From medical school to residency, I’ve worked with colleagues who don’t prescribe pain medications for their patients who truly need them. Or they are just very hesitant about doing so. Some simply don’t believe in them. Others fear the legal implications like being named to a med mal or wrongful death lawsuit. And several avoid pain meds, specifically opioids, like the plague because of possible addiction risk even when their …
In the mid-1980s, with the AIDS epidemic on the horizon, austere conservative Margaret Thatcher sanctioned the first needle exchanges in the U.K. to prevent the budgetary burden that HIV might otherwise have become on the National Health Service. Nearly forty years later, New York City opened its first supervised injection sites in November of 2021, where intravenous drug users inject their substances of choice under the watchful eye …
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“In my medical training, we were taught five ways to treat pain: lifestyle modifications, physical therapy, medications, injections, and surgery. Lifestyle modifications are positive changes in diet, exercise, sleep, and stress levels. This is the first-line treatment for painful inflammation. Yet we tend …
Twenty-six hours into the shakes, sweats, crawling anxiety, and gripping nausea of opioid withdrawal, Faye caves in and takes a couple of fentanyl tabs. She knows that she must tough out a couple of days without fentanyl to start Suboxone (buprenorphine/naloxone) through a medication-assisted treatment program, but the sickness gets the better of her. Those couple of tablets reset the clock on her withdrawal.
Starting buprenorphine – an evidence-based …
An excerpt from The Pain Solution: 5 Steps to Relieve and Prevent Back Pain, Muscle Pain, and Joint Pain without Medication.
The U.S. health care system is designed to handle emergencies. It manages life-threatening heart attacks and acute fractures well. Thankfully, it saves lives. But most ongoing medical conditions …
Eleven attorneys general (AGs) have responded to a long-awaited draft update on a nationwide opioid-prescribing guideline by asking that drafters do more to prevent prescription opioid diversion. Logically focused on law enforcement, the AGs, unfortunately, suggest reviving policies the Centers for Disease Control and Prevention (CDC) has already cited as potentially harmful to patients. In doing so, the AGs step into the practice of medicine which they are not qualified …
In 2017, the CDC rolled out a “solution” to the opioid crisis. The recommendations, which were never intended to become laws, were mostly level of evidence three or below.
To put it another way, they were not robust, nor were they based on research in any way that matters. There was also no input from the pain medicine associations.
The premise was that we would solve the problem using what those of …
They are the foundation of the CDC’s 2016 opioid guidelines, resulting in legislation limiting opioid prescribing in 36 states. Morphine milligram equivalents, or MMEs, are used to set arbitrary prescribing limits for opioids by physicians since many state legislators fail to understand — and translate into policy and law — the ’16 guidelines. If we had all known the history of MMEs, perhaps we would not have been so eager …
My niece and I look across the expanse of the second floor of Marshall’s Dranko Library as we take in the library’s Spring art exhibit: Creation in Confinement. We spot my moon drawings on black paper hanging on the opposite wall. As a new artist, accompanied by my niece artist, I excitedly read: Heavenly Moon and Worldy Skies, and how they are both done with pastels, colored pencils, and gel …
I have been writing of late about recent developments in the opioid saga. My first piece talked about a fresh decision in California’s seven-year-old The People vs. opioid pharma case. The next one focused on how the middle-man, distributors, contributed to the epidemic’s picture.
Now, I wanted to write an overarching piece hitting some astounding highlights that summarize the opioid crisis through its decades-long lifespan. …
As a family physician for more than 40 years, I have seen countless patients struggling to alleviate chronic pain, with far too many turning to self-destructive coping methods such as alcohol and opioids. Unfortunately, the struggle with chronic pain isn’t going away – and more alarming is the fact that those suffering from it are getting younger and younger. The latest data on chronic pain show patients between age 18 …
A recent headline in my neighborhood newspaper read, “A Dentist Became a Top Opioid Buyer in W. Va. Now a Drug Firm Faces Penalty for Ignoring Red Flags.” The drug firm sent 25,400 hydrocodone pills and 3,600 Xanax to one Huntington, WV area dentist. The DEA raided the dentist’s office and shut it down. The dentist admitted to ordering the pills for personal use.
This summer, also right …
On Monday, November 1, an Orange County California Superior Court Judge said, in a tentative decision, that the opioid pharmaceutical companies were not responsible for the opioid crisis.
This particular case, going by the name of “The People of the State of California v. Purdue Pharma,” started in 2014. The judge’s ruling noted that neither party requested a trial by jury. The trial took place before the judge between April 19, …
Chronic pain is an epidemic, currently affecting over 100 million American adults – more than diabetes, heart disease, and cancer combined. This doesn’t include children, 1 in 3 of whom live with a chronic pain condition ranging from migraine to chronic stomachaches. Chronic pain disrupts life, impeding the ability to work, exercise, have sex, engage in hobbies, even go outside. It’s the number one cause of long-term disability in the …
One of the most important purposes of a physician is to alleviate pain and suffering. Pain is the most common symptom prompting an emergency department (ED) visit. Emergency physicians are responsible for managing both acute pain and acute exacerbations of chronic pain resulting from a broad array of illnesses and injuries.
It has been shown that emergency medicine providers are not necessarily good at treating patients uniformly. Since the 1990s, numerous …
I recently had the pleasure of interviewing famous television and film actress, Claudia Christian. She has played significant roles in many notable movies and shows, including lead roles in the long-running sci-fi series Babylon 5 and the Disney film, Atlantis: The Lost Empire. In our podcast interview, we discussed treating alcoholism using the FDA-approved drug, naltrexone.
Why listen to an actress about medical treatment for addiction? First of all, doctors generally …
The younger you are when you are exposed to opioids, the higher the likelihood of addiction later in life. The prefrontal cortex is not fully formed until the age of 25. This means that alterations in the “feel-good” neurotransmitters, specifically dopamine (released by opioids), can have an effect that predisposes the person towards future opioid use.
Because teenagers have an overactive impulse to seek pleasure and less ability to consider the …
Lori Pinkley, a 50-year-old from Kansas City, Mo., has struggled with puzzling chronic pain since she was 15.
She has had countless disappointing visits with doctors. Some said they couldn’t help her. Others diagnosed her with everything from fibromyalgia to lipedema to the rare Ehlers-Danlos syndrome.
Pinkley has taken opioids a few times after surgeries, but they never helped her underlying pain, she said.
“I hate …
Americans have always loved their medicines and sought them out actively to cure whatever ailed them. Their interest ranged all the way from “staying well” to “feeling better.” Productivity in this hard-charging, pull yourself up by the bootstraps society required activity, and it’s hard to be active when you’re sick.
In the 18th-century in Germany, England, France, and Switzerland, men practicing pharmacy saw their retail operations as the …
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
Marijuana is made from the dried flowers of the cannabis plant. Made of more than 500 chemicals, including over 100 compounds called cannabinoids, the primary active compounds in the plant are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC acts on specific brain cell receptors that …
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