More Research Shows It's Not The Prescriptions, It's The Prohibition
Jeffrey A. SingerThe latest issue ofPublic Health Reports (the official journal of the Office of the Surgeon General and U.S. Public Health Service) presents a study by researchers at Boston University and the Massachusetts Department of Public Health which provides further evidence that the narrative driving present opioid overdose policy —that it results primarily from doctors prescribing opioids to patients in pain—is wrong. It results from non-medical drug users accessing drugs in the black market that results from prohibition. In the early part of this century the “drugs of choice” for non-medical users were d...
Source: Cato-at-liberty - October 9, 2019 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
The Rise and Rise of Quantitative Cassandras
By SAURABH JHA, MD
Despite an area under the ROC curve of 1, Cassandra’s
prophesies were never believed. She neither hedged nor relied on retrospective
data – her predictions, such as the Trojan war, were prospectively validated. In
medicine, a new type of Cassandra has emerged –
one who speaks in probabilistic tongue, forked unevenly between the
probability of being right and the possibility of being wrong. One who, by conceding
that she may be categorically wrong, is technically never wrong. We call these
new Minervas “predictions.” The Owl of Minerva flies above its denominator.
Deep learning (DL)...
Source: The Health Care Blog - October 7, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Artificial Intelligence Data Medical Practice Physicians RogueRad @roguerad acute kidney injury AI deep learning machine learning predictions Saurabh Jha Source Type: blogs
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
How do we manage pain in the era of the opioid crisis?
“6 in 10 Kids Got Opioids After Tonsil Surgery, Study Says.” So screams the headline from The Daily Beast.“In the midst of the opioid crisis, doctors sent many kids home with oxycodone and hydrocodone,” it goes on to say. Another example of scaremongering and sensational headlines, or is this something we should still be […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 2, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/rita-agarwal" rel="tag" > Rita Agarwal, MD < /a > < /span > Tags: Meds Medications Pain Management Source Type: blogs
There Is A Rather Worrying Trend In Opioid Harm That Is Not Really Reversing Just Yet.
This appeared a few days ago.Pharmaceutical opioid harm surges in VicNew data reveals more Victorians are showing up to emergency departments due to pharmaceutical opioid-related harm.Kaitlyn OfferAustralian Associated Press September 19, 20199:17amVictorians are inundating hospital emergency departments suffering from pharmaceutical opioid-related harm at a cost of $16 million over two years.Opioid-related emergency presentations increased annually by an average of 3.1 per cent during the 10-year period of 2008-09 to 2017-18, according to the Monash University Accident Research Centre.The centre's Hazard report released o...
Source: Australian Health Information Technology - September 24, 2019 Category: Information Technology Authors: Dr David G More MB PhD 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
Kratom: Fear-worthy foliage or beneficial botanical?
Depending on what you read, kratom is a dangerous, addictive drug with no medical utility and severe side effects, including overdose and death, or it is an accessible pathway out of undertreated chronic pain and opiate withdrawal. How can the US Drug Enforcement Agency (DEA), medical professionals, and millions of regular kratom users have such divergent views of the same plant?
What is kratom?
Kratom (Mitragyna speciosa) is a tropical tree from the coffee family native to Southeast Asia, with properties that range from stimulant-like, energizing and uplifting, to opiate-like, causing drowsiness and euphoria. Kratom has d...
Source: Harvard Health Blog - August 7, 2019 Category: Consumer Health News Authors: Peter Grinspoon, MD Tags: Addiction Pain Management Vitamins and supplements Source Type: blogs
Opioids for acute pain: How much is too much?
In this study, the researchers looked at opioid prescriptions in 2016, and the numbers are shocking. In the US, 22% of prescriptions written by dentists were for opioids, compared with just 0.6% for British dentists, and US dentists prescribed about 35 opioids per 1,000 population, compared to just 0.5 opioid prescriptions per 1,000 population in England. Additionally, the opioid prescribed in England was a relatively weak codeine-like drug, whereas in the US the majority of prescriptions were for hydrocodone, a stronger opioid with greater abuse potential.
When does an opioid prescription make sense?
It is simply impossib...
Source: Harvard Health Blog - July 24, 2019 Category: Consumer Health News Authors: Scott Weiner, MD Tags: Addiction Pain Management Source Type: blogs
Do You Think This Review Will Throw A Spanner In The Works For The Nth Time?
This appeared last week:Crossing bordersSheshtyn Paola 26/06/2019There is a “pressing need” for real-time prescription monitoring in NSW, says coroner, following a man’s death after buying opioids in both ACT and NSWNSW needs to urgently join Tasmania, Victoria and the ACT in implementing real-time prescription monitoring, the ACT Chief Coroner Lorraine Walker has sai d following another opioid-related death.Jay Alan Paterson, 43, died in 4 September 2017 at Calvary Public Hospital in Canberra after experiencing a polypharmacy overdose related to opioid painkillers.Mr Paterson had injured his knee and had extensive s...
Source: Australian Health Information Technology - July 2, 2019 Category: Information Technology Authors: Dr David G More MB PhD 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
Toward a Healthy Relationship with Opioids
In the June 14thWall Street Journal, Johns Hopkins University bioethicist Travis Rieder, in an excellent essay, shared with readers his battle with pain resulting from a devastating accident, the effectiveness of opioids in controlling the pain, and the hell he went through when he was too rapidly tapered off of the opioids to which he had become physically dependent. Like most patients requiring long term pain management with opioids, he developed a physical dependence, which is often mistakenly equated with addiction by policymakers and many in the media. The aggressive schedule launched me into withdrawal, and I l...
Source: Cato-at-liberty - June 17, 2019 Category: American Health Authors: Jeffrey A. Singer 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
