stated that 91 Americans lose their lives daily due to an overdose of opioid drugs. This public health crisis has inspired much apprehension even among Haitian diaspora in the United States. Although needed painkillers are notably lacking in developing countries, the fear of a similar path has led a high-profile personality to advise against their use in Haiti. Indeed, he...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Policy Pain Management Primary Care Source Type: blogs
Abstract The opioid crisis in the United States has been declared a public health emergency. Various governmental agencies, cancer care organizations and the Centers for Disease Control and Prevention have issued guidelines in hopes of managing this crisis. Curbing over-prescription of opioids by medical professionals has been a central theme in many of these guidelines. Gynecologic oncologists encounter patients with a variety of pain sources, including acute pain secondary to the underlying malignancy or surgical procedures as well as chronic pain related to the malignancy and the sequelae of treatments rendered...
Source: Gynecologic Oncology - Category: Cancer & Oncology Authors: Tags: Gynecol Oncol Source Type: research
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