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 – 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
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
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 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
I just found this interesting government web page, indicating that you can simply request a meeting with the FDA’s “Center of Medical Products and Tobacco” (an odd pairing) by filling out a short form online.
Meetings between stakeholders and the FDA’s Center for Drug Evaluation and Research (CDER) promote effective two-way communication to improve drug development and safety.
To submit your request for a meeting on drug-related topics, please click the Request a Meeting on Drugs button below and download the meeting request form to your desktop. Continue reading
Patient Abandonment in the Name of Opioid Safety | Pain Medicine | Oxford Academic – March 2013 – Stephen J. Ziegler, PhD, J.D.
This article speaks so directly to our current concerns that It’s hard to believe it’s almost 5 years old. Despite these years of increasing restrictions that have dramatically decreased opioid prescribing, opioid overdoses just keep going up.
In the political arena, when two branches of government are headed in one direction, the other branch is often dragged along in the process.
This also appears to be the case with prescription opioid policy, but instead of political branches, well-meaning researchers and politicians are dragging prescribers in a direction that could result in patient abandonment. Continue reading
#HPM Crash Course in Submitting Comments to CMS | Matthew Cortland on Patreon – Feb 2018 – by Matthew Cortland
Mr. Cortland gives excellent advice for the best way to write your comments on opioid policy. Though his words are aimed at Hospice & Palliative Medicine (HPM) clinicians, I believe many of us chronic pain patients have just as much knowledge and experience with this subject.
CMS has published their proposed changes to Medicare for 2019.
Here are the changes that, in my view, may be the most concerning to Hospice & Palliative Medicine (HPM) clinicians:
- Starting to crack down on opioid ‘potentiator’ drugs – like gabapentin and pregabalin.
- Limiting opioids to 90 MME per day.
- Making it more difficult for patients to fill two or more long-acting opioids. Continue reading
Prescribing Mindfulness Allows Doctors to Ignore Legitimate Female Pain – Feb 2018 – by Sarah Yahm
A few years ago, after a series of cascading injuries and illnesses that rendered me unable to type, drive, or sleep, I briefly became a professional patient.
Like all of my professions, I took it seriously. I went to appointments armed with lists of well-researched questions written down neatly on my yellow legal pad, brought in the occasional medical journal article, and compiled detailed descriptions of my array of increasingly bizarre symptoms.
My goal was to get my doctors to take me seriously so they would dive into the complexities of my case. Continue reading
The mysterious rise in knee osteoarthritis – Harvard Health Blog – Harvard Health Publishing
Osteoarthritis is the form of joint disease that’s often called “wear-and-tear” or “age-related,” although it’s more complicated than that.
While it tends to affect older adults, it is not a matter of “wearing out” your joints the way tires on your car wear out over time. Your genes, your weight, and other factors contribute to the development of osteoarthritis.
Since genes don’t change quickly across populations, the rise in prevalence of osteoarthritis in recent generations suggests an environmental factor, such as activity, diet, or weight. Continue reading