Teaching Cross-Tolerance for Patients with Opioid Use Disorder Across Settings (TH336)

Palliative care practitioners are increasingly treating patients with comorbid opioid use disorder (OUD), yet guidance is lacking for managing pain in this population. Historically, palliative care clinicians have liberally prescribed opioids to patients with limited prognosis. As medicine has evolved, patients with chronic illnesses, even metastatic cancer, are living longer thanks to immunotherapies and other novel treatments. Thus, palliative care patients are at greater risk of both developing OUD and/or chemical coping while receiving intensive treatments.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research

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AbstractPurpose of ReviewThe goals of this review are two folds: (1) to describe the recent understandings on the roles of calcitonin gene-related peptide- α (CGRP) in bone homeostasis and the underlying mechanisms of related neuronal regulation and (2) to propose innovative CGRP-modulated approaches for enhancing bone regeneration in challenging bone disorders.Recent FindingsCGRP is predominantly produced by the densely distributed sensory neuronal fibers in bone, declining with age. Under mechanical and biochemical stimulations, CGRP releases and exerts either physiological or pathophysiological roles. CGRP at phys...
Source: Current Osteoporosis Reports - Category: Orthopaedics Source Type: research
This article outlines a methodical approach to clinical evaluation of patients presenting with acute, subacute or chronic pain, and to possibly identifying those who have mixed pain. The authors propose the use of nine simple key questions, which will provide the practicing clinician a framework for identifying the predominant pain mechanisms operating within the patient. A methodical, fairly rapid, and comprehensive assessment of a patient in chronic pain - particularly one suffering from pain with both nociceptive and neuropathic components - allows validation of their experience of chronic pain as a specific disease and...
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
Chronic opioid therapies (COT) are widely prescribed for the treatment of chronic pain related to palliative care, active cancer, and end-of-life care.43, 189 However, the use of COT to alleviate and manage chronic non-cancer pain (CNCP) remains controversial due to the risk for development of opioid use disorder, overdose, and opioid-related deaths.43 Despite the increased use of opioids to manage a wide range of chronic pain conditions, there is limited data regarding the effectiveness of long-term opioid treatment for CNCP particularly when considering COT as a primary treatment option.
Source: The Journal of Pain - Category: Materials Science Authors: Tags: Review Article Source Type: research
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: https://www.fightaging.org/newsletter/ Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
To say we’re living through challenging times sounds like both a cliché and an understatement. In recent months, news about the pandemic, economic woes, and bitter political debates have triggered tremendous anxiety and sadness for many Americans. But when people look back on their lives, it is usually the most difficult challenges that gave them a new perspective or caused them to grow the most. Of course, in the midst of a crisis, it doesn’t feel that way. But there are steps you can take to cope during difficult times, using techniques from the field of positive psychology. How can positive psychology...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Behavioral Health Coronavirus and COVID-19 Mental Health Source Type: blogs
​Cerumen impaction removal may not be considered an emergent procedure in the emergency department, but this omnipresent natural phenomenon will bring patients, from infants to the elderly, to your department at all hours of the day and night because loss of hearing is a foreign and uncomfortable sensation.Cerumen impaction can cause complete hearing loss, pain, dizziness, chronic cough, and even infection. Patients who attempt to remove cerumen at home can end up with otitis externa or otitis media and even tympanic membrane trauma. The cerumen can block visualization of the tympanic membrane so TM rupture or ear infect...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
HORSHAM, PA, September 30, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today that the U.S. Food and Drug Administration (FDA) has approved SIMPONI ARIA® (golimumab) for patients 2 years of age and older for the treatment of active pJIA and has extended the PsA indication for this same patient population. “This latest FDA approval of SIMPONI ARIA for pediatric use in active pJIA and active PsA not only brings a new option to young patients living with these diseases but also adds to the growing body of evidence for this treatment,” said Mathai Mammen, M.D., Ph.D., Glob...
Source: Johnson and Johnson - Category: Pharmaceuticals Source Type: news
This article enhances provider knowledge and acceptance of the most effective and prevalent mind-body modalities: meditation, guided imagery, clinical hypnosis, and biofeedback. The scientific evidence is strongest for mind-body applications for chronic pain, primary headache, cardiac rehabilitation, and cancer rehabilitation, with preliminary evidence for traumatic brain injury and cerebrovascular events. Mind-body interventions are well-tolerated by patients and should be considered part of standard care in physical medicine and rehabilitation settings. PMID: 32981579 [PubMed - in process]
Source: The Medical Clinics of North America - Category: General Medicine Authors: Tags: Phys Med Rehabil Clin N Am Source Type: research
This study aims to identify the utilization trend of prescribing tramadol and other opioid analgesics and investigate the influence of government regulation on opioid prescribing in Taiwan. METHODS: This cross-sectional study used the Taiwan National Health Insurance claims database and the cancer registry from 2001 through 2016. The annual number of adult opioid users, opioid utilization (Defined Daily Doses [DDDs]/1000 registrants) and the number of supply days were enumerated for each calendar year and stratified by cancer or non-cancer patients. Descriptive statistics were used to report the trends in utilization ...
Source: J Formos Med Assoc - Category: General Medicine Authors: Tags: J Formos Med Assoc Source Type: research
ConclusionsThese results provide empirical evidence of a change in the brain following MBSR intervention associated with changes in the subjective experience of pain.Implications for Cancer SurvivorsThis study gives hope for a non-invasive method of easing the struggle of CNP in women following breast cancer treatment.
Source: Journal of Cancer Survivorship - Category: Cancer & Oncology Source Type: research
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