Archives for PROP

Legal

What Should Doctors Risk for their Patients?

The LA Times ran a very interesting story a few days ago about deaths from overdose of narcotic pain medications.  I strongly encourage readers of this blog to read the story, which discusses the issue from the perspectives of doctors, patients, and family members.

The story reports that a small number of Southern-California doctors wrote prescriptions that have killed a large number of patients. Over the past five years, 17% of the deaths...
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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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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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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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General

More of a Painful Topic

Thank you for your comments about my post about treating chronic pain with opioids.  I was in the middle of adding a response to one of the comments this morning, when I decided to elevate my response to a post of its own. Starting a new post might, I hope, keep the discussion going… and besides, I was struggling to find a stopping point!

Here are highlights from the...
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Addiction

More About Opioid Pain Treatment

Just a quick note-- A group of researchers from Boston University School of Medicine weigh in on the issue of opioid prescribing in an online editorial available through this link.  The editorial appears in the Journal of General Internal Medicine, and I do not know how long the link will be active.  All such articles are copyright-protected, keeping me from posting them here-- but the link operational for non-subscribers, at least...
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Addiction

Opioids for Chronic Pain (?)

I've written about the spectrum of medical and scientific opinion (not, unfortunately, always the same thing) over the use of opioids for treatment of chronic pain.  For those who missed the earlier discussion-- one that produced a heated response from readers-- I invite you to review those posts.

The essence of the issue is that over many years, there has been significant effort to increase patient access to potent opioids.  This effort has come in part from the...
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