The opioid epidemic in pediatrics: a 2020 update

We describe the historical use of opioids and the scope of the current opioid crisis, review the differences between dependence and addiction, and the private and public sectors response to pain management and highlight the issue of adolescent vulnerability. We conclude with a proposal for future directions that address both public and patient health needs.
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: PEDIATRIC ANESTHESIA: Edited by Jorge A. Gálvez Source Type: research

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Conclusions Analysis of ASC and HOR claims demonstrates significant differences and several common sources of liability. These include improving strategies for thorough screening, preoperative assessment and risk stratifying of patients, incorporating routine dental and airway assessment and documentation, diagnosing and treating perioperative pain adequately, and improving the efficacy of communication between patients and care providers.
Source: Journal of Patient Safety - Category: Health Management Tags: The Health Care Manager Source Type: research
Conclusions Sustained improvement in teamwork behaviors requires reinforcement. Level of Evidence Level III, prospective pre-post cohort study.
Source: Journal of Patient Safety - Category: Health Management Tags: Original Studies Source Type: research
I’ve been interviewing for jobs recently and am realizing how much of private practice pain is just a money making scheme. Comments like “schedule the procedure and medication refills on the same day so they come to get their procedure,” and “3-4 shots a year and a couple urines is not bad revenue” are so common. Tack on sketchy urine labs, churning out patients with scribes, getting paid $$$ by industry and the situation seems even more bleak. my question is - is this unique to pain? On... Read more
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Hello all, I I'm finishing my fellowship and was recommended for a job at a clinic. I had a phone interview with them today which went very well. They asked me to come see the facility in person at the end of the interview and had mentioned that they would like me to sign an NDA before seeing the clinic at the end of the interview. I'm very new to this and I'm not sure if this is the norm. My question is, I'm not sure what can be confidential/proprietary in a clinic setting and if I sign... Read more
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Objective The aim of the study was to assess centrally induced pain processing with pressure pain thresholds bilaterally and remotely in active volleyball and basketball athletes with mild patellar tendinopathy compared with asymptomatic control athletes. Secondary objective was to explore the role of exercise-induced analgesia during a training session in athletes with patellar tendinopathy. Design In this exploratory study, pressure pain thresholds of 21 patellar tendinopathy athletes and 16 age- and sex-matched asymptomatic team members were measured by a blinded assessor bilaterally on the patellar tendon an...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
Conclusions In this exploratory study, motor unit number index did not demonstrate discriminatory ability between patients with lumbar spinal stenosis and was not correlated with pain and functional measures. Further study is needed to explore motor unit number index’s role in longitudinal evaluation of patients with the clinical syndrome of lumbar spinal stenosis.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
ConclusionDespite being turned back from an effort to bluntly reduce opioid prescribing by the FDA in 2013 based on a lack of scientific evidence for its position (17,18), PROP has had a disproportionate effect on opioid policy in the Untied States for almost a decade. PROP found a willing federal regulatory partner in the CDC, and while PROP may not have “secretly written” the 2016 CDC Pain Guidelines (75), they certainly enjoyed disproportionate representation on CDC’s review panels and Core Expert Group (23-25) in a process that lacked transparency (22, 23, 26, 27). When the CDC admitted that its Pain ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: CDC health policy kollas opioids pain prop Source Type: blogs
With all the news media accounts and reports from governmental health organizations about the opioid epidemic, including the 70,237 drug overdose deaths in 2017, a newly emerging threat is gaining attention: use and misuse of benzodiazepines, opioid drugs and Z-drugs. Specifically, combining these three drugs can create a deadly combination that snuffs out lives. Benzodiazepine Overdose Deaths on the Rise Benzodiazepines, a class of sedative narcotic drugs including Xanax and Valium used to treat anxiety, insomnia and other disorders and classified as Schedule IV under the Controlled Substances Act by the Drug Enforcement ...
Source: Psych Central - Category: Psychiatry Authors: Tags: Addictions Substance Abuse Suicide Source Type: news
Conclusion Evaluating the potential harms of a commonly used drug—especially a complex substance like marijuana—is a challenging but vital task. Fully informed awareness of both the potential and proven benefits and the potential and proven harms of marijuana are necessary in order to have rational discussions with patients, teens, and decision makers regarding marijuana use. Based on a review of the current literature, we suggest the mnemonic DDUMB (dependence, driving, underachievement, mental illness, and “bad to worse”) as a tool that captures several of the more well-supported, brain-based risk...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Behavioral and Cognitive Neurology Child Adol Mental Disorders Cognition Current Issue Medical Issues Neurologic Systems and Symptoms Psychiatry Psychopharmacology Review Substance Use Disorders Cannabis dependence drug-related har Source Type: research
The prescription opioid crisis of overdosing and overprescribing has reached epic proportions, according to the North American media. Just last week, we learned that 91% of patients who survive opioid overdose are prescribed more opioids! The CDC calls it an epidemic, and notes there's been “a 200% increase in the rate of overdose deaths involving opioid pain relievers and heroin.” A recent paper in the Annual Review of Public Health labels it a “public health crisis” and proposes “interventions to address the epidemic of opioid addiction” (Kolodny et al., 2015).In the midst of this publ...
Source: The Neurocritic - Category: Neuroscience Authors: Source Type: blogs
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