Why do so few doctors treat people with opioid addictions?
Dear Doctor,
Please help me understand why so few of you have chosen to treat people with opioid addictions.
I’ve been following the topic of opioid addiction for years. It is one of the most common themes for First Opinion submissions. Authors routinely point to the importance of medication-assisted therapy, the standard of care for individuals with opioid addiction (a term that those in the know tell me I should replace with opioid use disorder). That means treatment with methadone, buprenorphine, naltrexone, or combinations of these — medications you could prescribe if you wanted to.
The surgeon general’s repor...
Source: Kevin, M.D. - Medical Weblog - July 15, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/patrick-skerrett" rel="tag" > Patrick Skerrett < /a > Tags: Conditions Medications Primary Care Public Health & Policy Source Type: blogs
Methadone and Mixed Messages
As a physician licensed to prescribe narcotics, I am legally permitted to prescribe the powerful opioid methadone (also known by the brand name Dolophine ) to my patients suffering from severe, intractable pain that hasn ’t been adequately controlled by other, less powerful pain killers. Most patients I encounter who might fall into that category are likely to be terminal cancer patients. I’ve often wondered why I am approved to prescribe methadone to my patients as a treatment for pain, but I am not allowed to prescribe methadone to taper my patients off of a physical dependence they may have developed from lo...
Source: Cato-at-liberty - July 13, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
ResQ is Using Games to Fight Opioid Addiction: Interview with Dr. Paul Glimcher
Earlier this year at the Health 2.0 WinterTech Conference, the Robert Wood Johnson Foundation (RWJF) and Catalyst @ Health 2.0 launched the RWJF Opioid Challenge, an initiative aimed at bringing together healthcare and technology innovators to solve a growing epidemic of addiction in the United States. A panel of 19 judges evaluated 97 initial submissions based on innovation, scalability, and overall design and intuitiveness of the solution, resulting in five semifinalists.
Resilience IQ (ResQ)
Hey, Charlie
Luceo/Canary App
Sober Grid
HashTag
Preparation for Phase 2 of the competition is underway with final submission...
Source: Medgadget - June 14, 2018 Category: Medical Devices Authors: Michael Batista Tags: Exclusive Medicine Net News Pain Management Psychiatry Public Health Rehab Source Type: blogs
The struggles of women in recovery during pregnancy
“I just don’t get it,” sighed the young mother, who was propped up in a hospital rocking chair, nursing her beautiful two-day-old infant. Mary (not her real name) continued, “I’ve been doing everything right. I have a job, an apartment, I pay my bills, and look” – Mary nods towards a shiny new black and pink infant car-seat sitting in the corner, “I even have a car seat. I’m ready.” As one of the pediatricians on the medical team caring for her baby, I had just explained to Mary that someone from the state social services office was going to be coming to investigate her case – and she was struck with ...
Source: Kevin, M.D. - Medical Weblog - May 27, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/rachel-alinsky" rel="tag" > Rachel Alinsky, MD < /a > Tags: Physician OB/GYN Source Type: blogs
6 ways to address the opioid epidemic
The devastating opioid epidemic is one of the largest public health problems facing the U.S. Over 2.5 million people in the U.S. suffer from opioid use disorder.
Four in five new heroin users started out misusing prescription painkillers. A 2015 analysis by the Centers for Disease Control and Prevention found people who are addicted to painkillers are 40 times more likely to be addicted to heroin.
The epidemic actually began more than three decades ago. In 1980, crack and cocaine addiction contributed to the thousands of overdose deaths, whereas now people die from pain relievers and synthetic opioids such as fentanyl.
In ...
Source: Kevin, M.D. - Medical Weblog - May 18, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/nabila-el-bassel" rel="tag" > Nabila El-Bassel, PhD < /a > Tags: Conditions Pain Management Public Health & Policy Source Type: blogs
PrEP: Protection against HIV in a pill?
HIV (the human immunodeficiency virus) weakens the human immune system and destroys the important cells that fight disease and infection. A person can get HIV when bodily fluids — including blood, semen, pre-seminal fluid, rectal fluids, or vaginal fluids of a person with the virus — come in contact with a mucous membrane or damaged tissue. HIV can be transmitted through breast milk, or when a contaminated needle or syringe comes into direct contact with the bloodstream.
There is no cure for HIV, but with proper medical care the virus and its effects can be controlled. HIV transmission can be reduced by consistent use ...
Source: Harvard Health Blog - May 18, 2018 Category: Consumer Health News Authors: Meera Sunder, MBBS, MRCOG Tags: Health HIV Infectious diseases Source Type: blogs
Are “Fatal” Opioid Concentrations Really Fatal?
When medical examiners conclude that the cause of death is opioid overdose, they rely primarily on the opioid blood concentration level in comparison to a pre-determined “fatal” cutoff. This approach is potentially inaccurate; the fatal ranges used are wide, and they overlap significantly with the ranges for living opioid users.Numerous fatal ranges have been quoted for methadone:220-3040 μg/L (mean, 1371),320-2980 μg/L (mean, 772), and600-3000 μg/L. Baselt’sDisposition of Toxic Drugs and Chemicals in Man found fatal levels of 400-1800 μg/L (mean, 1000) and 60-3100μg/L (mean, 280). These ranges are much too bro...
Source: Cato-at-liberty - May 14, 2018 Category: American Health Authors: Jeffrey Miron Source Type: blogs
Primary care physicians are on the front line of the opioid epidemic. Help them.
When it comes to the opioid epidemic, physicians are some of the best drug dealers around with almost unrestricted access to the purest substances. As the opioid epidemic spirals out of control, physicians continue to be able to provide their patients with a variety of options, including oxycodone, morphine and fentanyl. Many people would be surprised to know that physicians don’t need any additional training to prescribe opiates to their patients especially considering that 40 percent of opioid deaths last year involved a prescription medication. But paradoxically, if physicians want to treat opioid addiction, they are ...
Source: Kevin, M.D. - Medical Weblog - May 1, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/arjun-gokhale-and-john-huston" rel="tag" > Arjun Gokhale, MD and John Huston, MD < /a > Tags: Conditions Pain Management Primary Care Source Type: blogs
Cutting the red tape with buprenorphine treatment for opioid use disorder
Tuesday morning. Sarah wakes up at 4 a.m., like every other morning, to go to clinic to get a medicine she cannot function without. But it’s not as easy as that. She has to take her three small children with her because she is a single parent and has no one else to stay at home with them. She does this six days a week. This is her life. This is the reality of methadone clinics, and as a family physician, I worry about the impact this is having on the health and well-being of her family.
The opioid epidemic is increasingly being recognized as one of the largest health care problems facing our nation, and medicatio...
Source: Kevin, M.D. - Medical Weblog - April 10, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/christina-kinnevey" rel="tag" > Christina Kinnevey, MD < /a > Tags: Meds Pain Management Primary Care Source Type: blogs
A Pediatric OT's Screed on Trauma Informed Care (2015) - Three years later: Have we made progress?
Maybe some.A couple years ago I wrote this ' screed ' on trauma informed care (TIC) models. My concerns at the time were related to the lack of direct intervention that was promoted as part of this model - and that it appeared that some OTs were adopting a social work approach to the issue.Last night there was an #OTalk2Us twitter conversation about these models; I was not able to participate but I have been studying the conversation. I think that this is a good opportunity to see if we are progressing ideas on TIC to be more occupational therapy directed and intervention-focused.It was good to see more convers...
Source: ABC Therapeutics Occupational Therapy Weblog - April 2, 2018 Category: Occupational Health Tags: OT practice school-based practice Source Type: blogs
Help for Heroin Addiction
A couple comments for regular readers… first, watch for an upcoming change to a new name. For years I’ve debated whether to adopt a name centered on ‘buprenorphine’, rather than the more-recognizable ‘Suboxone’. I believe that time has come. Second, I’m going to ‘reset’ with some introductory comments about the proper approach to treating heroin addiction, intended for those who are seeking help – starting with this post.
I’m addicted to heroin. Which treatment should I use?
I’ve treated heroin addiction in a range of settings, including ab...
Source: Suboxone Talk Zone - March 27, 2018 Category: Addiction Authors: admin Tags: Addiction Clean Enough treatment addiction treatment Buprenorphine heroin addiction medication assisted treatment Methadone Source Type: blogs
Help for Heroin Addiction
A couple comments for regular readers… first, watch for an upcoming change to a new name. For years I’ve debated whether to adopt a name centered on ‘buprenorphine’, rather than the more-recognizable ‘Suboxone’. I believe that time has come. Second, I’m going to ‘reset’ with some introductory comments about the proper approach to treating heroin addiction, intended for those who are seeking help – starting with this post.
I’m addicted to heroin. Which treatment should I use?
I’ve treated heroin addiction in a range of settings, including ab...
Source: Suboxone Talk Zone - March 27, 2018 Category: Addiction Authors: admin Tags: Addiction Clean Enough treatment addiction treatment Buprenorphine heroin addiction medication assisted treatment Methadone Source Type: blogs
Help for Heroin Addiction
A couple comments for regular readers… first, watch for an upcoming change to a new name. For years I’ve debated whether to adopt a name centered on ‘buprenorphine’, rather than the more-recognizable ‘Suboxone’. I believe that time has come. Second, I’m going to ‘reset’ with some introductory comments about the proper approach to treating heroin addiction, intended for those who are seeking help – starting with this post.
I’m addicted to heroin. Which treatment should I use?
I’ve treated heroin addiction in a range of settings, including a...
Source: Suboxone Talk Zone - March 27, 2018 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Clean Enough treatment addiction treatment Buprenorphine heroin addiction medication assisted treatment Methadone Source Type: blogs
Can You Prevent Relapse with Mindful Meditation?
Mindfulness meditation teaches people how to accept suffering as a normal, cohesive experience, and then move on from it.
Relapse has always been a harsh reality of addiction, but as the opioid black market fills with powerful synthetics, relapse on heroin and similar drugs grows increasingly dangerous. Fatal overdoses nearly doubled between 2015 and 2016 — the majority of which are attributed to opioid-based drugs.
We are bombarded daily with news headlines — some factual, some fictitious — announcing the newest therapy, or the latest hysteria-provoking scare (does death by fentanyl dust at the grocery s...
Source: World of Psychology - March 25, 2018 Category: Psychiatry & Psychology Authors: Psych Central Staff Tags: Addiction Alcoholism Disorders Mindfulness Publishers Recovery Substance Abuse The Fix Mindfulness Meditation Relapse Source Type: blogs
Politicians Cannot Stop Punishing Patients for the Unintended Consequences of Drug Prohibition
It seems no amount of evidence can make political leaders disabuse themselves of the misguided notion that the nation ’s opioid overdose crisis is caused by doctors getting patients hooked on prescription opioids. A group of eight senatorsunveiled the CARA(Comprehensive Addiction and Recovery Act) 2.0 Act on February 27, targeting the opioid crisis. It would impose a 3-day limit on all opioid prescribing for patients in acute and outpatient postoperative pain.But the movement to restrict prescriptions is not evidence-based, as prominent experts havepointed out. The politicians base their proposal on the 2016 opioidguidel...
Source: Cato-at-liberty - February 28, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
