Tag Archives: medication

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

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Crash Course for Submitting Comments to CMS

#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:  

  1. Starting to crack down on opioid ‘potentiator’ drugs – like gabapentin and pregabalin.
  2. Limiting opioids to 90 MME per day.
  3. Making it more difficult for patients to fill two or more long-acting opioids.    Continue reading

FDA Wants to Work with Providers on Opioid Issue

FDA Wants to Work with Providers on Opioid Issue – by Joyce Frieden, News Editor, MedPage Today – February 07, 2018

The FDA would like to work with physicians to find a way to curb the opioid epidemic while still allowing patients who need opioids to have access to them, FDA Commissioner Scott Gottlieb, MD, said here Tuesday. Trying to write policy that works is difficult, says Gottlieb. [duh! -zyp]

Here we have the official word from the FDA Commissioner that opioids are sometimes absolutely necessary for chronic pain:

There aren’t a lot of alternatives for the treatment of chronic pain; for certain conditions, opioids are the only things that do work.   Continue reading

Same pain relief from Opioids and OTC meds?

No Differences Seen Between Opioids, OTC Pain Drugs for Extremity Pain in ED – Pain Medicine News – Jan 2018

There were no clinically meaningful differences in pain reduction at two hours after ingestion among four oral analgesics—two opioids and two over-the-counter painkillers—to treat acute extremity pain in the emergency room, according to a new trial.

A total of 416 patients at two urban emergency departments (EDs) in Bronx, N.Y., were equally randomly assigned to one of four combination, single-dose treatment groups:

You will see that they are using extremely low doses of opioids and much less acetaminophen than in the non-opioid dose, which contains a hefty dose of 500 ibuprofen and 1,000mg of acetaminophen.   Continue reading

Biopharma betting on pain drugs with a checkered past

Biopharma is betting on pain drugs with a checkered past – By DAMIAN GARDE – Jan, 2018

It was supposed to be a $10 billion idea, one that would help wean the world off its opioid dependence and give the drug industry a bounty of lucrative new products.

But the bottom fell out for a new class of pain medicines, called NGF inhibitors, when patients in clinical trials starting inexplicably blowing out their joints.

When we tinker with low-level biological functions in our bodies, we are only looking for one result, the desired outcome. But once we find it, we are too ignorant (and blinded by greed) to understand how our tinkering must also affect other parts of other biological functions.   Continue reading

Addiction psych questions forced opioid tapering

Addiction psychiatrist questions involuntary tapering of opioids – Jan 29, 2018 – by Nate Morabito

Finally, we hear from an addiction specialist who certainly has a great interest in preventing addiction, also condemning forced opioid tapers.

A renowned author and addiction psychiatrist says the efforts of the Department of Veterans Affairs and other institutions across the country to taper people off opioids without their consent is “an outrage.”

“To take a patient who’s doing well off of medication abruptly and without their permission is not unfair. I actually think it’s malpractice,” Dr. Sally Satel said.   Continue reading

Risks Associated With Antidepressant Meds

Risks Associated With Neuropathic Pain Treatment – Tara Haelle, MS   – March 07, 2017

The misleading original headline about Neuropathic Pain Treatment grabbed my attention, but I was disappointed to find that the article is only about antidepressants, one of the many non-opioid medications being used for chronic pain of any kind.

Still, the study shows that these alternatives to opioids, which are so readily prescribed in place of “dangerous” opioids, have very serious side effects and dangers too.

Death and serious outcomes resulting from overdose or poisoning from drugs used to treat depression more than doubled during the last decade and a half, found a recent study, with amitriptyline topping the list.  Continue reading

Digital Pills Track Patient Dosing

Digital Pills Track Patient Dosing and Combat Opioid Addiction – Jan 2018 – Pharmacy Times

Medication adherence presents a unique challenge for pharmacists. In the case of opioids-or prescription painkillers-the dilemma is amplified by medications prescribed on an as-needed basis, which means that decisions regarding frequency and dosage are left to the patient’s discretion.

Pharmacists don’t seem to like patients having autonomy over when and how much medication they are taking, but I have no sympathy for this supposedly amplified “dilemma”.

With pain from EDS that is more chronically resurgent than chronically constant, no one other than I can determine when and how much pain reliever I need.  Continue reading

Tylenol for Postoperative Pain?

Tylenol for Postoperative Pain? — Pain News Network – Dec 2017 – By Margaret Aranda, MD, Columnist

I saw them do it to our veterans. Now they were going to do it to me.

I heard the veterans scream decades ago, when I was president of a pre-med club at a VA hospital in Los Angeles. There was a little local anesthetic, no oxygen, no vital signs and no anesthesiologist. The hematologist-oncologist did the bone marrow extraction herself.  Continue reading

New morphine, M6S for acute and chronic pain

Preclinical assessment of utility of M6S for multimodal acute and chronic pain treatment in diabetic neuropathy – Life Sciences – Volume 192, 1 January 2018

Aims

Previous reports from our laboratory have established that morphine-6-O-sulfate (M6S) is a mixed μ/δ opioid receptor (OR) agonist and a potential improved alternative to morphine for treatment of chronic multimodal pain in non-diabetic rats.

This study extends the antinociceptive effects of M6S and morphine in STZ-induced diabetic rats.  Continue reading