Archives for Pain

History

I Told You So

The FDA recently released a Drug Safety Announcement regarding the use of codeine in young children after tonsillectomy/adenoidectomy surgery for obstructive sleep apnea.  I was somewhat surprised to see a safety announcement on a medication that has been in use for decades, but the release underscores our improved knowledge of drug metabolism, and the broadening demographics of the United States.

Codeine has little activity at opioid receptors.  The analgesic effects of codeine...
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Addiction

Enough Pain Regulations?

I’ve described the ongoing debate over the use of opioids to treat chronic pain.  To catch new readers up to speed, the country is in the midst of an epidemic of deaths due to overdose on pain medications or heroin.  The epidemic is evident to anyone who spends even a few minutes searching the internet using the keywords ‘overdose deaths.’   Another increasing phenomenon is the prosecution of physicians whose patients have died from...
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General

Compassion or Murder?

I subscribe to Google news alerts for the phrase 'overdose deaths.'  Google Alerts are a great way to follow any topic; subscribers receive headlines from newspapers and web sites for certain keywords from around the world. One thing that has become clear from my subscription is that there is no shortage of stories about deaths from opioids! Every day I see one article after the next, as news reporters notice the loss of...
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Addiction

Another Pain Advocacy Group Goes Under

I've written about the Pain Relief Network in prior posts -- one side of the battle between those trying to limit access to schedule II opioids (led by PROP, or Physicians for Responsible Opioid Prescribing), and until recently, the Pain Relief Network, or PRN.

If you haven't read my earlier posts on the subject, I encourage you to do so;  the final chapter, including the death of PRN's...
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Addiction

Same Old Story

My dad used to tell a joke about a bunch of soldiers sitting around the barracks.

One old guy yelled 31! - and the place broke out in laughter.  After a moment or two, another guy yelled 52! - and more laughter erupted.  Then a depressed-looking guy in the corner yelled 29! -- followed by silence.  He yelled again, 68!—and again, the room was silent.

The new recruit asked the guy in the next bunk what...
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Addiction

Inconvenient Truths

Next month I will be presenting a paper at the annual meeting of ASAM, the American Society of Addiction Medicine.  The paper discusses a new method for treating chronic pain, using a combination of buprenorphine and opioid agonists.  In my experience, the combination works very well, providing excellent analgesia and at the same time reducing—even eliminating-- the euphoria from opioids.

Ten years ago, I would have really been onto something. Back then there were calls...
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Opioids

A World of Pain, Without Medications

A reader sent a link to a recent NYT editorial about the lack of pain medications in some countries.  The writer of the editorial injured his leg while traveling in Africa, and was dismayed to find that opioid pain medications were in limited supply, with only enough for patients admitted to the hospital.

The writer went on to describe a number of developing countries where pain medications are in short supply,...
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Addiction

The PRN Pill-Mill Story

Wow. I just read an email about a story that I was vaguely aware of-- about a doctor in Kansas and his wife, who were together linked to scores of overdose deaths. But that is just the beginning. The doctor was supported, during his trial, by Siobhan Reynolds, founder of a nonprofit advocacy group called 'Pain Relief Network.' She started the group back in 2003, when her ex-husband was suffering from severe...
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Addiction

The Debate Continues

I've described the ongoing debate over use of opioids for chronic pain, and shared information about a group of physicians who are attempting to reduce the damage caused by careless over-prescribing.  Their attempts have created some backlash, as described here.

Feel free to comment in response -- here or there, or both! Pills photo available from...
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