The widespread use of fentanyl escalates the risk of overdose
A fentanyl overdose led to the recent death of musician and singer Prince, according to the medical examiner’s report released June 2. The drug seems likely to become as notorious as propofol did after the death of Michael Jackson in 2009.
For all of us in anesthesiology who’ve been using fentanyl as a perfectly respectable anesthetic medication and pain reliever for as long as we can remember, it’s startling to see it become the cause of rising numbers of deaths from overdose. Fentanyl is a potent medication, useful in the operating room to cover the intense but short-lived stimulation of surgery. The onset of a...
Source: Kevin, M.D. - Medical Weblog - June 30, 2016 Category: Journals (General) Authors: Karen S. Sibert, MD Tags: Physician Medications Pain management Source Type: blogs
Opioid Prescriptions Drop for Three Years in a Row
For the first time in decades, the number of opioid prescriptions in the United States is starting to fall, according to a recent report by the New York Times based on data from IMS Health For each of the past three years – 2013, 2014, and 2015 – prescriptions for opioids have declined. This marks the first sustained drop since OxyContin hit the market in 1996.
Some experts believe that the drop is an early signal that the long-running and often-discussed opioid epidemic may have reached its peak and that doctors and prescribers have begun to heed the warnings about the highly addictive nature of the drugs. It's also...
Source: Policy and Medicine - June 28, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
How pain scores escalated the opioid crisis
“It’s an 8,” I heard him say from behind the curtain as I walked into the room.
The nurse’s aide dutifully recorded the number while the automated blood pressure cuff searched for his pulse, and the plastic clip on the tip of his index finger measured his oxygen saturation.
“What does an 8 mean?” I asked.
“Oxycodone!” he chirped cheerfully, without a moment’s hesitation. “An 8 means oxycodone. Five milligrams!”
“Ah, but you’re wrong,” I corrected him. “An 8 means intravenous morphine to your nurse. Have you asked for Vicodin?”
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Source: Kevin, M.D. - Medical Weblog - June 10, 2016 Category: Journals (General) Authors: Mark Vierra, MD Tags: Physician Medications Source Type: blogs
Fame and Fentanyl
By KAREN SIBERT, MD
A fentanyl overdose led to the recent death of musician and singer Prince, according to the medical examiner’s report released June 2. The drug seems likely to become as notorious as propofol did after the death of Michael Jackson in 2009.
For all of us in anesthesiology who’ve been using fentanyl as a perfectly respectable anesthetic medication and pain reliever for as long as we can remember, it’s startling to see it become the cause of rising numbers of deaths from overdose. Fentanyl is a potent medication, useful in the operating room to cover the intense but short-lived stimulation of sur...
Source: The Health Care Blog - June 7, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Fetanyl Source Type: blogs
Fame and Fetanyl
By KAREN SIBERT, MD
A fentanyl overdose led to the recent death of musician and singer Prince, according to the medical examiner’s report released June 2. The drug seems likely to become as notorious as propofol did after the death of Michael Jackson in 2009.
For all of us in anesthesiology who’ve been using fentanyl as a perfectly respectable anesthetic medication and pain reliever for as long as we can remember, it’s startling to see it become the cause of rising numbers of deaths from overdose. Fentanyl is a potent medication, useful in the operating room to cover the intense but short-lived stimulation of sur...
Source: The Health Care Blog - June 7, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Fetanyl Source Type: blogs
Senator Durbin Asks Medical Associations to Endorse Mandatory Opioid CME – AMA Shows Interest
Following last month's letter to the Pharmaceutical Research and Manufacturers of America (PhRMA), asking the group to "take financial responsibility for the drug industry's role in curtailing the opioid overdose epidemic," United States Senator Dick Durbin sent a letter to four physician associations asking them to endorse mandatory CME programs.
The letter, which was sent to the American Medical Association (AMA), the American Academy of Family Physicians (AAFP), the American College of Emergency Physicians (ACEP), and the American Dental Association (ADA), noted several steps the Senator feels as though the associatio...
Source: Policy and Medicine - May 19, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Acetaminophen Probably Isn't an " Empathy Killer "
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Source: The Neurocritic - May 17, 2016 Category: Neuroscience Authors: The Neurocritic Source Type: blogs
Acetaminophen Probably Isn't an "Empathy Killer"
Left: Belgian physician Dr. Wim Distelmans, a cancer specialist, professor in palliative care and the president of the Belgian federal euthanasia commission. Right: Generic acetaminophen.What (or who) is an “Empathy Killer“? An Angel of Death Kevorkian-type who helps terminally ill patients with ALS or cancer put an end their excruciating pain? This is a very selfless act that shows extreme empathy for the suffering of others.Or is an “Empathy Killer” a medication that dulls your numerical ratings of empathic concern for fictional characters ever so slightly? If you guessed the latter, you are correct. Here's the a...
Source: The Neurocritic - May 17, 2016 Category: Neuroscience Authors: The Neurocritic Source Type: blogs
Treating Pain Without Feeding Addiction at ‘Ground Zero’ for Opioids - The New York Times
BRIDGEPORT, W.Va. — The doctors wanted to talk about illness, but the patients — often miners, waitresses, tree cutters and others whose jobs were punishingly physical — wanted to talk only about how much they hurt. They kept pleading for opioids like Vicodin and Percocet, the potent drugs that can help chronic pain, but have fueled an epidemic of addiction and deadly overdoses.
"We needed to talk about congestive heart failure or diabetes or out-of-control hypertension," said Dr. Sarah Chouinard, the chief medical officer at Community Care of West Virginia, which runs primary care clinics across a big rur...
Source: Psychology of Pain - May 12, 2016 Category: Anesthesiology Source Type: blogs
“@deathunderglass is taking over...
"@deathunderglass is taking over the@muttermuseum@instagram account this week to showcase some of the specimens in the museum collection related to forensic science!@deathunderglass is a collaboration between a forensic pathologist and forensic photographer that generates images of human tissue at high magnification. We tend to think that drug abuse is a social issue that popped up in the last 50 years. Think again - the history of drug abuse in America goes back quite a long way. Elixirs, tonics, and tablets containing cocaine were incredibly popular from the 1850s to the early 1900s and its use was promoted by medical l...
Source: Kidney Notes - May 10, 2016 Category: Urology & Nephrology Authors: Joshua Schwimmer Source Type: blogs
Let’s Put Opioids For Treating Addiction On Equal Footing With Prescribing Opioids For Pain
Hidden beneath our discussions about the opiate epidemic is the harm created by the contradictory, asymmetric approach taken by medical leadership and policymakers towards how physicians prescribe opiates for pain versus how they treat opiate addiction with medications, specifically buprenorphine.
The imbalance is transparent. Based on 2012 data, nearly all 1 million physicians could prescribe prescription opiates. This resulted in over 259 million prescriptions being written for opioid painkillers in the United States, enough for each adult to have at least one prescription. That same year, less than 23,000 physicians cou...
Source: Health Affairs Blog - May 10, 2016 Category: Health Management Authors: Krisda Chaiyachati and Jeffrey Hom Tags: Costs and Spending Drugs and Medical Technology Equity and Disparities Featured Health Professionals Medicaid and CHIP Public Health Quality Buprenorphine Drug Enforcement Administration medication-assisted treatment Opioid Addiction Source Type: blogs
Tell Me a Real Story
by Staci Mandrola Charlotte is three and a half years old. She loves stories. I tell real stories. John tells made up stories. The first words we hear when Charlotte walks in the house are “Tell me a story, PaPa!” Stories put me on a path more than 40 years ago. The path to being a doctor and then a hospice and palliative medicine doctor. I listened to my grandmother tell stories about her physician father leaving the house to check on a woman in labor or a dying patient. He might not return for days. His payment ranged from a chicken to a milk cow to a beat up John Deere. I listened to my dermatologist father tell the...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 10, 2016 Category: Palliative Care Tags: mandrola narrative physician The profession Source Type: blogs
Why I stopped prescribing narcotics, and never looked back
I was never a big prescriber of narcotics. I grew up “country,” in a tougher world where your parents taught you to accept pain as a part of life. Pain is how you know you’re still alive. They’d tell me, “if you’re hurtin’ you ain’t dead yet.” You fell down; it was going to hurt. You learned not to fall. Twisted your ankle doing something stupid (and it was always while doing something stupid, like jumping off the roof), well we’ll wait a day or two and see how it goes. Put ice on it, and next time think harder before you jump off the roof. Just because everyone else was doing it, yada y...
Source: Kevin, M.D. - Medical Weblog - April 10, 2016 Category: Journals (General) Authors: Alan G. Berg, DO Tags: Physician Pain management Source Type: blogs
Ultrasound: Foreign Body Removal
Part 2 in a SeriesAre you ready for summer? That means more bare feet, flip-flops, and the potential for foreign bodies of the foot and toe. We will continue to highlight tools and tricks to help you master soft tissue foreign body removal in the emergency department. A refresher on the basics of ultrasound is available in our blog post from last month: http://emn.online/1UGtduz.Foreign bodies of the toe or foot are common presentations in emergency departments, and one way to determine the size and shape of retained superficial foreign bodies is to use ultrasound and the linear probe. This simple technique may hel...
Source: The Procedural Pause - April 1, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
