Buprenorphine Overdose After Naltrexone Treatment
Naltrexone induces mu-receptor hypersensitivity.  Buprenorphine’s protective ‘ceiling effect’ may not prevent overdose in patients with this ‘reverse tolerance’. A new patient described his recent history of respiratory failure several days into buprenorphine treatment.  He was told by his doctors that he experienced an allergic reaction to Suboxone. The rarity of buprenorphine or naloxone allergy led me to look deeper into his history, and my conclusion differs from what he was told by his last treatment team. The patient, a man in his mid-50s, has a history of significant opioid use over t...
Source: Suboxone Talk Zone - February 15, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Buprenorphine Induction pharmacology receptor actions side effects Suboxone tolerance buprenorphine induction buprenorphine overdose naltrexone treatment Suboxone after vivitrol Suboxone allergy Source Type: blogs

Drug Wholesalers to Pay $36 Million Over West Virginia Pill Mill Claims
Two prescription drug wholesalers – AmerisourceBergen Corp. and Cardinal Health Inc. – will pay $16 million and $20 million, respectively, to resolve West Virginia’s claims relating to their distribution of controlled substances in the state, according to Governor Earl Ray Tomblin. The settlement – in which neither company admitted to any wrongdoing – is believed to be the largest pharmaceutical settlement in state history, after lawsuits dragged on for more than four years in Boone County Circuit Court and spanned the terms of two attorneys general. In 2012, McGraw filed lawsuits against Cardinal Health, Ameris...
Source: Policy and Medicine - February 12, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Bad HIT in pharmacy: Hospital to pay half million dollar fine after pharmacist's drug theft
This is an example where bad health IT in an " infrastructure " system (as opposed to a clinician-facing system) led to a quite unfortunate outcome for the community.Bad Health IT ( " BHIT " ) is defined as IT that is ill-suited to purpose, hard to use, unreliable, loses data or provides incorrect data, is difficult and/or prohibitively expensive to customize to the needs of different medical specialists and subspecialists, causes cognitive overload, slows rather than facilitates users, lacks appropriate alerts, creates the need for hypervigilance (i.e., towards avoiding IT-related mishaps) that increases stress, is l...
Source: Health Care Renewal - February 12, 2017 Category: Health Management Tags: Abington Memorial Hospital bad health IT bad phamacy IT DEA healthcare IT risks US Attorney ' s Office Source Type: blogs

Opioid Induced Hyperalgesia Prevented by Buprenorphine?
“Buprenorphine is a kappa receptor antagonist. For these reasons, buprenorphine might be unique in its ability to treat chronic pain and possibly OIH.” The opioid crisis has been fueled by the use of opioids to treat chronic pain.  Practice patterns have changed, but doctors are still criticized for their roles in the overuse of opioids.  I’ve sat through community ‘heroin forums’ (sometimes on stage) as sheriffs, politicians, and ‘recovered addicts’ firmly pointed fingers at health professionals.  I, meanwhile, kept my finger under the table, but had the thought that some of the people pointing ...
Source: Suboxone Talk Zone - February 5, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Acute Pain Buprenorphine Chronic pain Suboxone treatment buprenorphine treats chronic pain chronic pain treatment opioid induced hyperalgesia opioid pain relief pain vs. addiction Source Type: blogs

Medications that Increase the Risks of Falling
Falls are the leading cause of both fatal and non-fatal injuries for adults 65 and older, and research suggests that those taking four or more medications are at an even greater risk than those who don ’t.ByAlzheimer's Reading RoomWhat ’s the Difference Between Alzheimer’s and DementiaHow to Test Your Memory for Alzheimer's and DementiaHow to Get Answers To Your Questions About Alzheimer's and Dementia“Falls are the leading cause of both fatal and non-fatal injuries for adults 65 and older, and research suggests that those taking four or more medications are at an even greater risk than those who don’t – perhap...
Source: Alzheimer's Reading Room, The - February 1, 2017 Category: Neurology Tags: alzheimer's care care of dementia patients dementia care health help alzheimer's help with dementia care medications falls Prescription Medications Risks risk of falling senior care Source Type: blogs

Oxycontin: America ’s next new export
The health care system has been devastated by the opioid epidemic. Addictive opiate medications have not been shown to benefit patients with chronic pain, yet they are the most prescribed pills in the United States. As a pain management physician, I have seen opiates, when in the wrong hands, destroy lives. As doctors and health care organizations scramble to treat more than 2 million Americans suffering from opioid addiction, drug companies look to expand their brand. Recently, Mundipharma, a global network of pharmaceutical corporations, began a worldwide marketing campaign for Oxycontin, the drug at the heart of America...
Source: Kevin, M.D. - Medical Weblog - January 26, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/ankur-dave" rel="tag" > Ankur Dave, MD < /a > Tags: Meds Medications Source Type: blogs

Chronic Pain and the Opioid Epidemic: Wicked Issues Have No Simple Solutions
Written By Myra ChristopherMy mom was a steel magnolia (i.e., southern and perfectly charming), but she had a steel rod up her back. After her first surgery for stomach cancer at age 53, she refused pain medication because she said that she “could take it.” She was young and strong and committed to “beating cancer.” After nearly two years of chemotherapy, radiation and two more surgeries, the cancer won. Eventually, I watched her beg nurses to give her “a shot” minutes before another was scheduled and be told they were sorry but she would have to wait. I could tell by the expressions on ...
Source: blog.bioethics.net - January 23, 2017 Category: Medical Ethics Authors: Practical Bioethics Tags: Health Care chronic pain Opioid addiction Opioid Epidemic Opioid prescriptions syndicated Source Type: blogs

Drug Distributor McKesson Pays Record Penalty For Suspicious Opioid Orders
Drug distributor McKesson will pay a record $150 million civil penalty and also suspend sales of controlled substances from distribution centers in four states over allegations that it has once again failed to detect and report suspicious orders of controlled substances (see:McKesson finalizes $150 million settlement for failure to report suspicious opioid orders). An excerpt from this article is below:The nationwide settlement also imposes “new and enhanced compliance obligations” on McKesson's distribution system....The latest announcement follows a 2008 settlement in which McKesson agreed to a ...
Source: Lab Soft News - January 18, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Medical Consumerism Medical Ethics Pharmaceutical Industry Public Health Informatics Source Type: blogs

I ’ve seen the opioid epidemic as a cop. Living it as a patient has been even worse. - The Washington Post
A year ago, I woke in the night with pain so severe I was crying before I was fully aware what was going on. A 50-year-old cop sobbed like a child in the dark.It was a ruptured disc and related nerve damage. Within a couple of months, it became so severe that I could no longer walk or stand. An MRI later, my surgeon soothingly told me it would all be okay. He would take care of me; the pain would end.After surgery, I never saw that surgeon again. A nurse practitioner handed me a prescription for painkillers — 180 tablets, 90 each of oxycodone and hydrocodone.I was lucky: I already knew how easily opioid addiction could d...
Source: Psychology of Pain - January 11, 2017 Category: Anesthesiology Source Type: blogs

Deadlier than Heroin: How Fentanyl is Becoming Public Health Enemy No. 1
For the first time in the city’s recorded history, more than 1,000 New Yorkers are expected to die from a fatal drug overdose in 2017. Key to this record-breaking statistic is the increased abuse of fentanyl, a cheap synthetic opioid up to 100 times more powerful than heroin. Relatively unknown to the general public until recently, this drug’s astounding lethality is tearing across the country as deaths related to fentanyl and other synthetic opioids surged more than 70% from 2014 to 2015. So where did this drug come from, and why are so many people dying because of it? Fentanyl has been utilized in medical settings s...
Source: Cliffside Malibu - January 3, 2017 Category: Addiction Authors: Richard Taite Tags: Richard Taite Source Type: blogs

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My first published piece of creative nonfiction literature also happens to be quasi poetry. Here is me, in a word.As published in aptFavorite drug: OxyContin. Second favorite drug: Cinnabon. Most painful drug: chemotherapy. Second most painful drug: Cinnabon. Drug I consumed most: Benadryl. Person who has consumed most Benadryl in world history: me. Number of uses of Benadryl: infinite.Favorite food: pizza. Favorite topping: pepperoni. Practice never followed: kosher. Feeling experienced during bar mitzvah: nervousness. Substance wished knew about during bar mitzvah: whiskey.High school sport: tennis. Sport too short to su...
Source: cancerslayerblog - January 2, 2017 Category: Cancer & Oncology Tags: writing/speaking Source Type: blogs

In a Word
My first published piece of creative nonfiction literature also happens to be quasi poetry. Here is me, in a word.As published in aptFavorite drug: OxyContin. Second favorite drug: Cinnabon. Most painful drug: chemotherapy. Second most painful drug: Cinnabon. Drug I consumed most: Benadryl. Person who has consumed most Benadryl in world history: me. Number of uses of Benadryl: infinite.Favorite food: pizza. Favorite topping: pepperoni. Practice never followed: kosher. Feeling experienced during bar mitzvah: nervousness. Substance wished knew about during bar mitzvah: whiskey.High school sport: tennis. Sport too short to su...
Source: cancerslayerblog - January 2, 2017 Category: Cancer & Oncology Tags: writing/speaking Source Type: blogs

An opioid epidemic is what happens when pain is treated only with pills - The Washington Post
Too many opioids. Not enough opioids. Behold the opioid paradox.The United States is in the midst of a massive opioid epidemic, as The Washington Post and other news organizations have documented extensively. In 2015, more than 33,000 people died from overdoses of opioids, meaning prescription painkillers, heroin, fentanyl or any combination. That easily keeps pace here with fatal motor vehicle accidents and gun-related deaths.Certain states have been particularly affected. The Charleston Gazette just reported that opioid wholesalers shipped 780 million oxycodone and hydrocodone pills into West Virginia over a six-year per...
Source: Psychology of Pain - December 25, 2016 Category: Anesthesiology Source Type: blogs

Exporting Pain: Here ’s Why Some Doctors are Labeled ‘Opioiphobic’
Exporting Pain: Here’s Why Some Doctors are Labeled ‘Opioiphobic’ While patients and medical professionals in the United States have wised up to the potential harm of prescription opioids like OxyContin, its manufacturers aren’t willing to sell any less, instead choosing to pursue an aggressive marketing campaign internationally rather than give up on potential profits. This move is a threat to the health and well-being of millions of people worldwide. There’s no need for other countries to make the same mistakes we’re still overcoming. America is in the thick of an opioid addiction and overdose crisis that sta...
Source: Cliffside Malibu - December 20, 2016 Category: Addiction Authors: Richard Taite Tags: Richard Taite Source Type: blogs

We need to speed up our acceptance of the opioid guidelines
A couple of years ago, I inherited a patient who was on both a patch for the powerful painkiller fentanyl and a high dose of oxycodone four times daily — and she didn’t have cancer. I had 15 minutes with that patient to get her medical history, review her medications, assess her current complaints, and decide whether or not to continue her opioid prescriptions. I had no paper records and a very poor electronic medical record system. I lacked a lot of the information I needed in order to prescribe such a high opioid dose. However, if I refused to continue the opioid prescriptions, I would force the patient into with...
Source: Kevin, M.D. - Medical Weblog - December 17, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/kathryn-takayoshi" rel="tag" > Kathryn Takayoshi, NP-C < /a > Tags: Meds Pain management Source Type: blogs