Pain Management
Elite access vs. public scrutiny: Medication disparities exposed
A recent New York Times opinion piece detailed a lack of available pain medications. While the DEA claims that it is not purposefully restricting legitimate medication availability, even the names of its own operations belie this statement. On Halloween 2023, the DEA launched Operation “Bottleneck,” serving immediate suspension orders to six large pharmaceutical supply companies. These companies were accused of having failed to account for “a million doses” of …
Low-frequency ultrasound for pain relief [PODCAST]
How Enhanced Recovery After Surgery solves our opioid problems
In retrospect, we were an addicted nation waiting to happen. Not from a self-indulgent culture, not from an unwillingness to suffer hardship, nor any of the generational criticisms of lack of grit. Our opioid crisis derives from an impatient culture that fears loss of health more than health care profit. With pain as most people’s proxy for health, we were …
Topoisomerase inhibitors and chronic pain
Topoisomerase inhibitors emerged in the American medical landscape in 1971, thanks to the discovery by Dr. Jim Wang of the E. coli omega protein. Topoisomerase I, an enzyme identified by Dr. Wang, plays a crucial role in DNA unwrapping from supercoiling. Supercoiling involves tightly wrapping DNA for storage and protection, requiring unwrapping for reading, a process in which topoisomerase is indispensable.
Topoisomerase comprises two main types, aptly named types I and …
Opioid prescribing, pain management, and patient advocacy [PODCAST]
Doctor charged after treating a DEA agent
As I wait for the next patient to be brought in, I start reviewing their chart. Past medical records have been received and scanned in per protocol, I see. This won’t be the first time I’ve seen his chart as he had to submit medical records and be approved before he could get an appointment to see me.
A forty-something African American male has been complaining of chronic back pain for …
Ultrasound shows promise as new pain treatment, targeting a specific brain region
A recent study published in PhysicsWorld documented a possible new treatment for pain. Something most physicians would be surprised to hear. Ultrasound. That’s right, low-frequency ultrasound waves, when directed to a specific area of the brain called the insula, have been shown to give some pain relief to persons who were being subjected to a standard contact heat evoked potential (CHEP). In this test, brief pulses of heat are …
Exploring gene therapy for chronic pain [PODCAST]
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Join L. Joseph Parker, a research physician, as we explore recent breakthroughs in gene editing, including its use in curing deafness and treating sickle cell anemia. Joseph discusses the ethical implications, accessibility challenges, …
The opioid crisis: profits, lawsuits, and pharmaceutical influence
The absolute belief in a vast conspiracy is often associated with an unbalanced mind. People suffering from some forms of mental illness are prone to these beliefs, seeing the invisible hand of the CIA behind the music choices on their radio stations. But that’s not always the case. Dr. Andrew Wakefield was born in 1956 and completed his medical degree in 1981, becoming a fellow of the Royal College of …
Beyond opioids: a new hope for chronic pain relief
Opioids work through the mu opiate receptors throughout the body and brain, dampening pain signals being sent through the peripheral nervous system and spinal cord. It also acts on the ventral tegmental area, causing the release of dopamine in the nucleus accumbens, creating a sensation of euphoria. It is this euphoric effect that seems to be most related to addiction potential. Opiates mimic our endogenous endorphins and have been used …
The unseen battle: America’s veterans and the crisis of chronic pain
Since the Civil War, there have been seventy-four wars and conflicts America has fought in. But as bad as previous wars had been, there has never been anything in American history like the Iraq and Afghanistan wars. While America’s direct intervention against Germany and Japan lasted less than five years, the war on terror went on for decades. Extended time in extreme circumstances will cause extreme adaptations in the human …
Can we finally say goodbye to opioids? There may be new pain relief on the horizon.
In an article I recently wrote about a new calcium channel-blocking medication that could be effective in treating central chronic pain, I mentioned that medications like lidocaine block sodium channels to prevent the transmission of pain through the peripheral nervous system. I also said that these medications have limited use, usually just in the ER, because they are short-acting and injected, though there is a lidocaine patch that some …
The opioid addiction epidemic and its impact on health care costs
The opioid addiction crisis has escalated into a formidable challenge within the U.S. health care system, causing widespread devastation. The opioid epidemic has not only devastated communities and individual lives but has also inflicted a substantial economic toll on the health care system. The opioid epidemic has led to a surge in health care costs, stemming from the increased demand for addiction treatment, including psychiatric and psychological evaluations, emergency room …
Balancing research with safe opioid prescribing to reduce pain and improve quality of life
This article is sponsored by the Centers for Disease Control and Prevention.
Pain is a deeply personal experience and one of the most common reasons why individuals seek medical care in the U.S. The Centers for Disease Control …
Euphoria-free pain relief: A gabapentin alternative you’ve been waiting for?
A groundbreaking discovery in pain management could revolutionize how we treat chronic pain. In a report from a study published in the Proceedings of the National Academy of Sciences, researchers at New York University, in collaboration with colleagues at the University of Pittsburgh, have announced the discovery of a novel medication that could treat centralized pain that targets Cav2.2 calcium channels (also called N-type calcium channels).
First, what is centralized …
Uncovering the real story behind opioid prescriptions and deaths
As a non-clinician patient advocate and health care writer, I am frequently reminded of a quotation attributed to Samuel Clemens (Mark Twain): “Figures don’t lie. But liars figure.” I am also aware of a second quotation from economist Ronald H Coase: “If you torture the data for long enough, it will confess to anything.”
I find that both quotations apply directly to the U.S. Centers for …
Redefining medical caution: How recent studies challenge benzodiazepine prescription norms
I want to draw your attention to two fairly recent studies. One of these is the BIND study. I love it when studies use easy-to-remember acronyms because it really helps to keep them straight. The BIND study found that “Many prolonged symptoms subsequent to benzodiazepine use and discontinuation … have been shown in a large survey of benzodiazepine users. Benzodiazepine-induced neurological dysfunction (BIND) has been proposed as a term …
Confusing correlation with causation: the most common error in science
The universe can be a very confusing place.
Quite often, things will happen together or one-after-another that will cause even learned people to connect two events as causative when they are not. These misattributions are not just of academic concern. They can have real-world consequences.
In 1347, a plague began to sweep through Europe. At the time, no one knew what caused plagues, and the germ theory of disease was centuries away. …
What the DEA does not understand or does not care about medication cessation decisions
Reports sent back to Washington during the Vietnam War made it clear to everyone. The U.S. was winning. There could be no debate or doubt. It was right there in the numbers. When searching for a metric to measure “success,” U.S. politicians and the military had come to rely on body count comparisons. Defining “winning” as having a higher body count. And by that measure, the U.S. was indeed winning. …
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Past Week
-
Nurse practitioner reveals startling flaws in APRN education: Is patient safety at risk?
-
Climate change is exacerbating diseases in vulnerable populations in America and abroad
-
Doctors beware: the hidden legal risks of following CME guidelines
-
When a doctor acts like one of the kids
-
Ways to overcome the grief of disillusionment about medicine
-
How South Carolina’s eye care laws are blocking telemedicine innovation
-
Past 6 Months
-
Why is our health care system going down the drain and no one seems to care?
-
Nurse practitioner reveals startling flaws in APRN education: Is patient safety at risk?
-
The future of health care depends on hands-on training: We cannot afford to cut corners
-
Climate change is exacerbating diseases in vulnerable populations in America and abroad
-
How medical school curricula perpetuate inequality
-
Should transgender athletes compete in women’s sports?
-
Recent Posts
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Ways to overcome the grief of disillusionment about medicine
-
Care teaming: a new paradigm for anesthesia care teams and beyond
-
The legal trap every doctor needs to know before signing a contract
-
A patient gave me the best gift of my life
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Doctors, stop chasing wealth: How to find true happiness beyond the paycheck [PODCAST]
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Planting the seeds of a work ethic
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