Part 5 - Why Do We Lump the Non-Cancer Pain Syndromes Together?
by Drew Rosielle (@drosielle)A Series of Observations on Opioids By a Palliative Doc Who Prescribes A Lot of Opioids But Also Has Questions.This is the 5th post in a series about opioids, with a focus on how my thinking about opioids has changed over the years. See also:Part 1 – Introduction, General Disclaimers, Hand-Wringing, and a Hand-Crafted Graph.Part 2 – We Were Wrong 20 years Ago, Our Current Response to the Opioid Crisis is Wrong, But We Should Still Be Helping Most of our Long-Term Patients Reduce Their Opioid DosesPart 3 – Opioids Have Ceiling Effects, High-Doses are Rarely Therapeutic, and Ano...
Source: Pallimed: A Hospice and Palliative Medicine Blog - October 6, 2019 Category: Palliative Care Tags: opioid pain rosielle The profession Source Type: blogs

How do we manage pain in the era of the opioid crisis?
“6 in 10 Kids Got Opioids After Tonsil Surgery, Study Says.” So screams the headline from The Daily Beast.“In the midst of the opioid crisis, doctors sent many kids home with oxycodone and hydrocodone,” it goes on to say. Another example of scaremongering and sensational headlines, or is this something we should still be […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 2, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/rita-agarwal" rel="tag" > Rita Agarwal, MD < /a > < /span > Tags: Meds Medications Pain Management Source Type: blogs

Opioids for acute pain: How much is too much?
In this study, the researchers looked at opioid prescriptions in 2016, and the numbers are shocking. In the US, 22% of prescriptions written by dentists were for opioids, compared with just 0.6% for British dentists, and US dentists prescribed about 35 opioids per 1,000 population, compared to just 0.5 opioid prescriptions per 1,000 population in England. Additionally, the opioid prescribed in England was a relatively weak codeine-like drug, whereas in the US the majority of prescriptions were for hydrocodone, a stronger opioid with greater abuse potential. When does an opioid prescription make sense? It is simply impossib...
Source: Harvard Health Blog - July 24, 2019 Category: Consumer Health News Authors: Scott Weiner, MD Tags: Addiction Pain Management Source Type: blogs

When Police Officers Are On the Job … and On Drugs
A police officer who is using opioids illegally is breaking the very laws that he or she has sworn to uphold. This makes it even more difficult to reach out and get help for an addiction that may be spinning out of control. No one ever said being a police officer was easy. The job alternates between crushing boredom, bizarre situations, and unimaginable danger. When you’re a cop, much of the population that you’re paid to protect is afraid of you. You’re always being judged, whether it’s in the media or when you go to the corner store. Your hours are usually pretty awful, which means you don’t...
Source: World of Psychology - July 6, 2019 Category: Psychiatry & Psychology Authors: Psych Central Guest Author Tags: Addiction Publishers The Fix Drugs Law Enforcement opiods Police Officers Source Type: blogs

Toward a Healthy Relationship with Opioids
In the June 14thWall Street Journal, Johns Hopkins University bioethicist Travis Rieder, in an excellent  essay, shared with readers his battle with pain resulting from a devastating accident, the effectiveness of opioids in controlling the pain, and the hell he went through when he was too rapidly tapered off of the opioids to which he had become physically dependent. Like most patients requiring long term pain management with opioids, he developed a physical dependence, which is often  mistakenly equated with addiction by policymakers and many in the media. The aggressive schedule launched me into wit...
Source: Cato-at-liberty - June 17, 2019 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs

What are the Different Drugs Used for Heroin and Opioid Detox?
Understanding Heroin and Opioid Detox When someone is struggling with addiction to heroin or opioids, it can be almost impossible to quit cold turkey. This is due to unpleasant withdrawal symptoms, as well as intense drug cravings. When someone quits cold turkey, they will have to experience all these debilitating withdrawal symptoms and manage strong cravings on their own. This is extremely hard to do without the assistance of medication during heroin and opioid detox. According to Medline, about 948,000 people used heroin during the past year. In the same year, about 11.5 million people were nonmedical users of narcotic ...
Source: Cliffside Malibu - May 8, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Addiction Addiction Recovery Addiction Treatment and Program Resources Detox Resources for Alcohol and Drugs/Opiates Painkiller Substance Abuse drug detox heroin heroin addiction heroin users luxury heroin rehab medical medical det Source Type: blogs

Overprescribing Is a Key Component of the Opioid Crisis — Here’s How to Stop It
By DAVE CHASE  Today’s opioid crisis is one of the most dire side effects driven by our dysfunctional U.S. healthcare system. A recent JAMA Surgery report found that many surgeons prescribe four times more opioids than their patients use. This opens the door for misuse and abuse later on. In fact, the total combined cost of misuse, abuse, dependence and overdose is about $78.5 billion. Unfortunately, there’s a direct connection between the low-quality care many patients receive, and the astounding rates of opioid addiction. Often, insurance plans offer access to high-cost, volume-centric physicians and inc...
Source: The Health Care Blog - January 29, 2019 Category: Consumer Health News Authors: matthew holt Tags: Patients Value-Based Care Dave Chase Opioid epidemic Source Type: blogs

More Than Just Dander
First, a sort of meta-comment in the form of a shout-out to HCRenewal's intrepid editor, Dr. Roy Poses, for his just-published analysis of what we might call " blogging: rise and fall. " He sees decline reflected in publications long  devoted to health and health policy, yet now flaking off.Methinks, however, despite the usefulness of his overview of recent decades, Dr. P need not fret excessively. Water spilling out of the barrel's lip will slow down once folks come along and punch a whole bunch of little mid-section tweet-holes in it. Information still flows. (Sort of.)  In any case, surely there's ov...
Source: Health Care Renewal - January 25, 2019 Category: Health Management Source Type: blogs

The Mysteries Surrounding Rhodes Pharmaceuticals, the Sackler Family's Second Opioid Company
 Mysteries still abound in the not so wonderful world of health care dysfunction, so, quick, the game's afoot...Today's mysteries involve beneficial ownership.  Beneficial ownership questions are important to anti-corruption campaigners.  Beneficial ownership simply refers to " anyone who enjoys the benefits of ownership of a security or property, without being on the record as being the owner. " (per Wikipedia). Concealing who really owns a company enables concealing sources of funds (as in money laundering), market power (when the owner also owns competitors), and sources of political influence, ...
Source: Health Care Renewal - January 8, 2019 Category: Health Management Tags: anechoic effect concentration of power conflicts of interest dark money deception Donald Trump health care corruption marketing narcotics Purdue Pharma Source Type: blogs

Health IT Is In The Front Line To Try And Stem The Opioid Crisis in The US – Relevant Here Too!
This appeared last week:Providers turning to health IT to combat the opioid crisis By Marla Durben HirschPublished December 26 2018, 7:49am ESTProviders have begun to harness technology to improve their management of opioids and avoid misuse. It ’s not a moment too soon. The Centers for Disease Control and Prevention’s most recent reports, released in November, confirm that the opioid crisis is worsening. The number of drug overdose deaths in the United states in 2017 was 9.6 percent higher than in 2016. The rate of drug overdose deaths involving natural and semisynthetic opioids like oxycodone and hydrocodone ...
Source: Australian Health Information Technology - January 2, 2019 Category: Information Technology Authors: Dr David G More MB PhD Source Type: blogs

No Let Up On The Bad News About Overdose Deaths
The National Center for Health Statistics (NCHS) just issued  Data Brief Number 329, entitled “Drug Overdose Deaths in the United States, 1999-2017.” Drug overdose deaths reached a new record high, exceeding 70,000 deaths in 2017, a 9.6 percent increase over 2016. That figure includes all drug overdoses, including those due to cocaine, methamphetamines, and benzodiazepines. The actual breakdown according to drug category will be reported in mid-December. However,  estimates are opioid-related deaths will account for roughly 49,000 of the total overdose deaths. The big takeaways, quoting...
Source: Cato-at-liberty - November 29, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs

Has Opioid Hysteria Risen to the Point Where Innovation Is Forbidden?
On November 2 the Food and Drug Administration  announced the approval of Dsuvia, a sublingual tablet containing the powerful fentanyl analog, sufentanil. Sufentanil has been used for years in the hospital setting, primarily in intravenous form for anesthesia. It is  roughly 5 to 10 times more potent than fentanyl, and thus has a significant overdose potential. The FDA reached this decision following a 10-3 vote in favor of the drug’s approval by the Anesthetic and Analgesia Drug Products Advisory Committee (AADPAC),based on data from multicenter trials.  It was not approved for outpatie...
Source: Cato-at-liberty - November 6, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs

Telemedicine should be easy. Here ’s why it’s not.
Who was Ryan Haight? Ryan Haight was an 18-year-old honor student from La Mesa, California who died on February 12, 2001, from an overdose of hydrocodone ordered from an online doctor he never saw — and shipped to his home from a rogue online pharmacy during the beginning of the opioid epidemic. The pharmacist, Clayton Fuchs, filled the online prescription and thousands more like it along with four doctors who authorized the prescriptions. All five were charged in 2002 and subsequently either pleaded guilty or were convicted several months later. The four doctors involved in the conspiracy were paid between $40 to $1...
Source: Kevin, M.D. - Medical Weblog - October 12, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/dennis-wichern" rel="tag" > Dennis Wichern < /a > Tags: Meds Medications Pain Management Source Type: blogs

The Law of Unintended Consequences Strikes Again
Late last week UPI news ran a  report by E.J. Mundell with the headline, “Government efforts to curb opioid prescriptions might have backfired.” It cites two separate studies published online in JAMA Surgery on August 22 that examined two different restrictive opioid policies that fell victim to the Law of Unintended Consequences.The first  study, by researchers at the University of Michigan, evaluated the impact of the Drug Enforcement Administration ’s 2014 rescheduling of hydrocodone (Vicodin) from Schedule III to Schedule II. Prescriptions for Schedule III narcotics may be phoned or fax...
Source: Cato-at-liberty - August 26, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs

Death Notification as Behavior Modification: Let's think this through
by Ben Skoch (@skochb)Opioid Problem. Opioid Epidemic. Opioid Crisis.Call it what you will (as long as you don ’t use the word narcotic, butthat ’s another article), but the United States has a real issue with opioids right now. It has been much talked about, publicized, criticized, politicized, has left some people ostracized, to a point where the concern has become supersized. Six years ago,a reportstated enough opioid prescriptions were written for every adult in the US to have a bottle of pills, about 259 million. Couple that with thereport from the CDC that over 42,000 people died from opioid (illicit and ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - August 24, 2018 Category: Palliative Care Tags: behavior change burnout california journal article opioids research skoch The profession Source Type: blogs

Politics, Confirmation Bias, and Opioids
This post co-authored with Rafael Fonseca, MD, Chairman of the Department of Medicine, Mayo Clinic, Phoenix, AZMuch has been written about how politics and ideology influence research funding, suppress research in certain areas, and lead to the cherry-picking and misrepresentation of evidence in support of a narrative or agenda. Science journalist John Tierney explored “The Real War on Science” in an excellent essay in City Journal in 2016. Reflecting on this phenomenon in 2011,Patrick J. Michaels stated:The process is synergistic and self-fulfilling. Periodicals like  Science are ...
Source: Cato-at-liberty - August 7, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs

Depression: Common medication side effect?
This study is especially thought-provoking, given that more and more people are taking medications with depression or suicidal thoughts as possible side effects. The CDC just released updated data showing a troubling recent rise in suicide rates, and that 54% of those who die from suicide do not have a known mental health disorder, so this is an important public health issue. That said, it is important to note: in this study, people who used these medications were more likely to be widowed and have chronic health problems, both of which are associated with a higher risk of depression. And many (but not all) of these medica...
Source: Harvard Health Blog - July 16, 2018 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Anxiety and Depression Drugs and Supplements Health Source Type: blogs

FDA Commissioner Gottlieb ’s Sunday “Tweetorial” Is Both Encouraging and Frustrating
A fair reading of Food and Drug Administration Commissioner Scott Gottlieb ’s “Sunday Tweetorial” on the opioid overdose crisis leaves one simultaneously encouraged and frustrated. First the encouraging news. The Commissioner admits that the so-called epidemic of opioid overdoses has “evolved” from one “mostly involving [diverted] prescription drugs to one that’s increasingly fueled by illicit substances being purchased online or off the street.” Most encouraging was this passage:  Even as lawful prescribing of opioids is declining, we ’re seeing large in...
Source: Cato-at-liberty - July 2, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs

Might Depression Be Linked to One of These Popular Medications?
If you’re taking beta blockers, certain kinds of anxiety drugs, certain types of painkillers (including ibuprofen), proton pump inhibitors (PPIs) (used to treat acid reflux), ACE inhibitors (used to treat high blood pressure), or anti-convulsant drugs, you may be at greater risk for depression. That’s according to a new, large-scale study published earlier this week in JAMA. However, this was a correlational study, so it can’t say that these medications actually cause depression or not. It may be that people with greater health problems are more likely to take one of these medications and be depressed abo...
Source: World of Psychology - June 15, 2018 Category: Psychiatry & Psychology Authors: John M. Grohol, Psy.D. Tags: Depression General Medications Psychiatry Research Drugs cause depression popular medications Source Type: blogs

Want to dispose of drugs properly? Here ’s how.
According to Bloomberg, Americans spend more on prescription drugs per year than any other country in the world at around $1,100 per person. Additionally, the CDC reports that four out of five new heroin users started their addiction by using prescription opioid painkillers like hydrocodone or oxycodone. And we know from the Partnership for a Drug-free America that students and young adults oftentimes start their drug experimentation by taking unused medications from either their parent’s or grandparent’s medicine cabinets. So, with the above information and the responsibility we all have to help improve Americ...
Source: Kevin, M.D. - Medical Weblog - June 7, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/dennis-wichern" rel="tag" > Dennis Wichern < /a > Tags: Meds Medications Practice Management Source Type: blogs

How health insurers are making America ’s opioid epidemic worse - Vox
Mandy has now been in recovery from her opioid addiction for more than two months — and she's ready to keep that going. But the 29-year-old in the Chicago area is now dealing with a big obstacle: her health insurer.Mandy, who asked I use only her first name, said she struggled with addiction for six years. It started with back pain, which a doctor tried to treat with Vicodin. " I had tried [opioids] in high school, " she said. " I had an older boyfriend, and I tried some of his wisdom teeth painkillers to get high off of. And I was like,'Whoa, this is awesome.'When I got a Vicodin prescription for...
Source: Psychology of Pain - June 5, 2018 Category: Anesthesiology Source Type: blogs

While Politicians Cut Opioid Prescriptions, Fentanyl —With Help From the “Dark Web” and the USPS— Becomes the Number One Killer
A May 22  story in Bloomberg News describes with painstaking detail the underground pipeline through which the powerful synthetic opioid fentanyl floods the US market. According to the Drug Enforcement Administration, while the Mexican cartel plays a role by using its well-established heroin and methamphetamine d istribution networks, most of the fentanyl comes in to the US from China. The raw materials to make the synthetic opioids are cheap and they can be manufactured rather quickly in small laboratories. The laboratories are constantly creating new variations so as to skirt restrictions the Chinese gover...
Source: Cato-at-liberty - May 23, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs

Chronic pain treatment: Psychotherapy, not opioids, has been proven to work - Vox
When pain settled into Blair Golson's hands, it didn't let go.What started off as light throbbing in one wrist 10 years ago quickly engulfed the other. The discomfort then spread, producing a pain much"like slapping your hands against a concrete wall," he says. He was constantly stretching them, constantly shaking them, while looking for hot or cold surfaces to lay them on for relief.But worse was the deep sense of catastrophe that accompanied the pain. Working in tech-related startups, he depended on his hands to type."Every time the pain got bad, I would think some variation of,'Oh no, I'm ...
Source: Psychology of Pain - May 20, 2018 Category: Anesthesiology Source Type: blogs

Why physicians should respect the pain patients report
We’re all human beings, but we’re not all alike. Each person experiences pain differently, from an emotional perspective as well as a physical one, and responds to pain differently. That means that physicians like myself need to evaluate patients on an individual basis and find the best way to treat their pain. Today, however, doctors are under pressure to limit costs and prescribe treatments based on standardized guidelines. A major gap looms between the patient’s experience of pain, and the limited “one size fits all” treatment that doctors may offer. Concerns about the opioid epidemic&...
Source: Kevin, M.D. - Medical Weblog - May 3, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/karen-s-sibert" rel="tag" > Karen S. Sibert, MD < /a > Tags: Physician Hospital-Based Medicine Pain Management Primary Care Source Type: blogs

New Study from American Action Forum Adds to the Argument Against Present Supply-Side Opioid Policy
On April 11 the Washington Post  cited a new study from the American Action Forum that reinforces arguments I have made here and here, that despite a dramatic reduction in the opioid prescription rate —a 41 percent reduction in high-dose opioid prescriptions since prescriptions peaked in 2010—the overdose rate continues to climb, as nonmedical users have simply migrated to more dangerous substitutes like fentanyl and heroin while the supply of diverted prescription opioids suitable for abuse continues to come down.I have a minor quibble with the study ’s finding that &ld...
Source: Cato-at-liberty - April 12, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs

I ’m a doctor but I didn’t mean to be a drug pusher
I never wanted to be a drug pusher. A career in medicine was the opposite — healing in place of harming. However, I knew something was wrong when a detective asked to speak to me about one of my patients. My patient, addicted to Vicodin, had committed several acts of fraud and theft in desperate attempt to satisfy her needs. Her arrest was the final step in a long, slow unraveling of a happy and productive life. I was not just a witness to this painful process; I was an active participant. As her primary care physician, I helped fuel her addiction and shared in the responsibility. When the history of the opiate epide...
Source: Kevin, M.D. - Medical Weblog - March 25, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/kevin-haggerty" rel="tag" > Kevin Haggerty, MD < /a > Tags: Physician Pain Management Primary Care Source Type: blogs

There ’s no easy way out of the opioid epidemic
Across the United States at least forty people die each day from overdosing on opioids like Vicodin, codeine, heroin, and oxycontin. Seven percent of drivers who died in car crashes last year were found to have prescription opioids in their systems — seven times more than in 1995. Considering these alarming rates of overdosing and DUIs, this is serious business. Authorities view it in their traditional way: the problem is drugs. Thus doctors should curtail prescribing, and patients should clean up and go through rehab. But the situation’s less about drugs than, frankly, rampant suicide. These drugs’ risks...
Source: Kevin, M.D. - Medical Weblog - February 21, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/jeff-kane" rel="tag" > Jeff Kane, MD < /a > Tags: Physician Pain Management Psychiatry Source Type: blogs

In defense of FOX ’s The Resident
The public’s apparently insatiable appetite for medical drama continues unabated as yet another prime-time TV show set in a hospital has hit our screens. FOX’s The Resident has generated discussion like no other. This may simply be due to the fact it’s the first major launch in the era of widespread social media, but it seems to have enraged a vast swathe of our ranks. Has The Resident crossed a line or have we become a medical “generation snowflake”? Health care professionals don’t tend to admit that they watch medical shows. “Oh it’s too much like work!” is a common r...
Source: Kevin, M.D. - Medical Weblog - February 13, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/rohin-francis" rel="tag" > Rohin Francis, MD < /a > Tags: Physician Hospital-Based Medicine Mainstream media Source Type: blogs

Policy Insights from The Neurocritic: Alarm Over Acetaminophen, Ibuprofen Blocking Emotion Is Overblown
Just in time for Valentine's Day, floats in a raft of misleading headlines:Scientists have found the cure for a broken heartPainkillers may also mend a broken heartTaking painkillers could ease heartaches - as well as headachesParacetamol and ibuprofen could ease heartaches - as well as headachesIf Tylenol and Advil were so effective in “mending broken hearts”, “easing heartaches”, and providing a “cure for a broken heart”, we would be a society of perpetually happy automatons, wiping away the suffering of breakup and divorce with a mere dose of acetaminophen. We'd have Tylenol epidemics...
Source: The Neurocritic - February 11, 2018 Category: Neuroscience Authors: The Neurocritic Source Type: blogs

Policy Insights from The Neurocritic: Alarm Over Acetaminophen, Ibuprofen Blocking Emotion Is Overblown
Just in time for Valentine's Day, floats in a raft of misleading headlines:Scientists have found the cure for a broken heartPainkillers may also mend a broken heartTaking painkillers could ease heartaches - as well as headachesParacetamol and ibuprofen could ease heartaches - as well as headachesIf Tylenol and Advil were so effective in “mending broken hearts”, “easing heartaches”, and providing a “cure for a broken heart”, we would be a society of perpetually happy automatons, wiping away the suffering of breakup and divorce with a mere dose of acetaminophen. We'd have Tylenol epidemics...
Source: The Neurocritic - February 11, 2018 Category: Neuroscience Authors: The Neurocritic Source Type: blogs

A Doctor ’s Painful Struggle With an Opioid-Addicted Patient - Siddhartha Mukherjee - The New York Times
I once found myself entrapped by a patient as much as she felt trapped by me. It was the summer of 2001, and I was running a small internal-medicine clinic, supervised by a preceptor, on the fourth floor of a perpetually chilly Boston building. Most of the work involved routine primary care — the management of diabetes, blood pressure and heart disease. It was soft, gratifying labor; the night before a new patient's visit, I would usually sift through any notes that were sent ahead and jot my remarks in the margins. The patient's name was S., I learned. She had made four visits to the emergency room complaini...
Source: Psychology of Pain - February 5, 2018 Category: Anesthesiology Source Type: blogs

FDA REMS Blueprint on Opioids Finalized
On January 30, 2018, the United States Food and Drug Administration (FDA) finalized the “Opioid Analgesic REMS Education Blueprint for Health Care Providers Involved in the Treatment and Monitoring of Patients with Pain.” The Blueprint includes educational messages for health care providers involved in the treatment and monitoring of patients with pain. It also includes information on pain management, including the principles of acute and chronic pain management; non-pharmacologic treatments for pain; and pharmacologic treatments for pain (non-opioid analgesic and opioid analgesic).  This REMS represents a...
Source: Policy and Medicine - February 2, 2018 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

The Opioid Crisis – In Your Cupboard
The opioid epidemic of the last 20 years has served to illustrate the powerful addictive properties of anything that binds to opioid receptors of the human brain. Lives are ruined by opioid addiction, more than 100 deaths now occurring every day from overdose as people either take more and more to overcome the partial tolerance or new potent drugs like fentanyl make their way into street versions. Drugs such as oxycodone, hydrocodone, and fentanyl bind to the brain’s opioid receptors provoking a “high” while causing the user to desire more opioids as partial tolerance develops. And make no mistake: Much o...
Source: Wheat Belly Blog - January 31, 2018 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle addiction addictive eating disorder opiates opioids undoctored Source Type: blogs

RWJF Opioid Challenge: You Can Help
By CHELSEA POLANIECKI AND CHANLY PHILOGENE Opioid overdoses are the leading cause of death for Americans under 50 years old. In fact, the majority of drug overdose related deaths involve an opioid. According to the National Center for Health Statistics, deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have more than quadrupled since 1999. The U.S. is currently experiencing an opioid epidemic, as more than 2 million Americans have become dependent on, or abused prescription pain pills and street drugs. Substance misuse is not only affecting the users but also their families...
Source: The Health Care Blog - January 29, 2018 Category: Consumer Health News Authors: Matthew Holt Tags: Catalyst @ Health 2.0 Opioid Source Type: blogs

After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea - The New York Times
MUNICH — I recently had a hysterectomy here in Munich, where we moved from California four years ago for my husband's job. Even though his job ended a year ago, we decided to stay while he tries to start a business. Thanks to the German health care system, our insurance remained in force. This, however, is not a story about the benefits of universal health care.Thanks to modern medicine, my hysterectomy was performed laparoscopically, without an overnight hospital stay. My only concern about this early release was pain management. The fibroids that necessitated the surgery were particularly large and painful, and...
Source: Psychology of Pain - January 27, 2018 Category: Anesthesiology Source Type: blogs

Sexual Violence is Horrible, But First Look at Causes Outside the Brain
" At the brain level, empathy for social exclusion of personalized women recruited areas coding the affective component of pain (i.e., anterior insula and cingulate cortex), the somatosensory components of pain (i.e., posterior insula and secondary somatosensory cortex) together with the mentalizing network (i.e., middle frontal cortex) to a greater extent than for the sexually objecti fied women.This diminished empathy is discussed in light of the gender-based violence that is af flicting the modern society" (Cogoni et al., 2018).A new brain imaging paper onCyberball, social exclusion, objectification, and emp...
Source: The Neurocritic - January 10, 2018 Category: Neuroscience Authors: The Neurocritic Source Type: blogs

Narcan or Narcan’t?
​Part 2 in a Four-part Series​A 57-year-old man presented with acute onset altered mental status. His family said he had been behaving normally. Prior to dinner, however, he became difficult to arouse, and was speaking gibberish. He was somnolent but arousable to physical stimuli on arrival in the ED.He answered questions inappropriately and would then go back to sleep. His past medical history was consistent with hypertension, hypercholesterolemia, and spinal fusion a month ago. His medications included lisinopril, atorvastatin, and hydrocodone. His vital signs were a blood pressure of 110/65 mm Hg, heart rate of 90 b...
Source: The Tox Cave - January 2, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

PhRMA Releases New Policy Proposals
On December 11, 2017, the Pharmaceutical Research and Manufacturers of America (PhRMA) issued statements of support for several policy proposals focused on resolving the opioid crisis. The proposals included: limits on prescribing, a ban on prescribing of Schedule II opioids in an office setting, ongoing prescriber training, and expanded access to addiction treatment options. Along with the policy proposals came an announcement that PhRMA and the Addiction Policy Forum have entered into a multi-year, multi-million dollar initiative to combat the opioid crisis and implement the Forum's plan to help solve the opioid crisis....
Source: Policy and Medicine - December 21, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Don ’t let the opioid crisis affect the treatment course for your patients
Mrs. Smith is an 81-year-old female. She worked a long time doing very physical work and is now on a fixed income and comes to my office with chronic pain. X-rays show she has degenerative arthritis in her hips, knees and lumbar spine. She has taken Norco twice a day for years and has been able to be very stable on this. She has always been compliant with her medications. She has not lost them or had them stolen. She lives with her husband, and they use a safe where they keep their medications. The patient has done well with acupuncture and massage in the past but is not able to afford these, and her insurance doesn’...
Source: Kevin, M.D. - Medical Weblog - November 21, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/t-j-matsumoto" rel="tag" > T.J. Matsumoto, PA-C < /a > Tags: Meds Pain Management Primary Care Source Type: blogs

Digital Health Supports The Fight Against Opioids
The widespread U.S. opioid & overdose crisis is an ever-increasing tragic concern for everyone: writhing victims, family members being fain to see their relatives suffer or die, doctors prescribing opioid pain-killers what they thought before as safe, and regulators imposed to handle a tough situation. Addiction. It’s painful to even read about the skyrocketing numbers of people suffering, thus we decided to map how digital health could help tackle the opioid crisis. Why is it so difficult to deal with the opioid crisis? Once you become addicted, it sticks with you for a long time, if not for life, just as a...
Source: The Medical Futurist - November 14, 2017 Category: Information Technology Authors: nora Tags: Bioethics Mobile Health Virtual Reality in Medicine AI artificial intelligence data data analytics drugs future gc3 Innovation opioid opioid crisis pharma technology wearables Source Type: blogs

Drugstore pain pills as effective as opioids in ER patients - AP
Emergency rooms are where many patients are first introduced to powerful opioid painkillers, but what if doctors offered over-the-counter pills instead? A new study tested that approach on patients with broken bones and sprains and found pain relievers sold as Tylenol and Motrin worked as well as opioids at reducing severe pain.The results challenge common ER practice for treating short-term, severe pain and could prompt changes that would help prevent new patients from becoming addicted.The study has limitations: It only looked at short-term pain relief in the emergency room and researchers didn't evaluate how patient...
Source: Psychology of Pain - November 7, 2017 Category: Anesthesiology Source Type: blogs

The Modern-Day Plague
​Part 1 in a Four-part SeriesA 32-year-old man was taken to the ED by EMS after being found unresponsive in a subway station. His pupils were pinpoint, and he was breathing at fourth breaths per minute. He had a blood pressure of 94/63 mm Hg, pulse oximetry of 91% on room air, and a heart rate of 51 beats per minute. He was given 2 mg of intranasal Narcan by EMS and became more responsive, breathing at 14 breaths per minute with a blood pressure of 125/82 mm Hg, heart rate of 74 bpm, and 98% on room air. He admitted in the ED to using three bags of heroin.​The opioid epidemic is a national public health crisis in the U...
Source: The Tox Cave - November 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Reducing Opioid Abuse, A Quick Guide to Internet Resources
By DAVID HARLOW, MD The opioid crisis has been upon us for years now, and we are now seeing the problem become more pervasive, with more than 90 deaths per day in the U.S. due to this scourge. The president recently said he would be declaring a public health emergency (which would free up some funds) but has not done so as of this writing. The public health threat is so persistent that it calls for responses on many levels, and those responses are coming. Some have been in place for a while, some are more recent. These responses may be broken down into a number of different categories: Broader availability of naloxone (an...
Source: The Health Care Blog - November 1, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Charlie Baker Harlow Internet Massachussetts Opioid Opioid crisis Source Type: blogs

FDA Takes Important Steps to Stem the Tide of Opioid Misuse and Abuse
By Scott Gottlieb, M.D.  America is awash in immediate-release (IR) opioids. About 90 percent of all opioid pain medications prescribed – or 160 million prescriptions a year – are for IR formulations like hydrocodone and acetaminophen or oxycodone and acetaminophen … Continue reading → (Source: FDA Voice)
Source: FDA Voice - September 28, 2017 Category: American Health Source Type: blogs

The Case For Confronting Long-Term Opioid Use As A Hospital-Acquired Condition
The first principle of medicine is to “do no harm.” Over the past two decades, the medical community has attempted to honor this principle by treating patient pain with opioid prescriptions. Unfortunately, these good intentions have driven an epidemic of opioid addiction and drug overdoses, now the leading cause of accidental death in the United States. Inpatient overprescription of opioids such as morphine, oxycodone, and hydrocodone happens in a variety of ways—doctors prescribe too many doses, too large a dose, or allow patients to continue opioid treatment for too long. And many times, doctors could a...
Source: Health Affairs Blog - September 8, 2017 Category: Health Management Authors: Michael Schlosser, Ravi Chari and Jonathan Perlin Tags: Featured Health Professionals Hospitals Population Health hospital-acquired condition opioid epidemic overprescribing opioids pain management Source Type: blogs

Cutting down on opioids has made life miserable for chronic pain patients - Slate
On July 26, Todd Graham, 56, a well-respected rehabilitation specialist in Mishawaka, Indiana, lost his life. Earlier that day, a woman complaining of chronic pain had come to Graham's office in hope of receiving an opioid such as Percocet, Vicodin, or long-acting OxyContin. He reportedly told her that opioids were not an appropriate first-line treatment for long-term pain —a view now shared by professionals—and she, reportedly, accepted his opinion. Her husband, however, became irate. Later, he tracked down the doctor and shot him twice in the head.This horrific story has been showcased to confirm that phy...
Source: Psychology of Pain - August 30, 2017 Category: Anesthesiology Source Type: blogs

Opioid Abuse Up Among Older Adults
Source: U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), news release, July 26, 2017 “While *opioid abuse has fallen among younger Americans, the same cannot be said for older adults, a new government report shows. Rates of opioid abuse among young adults — aged 18 to 25 — decreased from 11.5 percent in 2002 to 8 percent in 2014. But in adults 50 years and older, opioid abuse doubled, from 1 percent to 2 percent, according to the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).” “These findings highlight the need for prevention programs for all a...
Source: BHIC - July 28, 2017 Category: Databases & Libraries Authors: Michelle Burda Tags: General Opioid Abuse and Addiction Public Health Senior Source Type: blogs