Tag Archives: opioids

Opioids Have Little Effect on Cognition

The Effects of Opioids on Cognition in Older Adults With Cancer and Chronic Noncancer Pain: A Systematic ReviewOct 2019

I’m only able to access the abstract here, but it says pretty much what pain patients already know: unless we’re also taking other non-opioid medications, like Gabapentin or antidepressants, there is “no effect of opioid use on cognitive domains”.

Context

Opioids are prescribed to manage moderate-to-severe pain and can be used with older adults; however, they may lead to several adverse effects, including cognitive impairment.

This is purely conjecture since it has NOT been proven.   Continue reading

Opium, Opioids And A Pendulum Of Pain

Opium, Opioids And A Pendulum Of Pain – by Hayley Sperling  Wisconsin Public Television – Feb 2019

The story of opioids in the 21st century is one fraught with urgency, pain and heartbreak. To understand how opioids came by their contemporary and often-negative reputation, it’s crucial to examine their history.

The earliest reference to opium use was in about 3500 B.C.E., Dahl said. By 1300 B.C.E., the Egyptians cultivated the opium poppy plant, and its use spread when in 330 B.C.E., Alexander the Great introduced it to Persia and India.

Because they’ve been used for millennia, we know more about opioids than any pharmaceuticals developed by modern science. In some ways, this makes them much “safer” than any of the alternatives suggested.  Continue reading

Chronic Pain After Cancer: The Role of Opioids – part 2

Chronic Pain Following Treatment for Cancer: The Role of Opioids – Ballantyne – 2003 – The Oncologist – Wiley Online LibraryJane C. Ballantyne –  Dec 2003

This is part 2 of a long article (part 1 here) making very reasonable arguments for using opioids after cancer treatment when chronic pain persists. Her views used to be reasonable, but now she’s one of the most adamant anti-opioid zealots.

Stable Pain Treatment

Ideal chronic opioid therapy, assuming the pain and disease are stable, uses a stable dose of opioid medication

Often, chronic pain is constant and unremitting, and in that case, long‐acting drugs and formulations given round the clock are useful. Round‐the‐clock dosing allows many patients to achieve maximum functionality, without the need to focus on the next dose of drug and without the swings in analgesic level associated with as‐required dosing.   Continue reading

Chronic Pain After Cancer: The Role of Opioids – part 1

Chronic Pain Following Treatment for Cancer: The Role of Opioids – Ballantyne – 2003 – The Oncologist – Wiley Online LibraryJane C. Ballantyne –  Dec 2003

This study was done just months after Ballantyne had authored a study claiming hyperalgesia is a common problem with continued opioid use.

Ballantyne is one of the most adamant anti-opioid zealots who now insists that “opioids are bad” under all circumstances and shouldn’t be used for chronic pain, but in 2003 she was apparently still reasonable.

Opioids are the most effective analgesics for severe pain.

opioid tolerance, if it develops, is relatively easy to overcome, and other problems of opioid use, including substance abuse, are unlikely to be problematic.

So, in 2003, she believed that opioid use is unlikely to be problematic, a view directly opposed to her current position. We never see references to these positive findings of opioid use anymore.
Continue reading

Review Finds Opioid Patients Often Feel Stigmatized

Opioid Patients Often Feel Stigmatized, Review Finds | HCPLive – by Samara Rosenfeld – Feb 2020

Patients who took opioids for chronic non-malignant pain often felt stigmatized and did not want to take the medication, according to a recent review.

Since we don’t even want to take opioids, this is clearly NOT addiction!

The findings of the review highlighted that individuals who took opioids weighed the pros and cons of the medication but felt they had no choice but to take them because of their pain.

This is exactly how I feel: what choice do I really have?  Continue reading

Clinical Challenge: Opioid Tapering

Clinical Challenge: Opioid Tapering | MedPage Todayby Judy George, Senior Staff Writer, MedPage Today March 1, 2020

Too much focus on the pill and not enough on the whole person: that’s a key piece missing in the movement to reduce opioids among chronic pain patients, said Beth Darnall, PhD, of Stanford University in Palo Alto, California.

Some agencies and companies used the 2016 guideline to push hard dose limits and abrupt tapering, which the CDC later said was inconsistent with its recommendations

I notice that this hasn’t changed any of the “wrong” laws, which may be enforced long after the truth is known.   Continue reading

Nurses Defend Doctor Charged in Hospital Deaths

Nurses Defend Ohio Doctor Charged in Deaths at Hospital – The New York Times – Dec. 20, 2019

After I’d annotated this article back in December, I went back to look at it and got the error” Page No Longer Available” from the NY Times. This has never happened before, so I’m left to wonder why this particular article would be disappeared.

I suspect it’s because it points out that the “leaders” of healthcare industries are utterly ignorant about opioid doses, while the people spending time with the real patients, like doctors and nurses, are doing their best to ease the pain and suffering of their most sick and dying patients.

Ten former colleagues of an Ohio hospital doctor who pleaded not guilty to murder in 25 patients’ deaths are coming to his defense in a new lawsuit.   Continue reading

Scrutiny Of Painkiller Distributors Harms Patients

Scrutiny Of Painkiller Distributors Harms Patients Sally Satel,  Contributor – Dec 2019

Anyone following the opioid problem knows about the delinquent practices of some drug distributors, the companies that deliver painkillers from manufacturers to pharmacies. 

By transporting “suspicious orders” – regulatory code for unrealistically large shipments — to rogue pharmacies, they helped fuel the crisis of addiction and overdose.

This is like a history lesson from 10 years ago when this was happening. By now the overdoses are no longer from pills because they’re too difficult to get and too expensive. Instead, they use some powdered street drug (heroin, meth, cocaine) that’s been laced with undetermined quantities of fentanyl, frequently enough to kill them.  Continue reading

Opioid Prescribing and Physician Autonomy

Opioid Prescribing and Physician Autonomy: A Quality of Care Perspective  free full-text /PMC6384205/ Feb 2019

As one article published in American Family Physician in 2000 stated: “Despite recent advances in the understanding of pain management, patients continue to suffer needlessly, primarily because of improper management and inadequate pain medication”

This article evaluates the effectiveness of recent legislative mandates and restrictions on opioid prescribing and proposes alternative frameworks for combatting and preventing harms caused by the misuse of prescribed opioids.   Continue reading

Long-term Use of Opioids for Complex Chronic Pain

Long-term Use of Opioids for Complex Chronic PainOct 2014

This chapter focuses on the use of opioids for care of chronic musculoskeletal pain conditions such as back pain, and addresses clinical and public health issues that arise when opioids are used long-term for these conditions.

For our purposes, long-term use is defined by use of opioids for two months or more on a daily or near-daily basis. While the large majority of patients who use opioids for a few days or weeks discontinue use, the likelihood of sustained use is increased among persons who sustain daily or near daily use for more than two months

That’s because “daily use” is due to daily pain! Continue reading