Failing health of the United States

Failing health of the United States | The BMJ – BMJ – Feb 2018  “The role of challenging life conditions and the policies behind them.” by Steven H Woolf, director, and Laudan Aron, senior fellow

The subtitle says it all: our country doesn’t know how to handle “challenging life conditions” because we’ve been the “land of plenty” for so long.

But with surging income inequality, the number of people living in poverty is on a relentless climb. With the previously existing economic and social safety nets dismantled, what is to become of us?   Continue reading

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Tell Medicare to Stop Its War on Pain Patients

Tell Medicare to Stop Its War on Pain Patients — Pain News Network – February 19, 2018 – By Richard A. Lawhern

In March 2016, the Centers for Disease Control and Prevention published a deeply biased and scientifically unsupported guideline for the prescription of opioid pain relievers.  Congress made this “guideline” mandatory in the Department of Veterans Affairs three months before it was even published.  

The VA has since enacted practice guidelines that effectively eliminate opioids as a treatment option for many veterans.  

And we’re seeing the tragic result as increasing numbers of veterans with chronic pain take their lives when pain relief is withheld. (see VA Acknowledges Suicides)

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A better method for pain medication research

A better method for preclinical pain medication research – December 18, 2015January 19, 2016 by Tom Ulrich

The global market for pain medications is huge — some estimates predict it will hit $41.6 billion by 2017.

However, the costs of pain medicine development are huge, too; it takes roughly $900 million to bring a new analgesic compound to market.

In part, this is because some 80 percent of compounds that look promising in preclinical animal studies (largely in rodents) fail in late-stage clinical trials.  
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VA Acknowledges Suicides

This comes from the advance notes of the 2018 National Rx Drug Abuse & Heroin Summit, more of which I’ll post later.

Surprising VA Data About Opioid Discontinuation, Overdose and Suicide: Clinical Implications –  Wednesday, April 4, 2018 – Stefan Kertesz, MD, MSc, Professor, University of Alabama at Birmingham, Birmingham VA Medical Center

Despite recommendations within recent guidelines for patient-centered evaluation of the risks and benefits for prescribing opioids for chronic pain, there are concerns regarding the potential iatrogenic effects of initiatives from state regulators, insurers, payers and healthcare organizations that have presented mandates to reduce opioid doses or to discontinue those in patients who currently receive them.    Continue reading

Americans abusing OTC pain drugs too

Americans are abusing over-the-counter drugs as well as opioids, study shows – Feb 2018 – By Corky Siemaszko

Our society is suffering from an epidemic of chronic pain as our society ages, and increasing numbers of these people need some method of alleviating it enough so they can continue living their lives as employees, parents, and citizens.

Until there exists an *effective* and *accessible/affordable* substitute for opioids, we cannot simply stop treating pain because desperate people will resort to other, sometimes dangerous (including suicide), means of pain control.

Americans aren’t just abusing prescription opioid painkillers — they’re taking too much of the over-the-counter stuff as well.   Continue reading

FDA Asks, Gets Answers, Pain Patients not Involved

FDA Asks, Gets Answers on Reducing Opioid Epidemic – Pain Medicine News – Oct 2017 – Kenneth Bender

The prevalence and consequences of opioid use disorder can be reduced without preventing patients with pain from receiving necessary opioid analgesics, according to a consensus report from the National Academies of Sciences, Engineering, and Medicine requested by the FDA.

Perhaps it can be, but it certainly is not.

Once again, the fate of pain patients is being decided by people who don’t understand the cruel waste of a life devastated by chronic pain.   Continue reading

Medical Taylorism: Industrialization of Medicine

Medical Taylorism – NEJM – Jan 2017

This “Perspective” from the prestigious New England Journal of Medicine laments the industrialization of medicine, the application of standardization and manufacturing efficiencies to the practice of healing.

Frederick Taylor, a son of Philadelphia aristocrats who lived at the turn of the last century, became known as the “father of scientific management” — the original “efficiency expert.”

He believed that the components of every job could and should be scientifically studied, measured, timed, and standardized to maximize efficiency and profit.   Continue reading

Lawmakers are addicted to bad opioid policy

Arizona lawmakers are addicted to bad opioid policy – The Arizona Republic – Dr. Jeffrey A. Singer

The governor of Arizona is calling on the Legislature this week to enact prescription limits as well as other bureaucratic intrusions into the doctor-patient relationship.

Such policies are nothing new: State lawmakers are addicted to the idea of restricting doctors from providing opioids to patients in pain.

This strategy is premised on a false narrative.   Continue reading

The Nuts and Bolts of Low-level Laser (Light) Therapy

Here are my annotations of five studies showing the efficacy of photobiomodulation (PBM), also called LLLT, for pain, depression, and muscle function. (as of 2/9/2018)

The Nuts and Bolts of Low-level Laser (Light) Therapy – Ann Biomed Eng. 2012 Feb;  /PMC3288797/

This full-text article explains how LLLT works.

Soon after the discovery of lasers in the 1960s it was realized that laser therapy had the potential to improve wound healing and reduce pain, inflammation and swelling.

In recent years the field sometimes known as photobiomodulation has broadened to include light-emitting diodes and other light sources, and the range of wavelengths used now includes many in the red and near infrared   Continue reading

Rest and Ice may Delay Healing

Rest ice compression elevation | Rice Therapy and Price Therapy – Caring Medical

For many athletes a doctor’s recommendation of the RICE protocol for healing their sports related soft tissue issue injury was seen as the gold standard of care.

However, this treatment is now under criticism from a surprising source, the doctor who created the RICE treatment guidelines, Gabe Mirkin, MD.

In a recent article on his own website, Dr. Mirkin admits that both ice and rest (key components of RICE) may delay healing.   Continue reading