Unintended consequences of United States chronic pain guidelines

AbstractIn 2015, the United States of America (USA) Department of Health and Human Services (HHS) released an issue brief that addressed opioid addiction, opioid overdoses, and opioid-related deaths as a public health concern within the country. After collaboration with state and stakeholder organizations, the HHS identified three target initiatives aimed to mitigate the negative consequences of opioid use within the USA. One initiative included implementation of guidelines to help reduce inappropriate opioid prescribing with a goal to reduce morbidity and mortality. The aim of this commentary is to discuss the misapplication and unintended consequences of the USA CDC Guideline for Prescribing Opioids for Chronic Pain.
Source: International Journal of Clinical Pharmacy - Category: Drugs & Pharmacology Source Type: research

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The ongoing opioid crisis, centered in the United States, demands new insights into the complex and largely unknown mechanisms of opioid tolerance and addiction. Opioids, ranging from the natural opiates such as morphine to synthetic alternatives such as fentanyl, are widely used in the clinic as analgesics for acute and chronic pain. However, long-term administration of opioids may result in tolerance development and thus increase the risk of overdose and death. Broad availability of both prescription and illegal opioids has fueled substance use disorders.
Source: Biological Psychiatry - Category: Psychiatry Authors: Tags: Early Career Investigator Commentary Source Type: research
mer Adequate pain management, particularly chronic pain, remains a major challenge associated with modern-day medicine. Current pharmacotherapy offers unsatisfactory long-term solutions due to serious side effects related to the chronic administration of analgesic drugs. Morphine and structurally related derivatives (e.g., oxycodone, oxymorphone, buprenorphine) are highly effective opioid analgesics, mediating their effects via the activation of opioid receptors, with the mu-opioid receptor subtype as the primary molecular target. However, they also cause addiction and overdose deaths, which has led to a global opioid ...
Source: Molecules - Category: Chemistry Authors: Tags: Review Source Type: research
Prescription opioids are used for some chronic pain conditions. However, generally, long-term therapy has unwanted side effects which may trigger addiction, overdose, and eventually cause deaths. Opioid addiction and chronic pain conditions have both been ...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
Funding Opportunity RFA-NS-22-016 from the NIH Guide for Grants and Contracts. More than 25 million Americans suffer from daily chronic pain, a highly debilitating medical condition that is complex and difficult to manage. In recent decades, there has been an overreliance in the prescription of opioids for chronic pain despite their poor ability to improve function and high addiction liability. This contributed to a significant and alarming epidemic of opioid overdose deaths and addictions. Innovative scientific solutions to develop alternative pain treatment options are thus critically needed. Through targeted research e...
Source: NIH Funding Opportunities (Notices, PA, RFA) - Category: Research Source Type: funding
CONCLUSION AND SCIENTIFIC SIGNIFICANCE: Drug-related dreams were common among individuals in the present sample and were related to other clinically relevant phenomena. Interventions that treat co-occurring OUD, pain, sleep symptoms, and affective symptoms may improve overall well-being in this population.PMID:34459058 | DOI:10.1111/ajad.13219
Source: The American Journal on Addictions - Category: Addiction Authors: Source Type: research
elsen Prescription opioids are used for some chronic pain conditions. However, generally, long-term therapy has unwanted side effects which may trigger addiction, overdose, and eventually cause deaths. Opioid addiction and chronic pain conditions have both been associated with evidence of genetic and epigenetic alterations. Despite intense research interest, many questions about the contribution of epigenetic changes to this typology of addiction vulnerability and development remain unanswered. The aim of this review was to summarize the epigenetic modifications detected in specific tissues or brain areas and associate...
Source: Genes - Category: Genetics & Stem Cells Authors: Tags: Review Source Type: research
Despite practicing in multiple venues where people with opioid use disorders require services, most public service psychology providers are not delivering, or being trained to deliver, treatment for substance use disorders. In addition, unintentional overdose and death from opioids continue, treatment options for chronic pain remain limited, and a larger discussion on the problem and role of drug and alcohol addiction in society remains largely unspoken. The articles received and included in this special section present some changes in the way that precipitants and prevention of opioid use disorder may be addressed and the...
Source: Psychological Services - Category: Psychiatry & Psychology Source Type: research
CONCLUSIONS: Industry-funded REMS-compliant CME on opioids contain messages that misrepresent scientific evidence and may foster overprescribing of opioids.PMID:34323440
Source: Pain Physician - Category: Anesthesiology Authors: Source Type: research
AbstractMillions of Americans experience pain daily. In 2017, opioid overdose claimed 64,000 lives increasing to 84,000 lives in 2020, resulting in a decrease in national life expectancy. Chronic opioid use results in dependency, drug tolerance, neuroadaptation, hyperalgesia, potential addictive behaviors, or Reward Deficiency Syndrome (RDS) caused by a hypodopaminergia. Evaluation of pain clinic patients with the Genetic Addiction Risk Score (GARS) test and the Addiction Severity Index (ASI- Media Version V) revealed that GARS scores equal to or greater than 4 and 7 alleles significantly predicted drug and alcohol severit...
Source: Molecular Neurobiology - Category: Neurology Source Type: research
Background: More than 1 million Americans receive primary care from federal homeless health care programs yearly. Vulnerabilities that can make care challenging include pain, addiction, psychological distress, and a lack of shelter. Research on the effectiveness of tailoring services for this population is limited. Objective: The aim was to examine whether homeless-tailored primary care programs offer a superior patient experience compared with nontailored (“mainstream”) programs overall, and for highly vulnerable patients. Research Design: National patient survey comparing 26 US Department of...
Source: Medical Care - Category: Health Management Tags: Original Articles Source Type: research
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