For the last three decades, the numeric pain score has been the go-to assessment for acute pain in the hospital setting. Since this methodology was developed for research purposes to see if drug “A” had an effect on patient “A,” its clinical utility is not just worthless but dangerous. Let’s look at a simple example of a pain order set that is commonly used across the country. If a patient says ...

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I often hear the mantra, “You must stay ahead of your pain, or else.” The president of the American Academy of Pain Medicine, states a common mistake people make, is waiting too long to take pain medication. By the time you’re in pain, you’re starting from behind the eight ball. "It takes a lot more medicine to control pain after it’s started as opposed to starting it ahead of time," he ...

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I often wonder what it was like before patient-centered care became a mainstream catchphrase. Was there a poor relationship between the patient and physician in the outpatient setting? Were hospitalized patients’ feelings, desires, goals, and therapy options ignored? It amazes me that we were able to care for patients more than ten years ago without using a “patient-centered” approach. According to NEJM Catalyst, “Patient-and family-centered care encourages the ...

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We have embarked upon a unique strategy to assess and manage pain. "Opioids Rarely Help Bodily Pain" is not a catchy phrase but a mnemonic related to educational learning which serves as the cornerstone of a new acute-pain management paradigm. As is known, the evaluation of pain is extremely difficult due to its subjective nature. However, this new evaluation not only accounts for the patients’ self-assessment but, for the first ...

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As we follow the national opioid epidemic, with its greater than five deaths per hour from opioid overdoses, the focus is shifting to methods for limiting an individual’s exposure to these drugs. For most of us, our first contact with these highly addictive medications is after surgery. Studies now reveal that 60 percent of pills prescribed for pain after surgery go unused. These opioids often make their way to other family ...

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In order to fully understand the issues surrounding opioid prescribing practices, it is important to review a brief history of how these drugs came to market. Opium was the first opioid, derived from the sap of opium poppies whose growth and cultivation dates back to 3,400 BC. In the 18th century, physicians in the U.S. used opium for multiple ailments. Towards the end of the 18th century, the addictive qualities of ...

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After years of exaggeration, misinformation and a national epidemic of opioid and heroin abuse, the nation is finally coming to terms with the fact that pain is not the fifth vital sign. This heresy, as I understand it, has existed for close to three decades and, in my opinion, has been directly responsible for the deaths of thousands of patients and lethal drug overdoses of hundreds of thousands of American ...

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