Pain Management

Vague criteria can lead to misdiagnosis and prison

Conditions
September 24, 2023

The definition of addiction, now called substance use disorder, has varied greatly over time. The first edition of the Diagnostic and Statistical Manual, from 1952, didn’t include specific diagnostic criteria for this condition. Over the next sixty years, the DSM went through six revisions, with a slow evolution of the terms “substance abuse” and “dependence.” The first was limited to substance use causing social and occupational problems, while the last …

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Balancing pain management and legal realities [PODCAST]

Podcast
September 13, 2023
YouTube video

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Join L. Joseph Parker, a research physician, as we dive into the intricate world of medical practice and legal challenges faced by health care professionals treating patients with pain and addiction. Joseph sheds light on the complexities of opioid prescriptions, the impact …

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Balancing opioid medication in chronic pain

Conditions
September 13, 2023

She walked in with a cane, bent over like a question mark. She was in her seventies and as sweet as people in that age group tend to be. I think most of the cranky ones don’t make it that far. She was something of an emergency because her doctor had just passed away, and it was time to refill her medications. It would not be safe for her to …

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Doctor convictions: Unmasking the 3 threats you need to know

Physician
September 10, 2023

Why would anyone lie about you? And what makes you prone to conviction? There are three types of people that will absolutely bring your world crashing down on you, and you need to know who they are. But first, we need to understand the formula that prosecutors have developed to target doctors.

Prosecutors go after doctors because they are easy targets. The formula developed by prosecutors has three steps: First, make …

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Misunderstandings about opioid use disorder

Conditions
September 3, 2023

At a recent scientific conference on narcotics, a researcher mused, “Honestly, opioids make me feel gross. I don’t see how anyone could get addicted.” This is a little like a doctor in the delivery end of a needle saying, “Honestly, you’re a wimp. This doesn’t hurt.” Both examples reveal a lack of empathy and a fundamental misunderstanding of current neuroscience.

The contributions or fear, reward, fight, and flight are a complicated …

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Post-surgery opioid risks [PODCAST]

Podcast
August 27, 2023
YouTube video

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Join Amy Baxter, a clinical associate professor of emergency medicine, as we explore the intricate balance between physicians’ roles in perpetuating the crisis, addressing systemic factors, and the influence of pharmaceutical industry-sponsored education. Discover the brain’s response …

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The preference for insurance coverage of opioids over non-pharmaceutical options explained

Meds
August 16, 2023

Pain is the primary reason people seek medical care. Pain is also the problem that ignited the opioid crisis and continues to supply fuel. Eighty percent of opioid misuse begins with a pill prescribed for pain. Purdue invested heavily in marketing Oxycontin to physicians, training them that home opioids are the standard of care for recovery from surgery. While addiction debunked the myth of universal safety, two fallacies embedded in …

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Reshaping opioid policies: a patient advocate’s call [PODCAST]

Podcast
August 9, 2023
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Join patient advocate Richard A. Lawhern as he challenges prevailing myths surrounding the opioid crisis. With insights from medical literature, he questions the link between opioid prescribing and toxicity, highlighting the need for evidence-based public health policies. …

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The persecution of pain management doctors

Physician
July 25, 2023

The call came in during a busy workday. My comprehensive primary care clinic had been built over a decade of hard work and had a general practice clinic staffed by a very capable former surgeon and several nurse practitioners, as well as a pain management program and an addiction treatment clinic. We also had several counselors on staff. I immediately recognized the voice on the other end of the line …

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How legal liabilities and skewed decision-making plague clinical encounters

Physician
July 15, 2023

The opioid crisis continues to ravage communities, and everyone, including politicians and federal agents, has a plan. However, no one has an actual solution.

It’s time to examine the crisis from a more detailed perspective: the clinical perceptions that form during a clinical encounter between a physician and a patient. It is here that we see the true effects of opioid policy and understand why they are so ineffective.

At the end …

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Ending the opioid crisis starts with physicians

Conditions
July 11, 2023

A recently published opinion article by opioid advocates attempts to assuage physicians’ prescribing guilt, arguing “doctors prescribing to their patients did not create the U.S. opioid crisis.” As lawsuit after lawsuit concludes, Purdue Pharma, Johnson and Johnson, and blindered distributors and pharmacies share the blame for propping up pills for profit. Physicians may inflate home narcotic quantities for convenience, but with rare prosecutable exceptions, not monetary gain. But the …

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Everything the government thinks it knows about the opioid crisis is wrong

Conditions
July 1, 2023

“In July 2015, journalist Johann Hari gave a TED Talk that over 20 million people have since viewed. Hari offered convincing evidence that vulnerability to opioid addiction is a consequence of the conditions under which people live — the social determinants of health — rather than simple exposure to opioid pain relievers. This theme is brilliantly elaborated by economist Anne Case and Nobel Prize winner Angus Deaton …

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A physician’s journey through propaganda and misinformation [PODCAST]

Podcast
June 20, 2023
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Join us for a fascinating podcast episode as we explore the dangerous consequences of propaganda and misinformation within the context of the opioid epidemic. Our guest, Jay K. Joshi, a family physician and author of Burden of …

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Telemedicine in the opioid crisis: a game-changer threatened by DEA regulations

Meds
March 27, 2023

In March 2020, I was directing a federally qualified health center in rural New Mexico when the first flashover of COVID ripped through the state. In two days, the clinics transitioned from an entirely in-person model to a near-total remote model. The transformation was raw and unplanned, trialing mediocre communications platforms in real-time and stumbling through the vagaries of electronic prescribing. As we got our feet under us, unexpected upsides …

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The real cause of America’s opioid crisis: Doctors are not to blame

Meds
March 22, 2023

We’ve all heard about America’s so-called “opioid epidemic.” Nearly 100,000 people died in 2021 of causes that included overdose by one or more narcotic drugs and often alcohol. We also hear assertions from anti-opioid advocates that this epidemic was caused by doctors “over-prescribing” opioid pain relievers to their patients. These assertions are fundamentally wrong on fact. U.S. national health care policy and law redirections are needed to correct such distortions.

Doctors …

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Critical thinking in pain management [PODCAST]

Podcast
March 7, 2023
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In this episode, we welcome special guest Ronald A. Zent, a family physician, to discuss the ongoing opioid crisis. With a fourfold increase in opioid prescriptions and overdose deaths from 1999-2010, Ronald shares his insights on how …

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CME Spotlights