Tag Archives: opioids

Fentanyl: Potent and Deadly in Illicit Form

The Fentanyl Story – The Journal of Pain – Dec 2014 – free full-text article

Here’s everything you ever wanted to know about fentanyl, the ultra-strong opioid first synthesized in 1960 for IV medical use.

This article explains the history and the rationale for using this particular opioid medically in transdermal patches (continuous dose) and sublingual wafers (immediately effective).

Unfortunately, even in 2014, it seems the scientific community was unaware that fentanyl was and is being illicitly manufactured for sale on the black market. It is this illicit fentanyl that’s causing so many overdoses due to its extreme potency and poorly controlled careless handling.   Continue reading

Low Risk of Opioid Use Disorder in Primary Care

Low Risk of Producing an Opioid Use Disorder in Primary Care by Prescribing Opioids to Prescreened Patients with Chronic Noncancer Pain | Pain Medicine | Oxford Academic – March 2017

This study shows what pain patients have been saying all along: prescribing opioids for patients with chronic pain very rarely causes problems of drug abuse.

Objective: 

To examine the risk of developing aberrant behaviors that might lead to a substance use disorder (addiction) when prescribing opioids for the relief of chronic noncancer pain in primary care settings.   Continue reading

Tapentadol: for acute and chronic pain

Here are excerpts from 5 PubMed studies on tapentadol (an atypical opioid):

Tapentadol Prolonged Release for Chronic Pain: A Review of Clinical Trials and 5 Years of Routine Clinical Practice Data. – PubMed – NCBI – Pain Pract. June 2017

Tapentadol prolonged release (PR) for the treatment of moderate to severe chronic pain combines 2 modes of action.

These are μ-opioid receptor agonism and noradrenaline reuptake inhibition in a single molecule that allow higher analgesic potency through modulation of different pharmacological targets within the pain-transmitting systems.   Continue reading

Ketamine’s antidepressive effects tied to opioid system in brain

Ketamine’s antidepressive effects tied to opioid system in brain – By Kimber Price – Aug 2018

Scientists at the Stanford University School of Medicine have discovered that ketamine works as an antidepressant at least in part by activating the brain’s opioid system.

The finding overturns previously held beliefs that the drug’s antidepressant effects stemmed solely from its impact on the glutamate system.

These beliefs led to the widespread use of ketamine to treat depression and spurred the development of glutamate-blocking drugs for use as antidepressants.   Continue reading

Efforts to curb opioid Rx may have backfired

Government efforts to curb opioid prescriptions may have backfired – Aug. 24, 2018

In the case of the DEA’s 2014 action to move opioid painkillers [hydrocodone, Vicodin] to a more restricted class, this “may inadvertently motivate surgeons to prescribe greater amounts to ensure adequate pain treatment,” said Dr. Jennifer Waljee, lead author of one of the studies.

Her team believes that once prescription refills became tougher under the new DEA rules, surgeons who worried about a patient’s longer-term pain control simply ordered a larger number of pills so the patient had a “stockpile” of opioids to use at home.  

This seems like a perfectly appropriate medical response to such arbitrary limits.   Continue reading

Promising Results Finding Non-addictive Pain Killer

Scientists Take Big step Toward Finding Non-addictive Pain Killer – Aug 2018 – Wake Forest Baptist Medical Center

scientists at Wake Forest School of Medicine have been working to find a safe, non-addictive pain killer to help fight the current opioid crisis in this country

Known as AT-121, the new chemical compound has dual therapeutic action that suppressed the addictive effects of opioids and produced morphine-like analgesic effects in non-human primates.

How well the results will hold up in humans is always a question that remains unasked as these new drugs are touted as breakthroughs.   Continue reading

Fentanyl Exposure Concerns Among Prison Staff

Heroin-Fentanyl Mix Led to Drug Exposure Concerns at Prison | Maryland News | US News – Aug. 30, 2018 – By LISA CORNWELL, Associated Press

A substance that led to nearly 30 people at an Ohio prison being treated for drug exposure or suspected exposure was a mixture of heroin and fentanyl, the State Highway Patrol said.

Prison guards, nurses and inmates at Ross Correctional Institution in Chillicothe were treated Wednesday with the anti-overdose drug naloxone after an inmate showed signs of a drug overdose, and some people experienced symptoms consistent with exposure to the opioid fentanyl.

Because illicit fentanyl must be injected (like heroin), “snorted” (like cocaine), or swallowed in counterfeit pills, there is no way anyone would be affected by another person’s fentanyl. Lab technicians can handle it without protection (even the liquid) because it can’t be absorbed through the skin.    Continue reading

The Medical Luddites vs. People in Pain

America’s Opiate War: The Medical Luddites vs. People in Pain – By Robert WilburTruthout – June 3, 2012

Even way back in 2012, the DEA was interfering with the medical practice of pain management.

When I published my first paper in clinical psychopharmacology in 1980 with a psychiatrist collaborator, the physician-patient relationship was still virtually sacrosanct.

But with frightening hubris, narcs from the Drug Enforcement Administration (DEA), are now muscling into the practice of medicine.

At this writing, politicians are preparing to launch what may turn into a witch hunt on the medical profession and the medical professionals at the FDA.    Continue reading

Ultra-Low-Dose Opioid May Quash Suicidal Ideation

Ultra-Low-Dose Opioid May Quash Severe Suicidal Ideation – Nancy A. Melville – February 24, 2016

I found this article from last year that shows an unexpected beneficial effect of opioids on mental health. These are truly wonder drugs.

The short-term use of ultra-low-dose buprenorphine (multiple brands) may reduce suicidal ideation in severely depressed patients, new research shows.

“If our results are corroborated by further studies, the short-term use of ultra-low-dose sublingual buprenorphine may emerge as an acute, symptomatic, safe treatment for suicidal ideation,” lead author Yoram Yovell, MD, PhD, of the Institute for the Study of Affective Neuroscience, University of Haifa, in Israel.   Continue reading

A brave high-ranking doctor says opioids help patients

Despite epidemic, doctor says opioids help patients – Aug 2018 – by Janelle Griffith  janelle.griffith@newsday.com

More doctors are starting to push back against the rampant anti-opioid fervor ignited and exacerbated by the media’s focus only on the risk of addiction, not pain relief, when using opioids.

Opioid addiction is an epidemic gripping the nation, leading to thousands of overdose deaths annually. But Dr. Kevin Zacharoff, an anesthesiologist with more than 25 years of experience in pain medicine, says opioids can also provide much-needed relief to many patients.

His 25 years of pain medicine have obviously shown him the truth and he has resisted the anti-opioid PROPaganda that has spread far and wide.   Continue reading