Part 3 - Opioids Have Ceiling Effects, High-Doses are Rarely Therapeutic, and Another Hand-Crafted Graph
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 3rd post in a series about opioid, 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 DosesThis is Part 3 – Opioids Have Ceiling Effects, High-Doses are Rarely Therapeutic, and Another ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - October 4, 2019 Category: Palliative Care Tags: opioids pain rosielle The profession Source Type: blogs
Is the DEA Branching Out Into Regulating Medicine?
Jeffrey A. SingerThe Drug Enforcement Administration, having virtually eliminated the diversion of prescription pain relievers into the underground market for nonmedical users, appears to be setting its sights on regulating the medical management of pain, a mission not suited for law enforcement. Acting under the authority of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act), the DEA announced a proposal to reduce, once again, the national production quotas for fentanyl, morphine, hydromorphone (Dilaudid), oxycodone, and oxymorphone, bringing...
Source: Cato-at-liberty - September 23, 2019 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
NJ Appellate Court Overturns Suspension of Aid-in-Dying Law
This morning, a New Jersey appellate court overturned a superior court’s temporary restraining order that had suspended the state’s new medical aid-in-dying law.
The court’s ruling stated: “Having reviewed the record against the applicable law, we conclude the court abused its discretion in awarding preliminary injunctive relief...Accordingly, we dissolve the restraints issued pursuant to the August 14, 2019 order.”
The appellate court ruling reinstated the law, which originally took effect on Aug. 1. Now, terminally ill state residents will be able to use it to peacefully end their suff...
Source: blog.bioethics.net - August 27, 2019 Category: Medical Ethics Authors: Thaddeus Mason Pope, JD, PhD Tags: Health Care syndicated Source Type: blogs
The March Toward a Pre-Modern Approach to the Treatment of Pain Continues, Undeterred by Science
It seems that no amount of data-driven information can get policymakers to reconsider the hysteria-driven pain prescription policies they continue to put in place.I can understand lay politicians and members of the press misconstruing addiction and dependency, but there is no excuse when doctors make that error. Yet National Public Radio reports that surgeons in 18 Upstate New York hospitals have agreed on an initiative to limit the amount of pain medicine they will prescribe to postoperative patients discharged from the hospital. The reporter says that researchers “now know” that patients prescribed opioids for pos...
Source: Cato-at-liberty - August 12, 2019 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Data From Germany Provide More Reasons For Policy to Shift From Prescription Pills to Harm Reduction
In February of this year, I co-authored a paper in the Journal of Pain Research explaining why there is no correlation between the amount of opioids prescribed and the incidence of non-medical use or prescription pain-reliever use disorder. That same month my colleague Jeffrey Miron and co-authors revealed similar findings in this Cato Institute Policy Analysis.Now researchers in Germany have provided more evidence to pour cold water on the idea of any relationship between the volume of opioid prescribing and the incidence of opioid use disorder. Publishing in the German Medical Association’s international...
Source: Cato-at-liberty - August 1, 2019 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
When Addiction is Stigmatized and Criminalized We All Lose
In a recent Wall Street Journal column entitled Even Heroes Can Struggle With Addiction, Timothy McMahan King offers convincing evidence that the great British abolitionist and statesman, William Wilberforce, responsible for ending the slave trade within the British Empire in 1807, was an opium addict for much of his adult (and productive) life. Because of the stigma attached to addiction, most historians and biographers have hidden, ignored, or buried that fact.Similarly, few of us who rely mainly on the history lessons we received in high school are aware of the regular and (by today ’s standards) excessive use o...
Source: Cato-at-liberty - July 21, 2019 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Why Do I Have to Keep Using More to Get High?
When using drugs or alcohol, you may start to find that you need to keep using more to get high than you did when you first started. When a couple of glasses of wine used to get you plenty drunk, you’re finding that you need a full bottle or even more. This is called building tolerance and can cause some damaging effects to the body, including leading to addiction and death.
Using More to Get High: Building Tolerance
According to the National Institute on Drug Abuse, tolerance occurs when the person no longer responds to the drug in the way that person initially responded. Stated another way, it takes a higher dose of t...
Source: Cliffside Malibu - July 17, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Addiction Addiction Recovery Alcohol Alcoholism Drug Treatment Substance Abuse alcohol addiction alcohol dependence alcohol dependency alcohol detox alcohol disorder drug addiction drug addiction recovery drug addiction treatment Source Type: blogs
Eat, Pray, Push
Here’s an excerpt from chapter 4 of Wheat Belly Total Health, Your Bowels Have Been Fouled: Intestinal Indignities From Grains:
“A condition as pedestrian as constipation serves to perfectly illustrate many of the ways in which grains mess with normal body functions, as well as just how wrong conventional ‘solutions’ can be. Constipation remedies are like the Keystone Kops of health, stumbling, fumbling, and bumping into each other, but never quite putting out the fire.
“Drop a rock from the top of a building and it predictably hits the ground—not sometimes, not half the time, but every time. That’s how the b...
Source: Wheat Belly Blog - June 25, 2019 Category: Cardiology Authors: Dr. Davis Tags: News & Updates Gliadin gluten grain-free wheat belly Wheat Belly Total Health Source Type: blogs
Thunderclap headache: The “worst headache of my life”
Not all headache disorders are the same. An excruciating, sudden-onset headache known as thunderclap headache (TCH) is a medical emergency, very different from more common headache disorders such as migraine and tension headache. If you develop TCH, you should call 911 or immediately go to the closest hospital.
TCH is associated with a variety of causes, ranging from benign to potentially fatal. Urgent evaluation in an emergency setting is needed to quickly identify and treat any underlying condition.
Diagnosing and treating secondary thunderclap headache
When you arrive at the hospital, the medical team will want to confi...
Source: Harvard Health Blog - June 25, 2019 Category: Consumer Health News Authors: Aneesh Singhal, MD Tags: Headache Health Source Type: blogs
Is tramadol a risky pain medication?
All medications come with a dose of risk. From minor side effects to life-threatening allergic reactions, every decision to take a medication should be made only after the expected benefits are weighed against the known risks. You aren’t on your own in this: your doctor, your pharmacist, and a trove of information are available for your review. Recently, I wrote about how newly approved drugs often accumulate new warnings about their safety, including a gout medication that garnered a new warning due to an increased risk of death. Now, according to a new study, the common prescription pain medication tramadol may earn a...
Source: Harvard Health Blog - June 14, 2019 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Addiction Pain Management Source Type: blogs
The Brain Stage: The Power & Promise of The Cephalic Phase for Health
Listen to the Podcast or Read the Transcript
[00:00:03] Hi I’m Dr. Alan Greene pediatrician and I’d like to talk with you tonight about The Brain Stage.
[00:00:10] I remember vividly when I was a pediatric resident in training go to a Grand Rounds about a surprising topic.
[00:00:18] The function of the brain and the function of the skin and one of the things that dermatologists talked about was a common procedure freezing warts. Freezing warts was then, and is still, one of the most common ways to get rid of warts. What she talked about was how wildly different the results were in different studies. People use...
Source: Conversations with Dr Greene - May 23, 2019 Category: Child Development Authors: Dr. Alan Greene Tags: Dr. Greene's Blog Uncategorized Cephalic Phase Placebo The Brain Stage Source Type: blogs
The Brain Stage: The Power & Promise of The Cephalic Phase for Health
Listen to the Podcast or Read the Transcript
[00:00:03] Hi I’m Dr. Alan Greene pediatrician and I’d like to talk with you tonight about The Brain Stage.
[00:00:10] I remember vividly when I was a pediatric resident in training go to a Grand Rounds about a surprising topic.
[00:00:18] The function of the brain and the function of the skin and one of the things that dermatologists talked about was a common procedure freezing warts. Freezing warts was then, and is still, one of the most common ways to get rid of warts. What she talked about was how wildly different the results were in different studies. Peo...
Source: Conversations with Dr Greene - May 23, 2019 Category: Child Development Authors: Alan Greene MD Tags: Dr. Greene's Blog Uncategorized Cephalic Phase Placebo The Brain Stage Source Type: blogs
Undoing the harm: Tapering down from high-dose opioids
For many years, health care providers like me were told that we were undertreating pain and that pain was a vital sign that needed to be measured. Concurrently, we were reassured that opioids were a safe and effective way to treat pain, with very little potential for development of abuse. As a result, opioid prescriptions in the United States skyrocketed. A common way to compare opioids is to calculate their strength relative to morphine, called morphine milligram equivalents, or MMEs. In 1992, our country dispensed 25 billion MMEs of prescription opioids; by 2011, that number had reached 242 billion. Meanwhile, opioid-rel...
Source: Harvard Health Blog - May 10, 2019 Category: Consumer Health News Authors: Scott Weiner, MD Tags: Addiction Pain Management Risks and Prevention 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 7, 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
