My 14 Year Old Cancer Patient May Be Addicted to Opioids. What Do I Do?
By JULIE KIM, MD
I’m a pediatric oncologist, but cancer is not always the most serious problem my young patients face. Currently one of them, a 14-year-old boy, his mother, or both may be opioid addicts. I may be enabling their addiction.
Tragically, their situation is not unique. Adolescent patients are at risk for addiction from opioid pain medications just as adult patients are. But pediatric patients are overlooked in this war against opioid addiction. No policies protect them or those caring for them.
Usually pain is short-term, and only limited opioids are needed. Most providers, including those caring for children...
Source: The Health Care Blog - October 25, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Cancer Julie Kim Opioids Source Type: blogs
Class Action Suits Over Opioid Epidemic Ramping Up
A coalition of 41 states' attorneys general have served five major opioid manufacturers with subpoenas seeking information about how these companies marketed and sold prescription opioids. The coalition is also demanding documents and information related to distribution practices from three drug distributors.
The investigative subpoenas and document requests were sent to pharmaceutical manufacturers Endo International, Janssen Pharmaceuticals, Teva Pharmaceutical Industries Ltd./Cephalon Inc. and Allergan. The group also served a supplemental investigative subpoena to Purdue Pharma. Documents were also requested of three ...
Source: Policy and Medicine - October 18, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
How the pain scale and patient satisfaction leads to death
Unless you’ve been living under a rock, you’re well aware that the United States is in the grip of a really big epidemic of opioid abuse. The epicenter of much of this has been my beloved Appalachia. My home-town, Huntington, WV, might as well be re-named “Oxycontin,” or maybe “Heroinville.” It’s ugly.
Enormous amounts of ink have been spilled on this topic, and I don’t intend to explain the genesis of it in detail. In short, however, about 20 years ago some doctors thought we weren’t being kind enough in our treatment of pain. Some articles were published to draw attention to th...
Source: Kevin, M.D. - Medical Weblog - October 9, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/edwin-leap" rel="tag" > Edwin Leap, MD < /a > Tags: Physician Emergency Medicine Hospital-Based Medicine Primary Care Source Type: blogs
The moment this physician realized she hated the pain scale
I was surprised when I felt my body stiffen as I became aware that an iPhone had just been fiercely thrown in my direction. “I’m calling security,” shouted a distant voice in the background.
“I want the 10 mg oxycodone pills! I am in 10/10 pain!” The patient shouted this to me as he abruptly got up, violently launched his phone in my direction and stomped toward the exit of the consult room.
Let’s rewind for a moment. This adolescent patient was already discharged from the hospital. I was called to the consult room to discuss the plan with his mom and to re-emphasize his pain management plan. Upon entering the ...
Source: Kevin, M.D. - Medical Weblog - October 6, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/cherilyn-cecchini" rel="tag" > Cherilyn Cecchini, MD < /a > Tags: Physician Hospital-Based Medicine Medications Oncology/Hematology 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
Too many pain pills after surgery: When good intentions go awry
As a physician with an interest in reducing opioid-related problems, I frequently hear stories from colleagues and friends about their loved ones who either struggle with opioid addiction or have even died from opioid-related overdose. My follow-up question to them is usually: “How did it begin?” Almost every time the answer is the same: the individual experienced acute pain either from a trauma or surgery, was started on opioids by a doctor, and then couldn’t quit.
My son’s baseball coach, who is not in the medical field, described it perfectly. He went in for a minor back surgery and was discharged with 60 tabl...
Source: Harvard Health Blog - September 11, 2017 Category: Consumer Health News Authors: Scott Weiner, MD Tags: Addiction Health Injuries Pain Management Surgery 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 avoid opi...
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
Dying at home: The problem hospices have with stolen opioids
Nothing seemed to help the patient — and hospice staff didn’t know why.
They sent home more painkillers for weeks. But the elderly woman, who had severe dementia and incurable breast cancer, kept calling out in pain.
The answer came when the woman’s daughter, who was taking care of her at home, showed up in the emergency room with a life-threatening overdose of morphine and oxycodone. It turned out she was high on her mother’s medications, stolen from the hospice-issued stash.
Continue reading ...
Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how...
Source: Kevin, M.D. - Medical Weblog - August 31, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/melissa-bailey" rel="tag" > Melissa Bailey < /a > Tags: Meds Pain Management Palliative Care Primary Care 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 physicians ...
Source: Psychology of Pain - August 30, 2017 Category: Anesthesiology Source Type: blogs
Did Medicaid Expansion Cause The Opioid Epidemic? There ’s Little Evidence That It Did.
Conclusion
Some Medicaid recipients who gained coverage under the ACA may have become addicted to opioids, but we find little evidence that Medicaid expansion caused aggregate drug-related death rates to increase. Future research on the opioid epidemic should develop approaches that untangle the effects of Medicaid expansion from pre-existing economic trends and the spread of accessible illegal drugs. That said, by addressing the causes of addiction and promoting appropriate treatment, Medicaid could be an important tool for policy makers in the fight against opioid abuse. In January 2016, the Centers for Medicare and Medi...
Source: Health Affairs Blog - August 23, 2017 Category: Health Management Authors: Andrew Goodman-Bacon and Emma Sandoe Tags: Following the ACA Medicaid and CHIP Public Health Quality Medicaid expansion opioid epidemic Source Type: blogs
It Seems Victoria Is Being Sensible In Getting Going On The Prescription Monitoring System.
This appeared last week:7 August 2017Victoria goes it alone on real-time monitoringPosted by Julie Lambert The Victorian government ’s decision to go it alone with a mandatory real-time prescription monitoring for high-risk medicines has exposed some disarray in the plans for a national scheme.Victoria’s Health Minister, Jill Hennessy, recently announced a $29.5 million plan to roll out the surveillance program to crack down on the misuse of dangerous prescription drugs within the next year, including $1 million to train doctors and pharmacists.“In an Australian first, and following worldwide best practice, using the...
Source: Australian Health Information Technology - August 15, 2017 Category: Information Technology Authors: Dr David More MB PhD FACHI Source Type: blogs
Ultrasound Controls Delivery of Local Anesthetic Just When and Where It Hurts
Localized pain caused by disease, injury, or surgery can be hard to control, and it leads too many people to use opioids. Though there are electronic and physical methods that can help manage some pain, these are typically only marginally effective and usually only work on targets close to the skin. Now a team from Boston Children’s Hospital has come up with a way to use ultrasound to trigger the release of an anesthetic previously injected into the affected region.
The anesthetic is encapsulated within liposomes, tiny sacks made of lipids derived from cellular membranes. The walls of the liposomes are also seeded wi...
Source: Medgadget - August 10, 2017 Category: Medical Devices Authors: Editors Tags: Anesthesiology Nanomedicine Pain Management Surgery Source Type: blogs
More Than 1 Million Young Caregivers Live In the United States, But Policies Supporting Them Are Still ‘Emerging’
Being a family caregiver today is a demanding responsibility. If caregiving is stressful for the “typical” caregiver—a 49-year-old woman—think how much more is at stake when the caregiver is a child or teenager. Yet more than a million youngsters ages 8–18 take on challenging tasks to help a parent, grandparent, sibling, or other relative. While that number is undoubtedly an underestimate, it does not even include an emerging subgroup—children whose parents are struggling with opioid addiction.
If we have limited information about the young people taking care of those with diabetes, cancer, and ...
Source: Health Affairs Blog - August 7, 2017 Category: Health Management Authors: Carol Levine Tags: Featured Population Health Public Health Quality Agnes Leu child caregivers family caregivers National Alliance for Caregiving Saul Becker United Hospital Fund 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
The stupidity epidemic is far more lethal than the opioid epidemic
Substance abuse and overdose deaths are nothing new. People who use opioids are dying, and they will keep dying until we learn how to fix our bigger problem: the “stupidity epidemic.” We see and hear about the opioid epidemic every single day in the media, but no one is talking about the epidemic of stupidity, both in the medical and non-medical communities. We have thrown time, money and even tears at the opioid problem, yet we have failed to address the real problem that was created in the mid-1990’s when Oxycontin began saturating the market with its false claims as a non-addictive solution to our nation’s most ...
Source: Kevin, M.D. - Medical Weblog - July 27, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jay-joshi" rel="tag" > Jay Joshi, MD < /a > Tags: Physician Medications Source Type: blogs
