Tag Archives: opioids

The Opioid Crackdown: Have We Gone Too Far? (Part II)

The Opioid Crackdown: Have We Gone Too Far? Part II – November 15, 2017 – by Anne Fletcher

Common misconceptions and misinformation have fueled near hysteria about the so-called opioid “epidemic,” fed what’s been called a “civil war” within the medical profession, and downplayed concerns about other major drug problems.

Furthermore, misinterpretation of the widely followed 2016 “CDC Guideline for Prescribing Opioids for Chronic Pain – with its 12 “recommendations” for “determining when to initiate or continue opioids for chronic pain” – has left some chronic pain patients feeling defenseless against their agony.   Continue reading

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Review of opioid-induced hyperalgesia

A comprehensive review of opioid-induced hyperalgesia. – PubMed – NCBI – Pain Physician. 2011 Mar-Apr – Free full text

Opioid-induced hyperalgesia (OIH) is defined as a state of nociceptive sensitization caused by exposure to opioids.

The condition is characterized by a paradoxical response whereby a patient receiving opioids for the treatment of pain could actually become more sensitive to certain painful stimuli.

When a patient has this (which has never been proven in humans), giving more opioids leads to more pain, instead of less. Continue reading

Chronic Pain, Chronic Opioid Addiction: a Complex Nexus

Chronic Pain, Chronic Opioid Addiction: a Complex Nexus – free full-text /PMC4781803/ – J Med Toxicol. 2016 Mar

Opioid therapy is regarded as necessary in the treatment of acute pain, such as post-operative pain.

Chronic opioid therapy (COT) is often utilized in palliative care and cancer pain paradigms.

However, COT remains controversial for the treatment of chronic non-cancer pain (CNCP), which often leads to physical dependence and may resemble an addictive disorder.   Continue reading

How to Increase the Odds of Filling your Opioid Rx

10 ways to increase the odds of filling your narcotic prescription at a pharmacy – Oct 2017 – written from a pharmacy tech’s point-of-view

Filling a schedule II (C-II) or narcotic prescription at a retail pharmacy can be a daunting task nowadays. It doesn’t matter what kind of medicine – Narcotic pain relievers, Adderall, Vyvanse for the kids or Patches of any type.

Legitimate patients are paying the price of a society that has gone wide with the abuse and misuse of opioid narcotic pain relievers.

This problem has prompted government agencies to respond

Unfortunately, the response has been punitive for Pharmacies.  Continue reading

A World Without Pain Medication

Russian cancer patients are killing themselves because they can’t get pain meds — Quartz – by Katerina Gordeeva – March 27, 2015

This is what the world is like without pain medication:

In Feb. 2014 in Moscow alone, 11 cancer patients committed suicide

There’s no end to the pain. It won’t stop the next morning, or tomorrow, or the day after,” whispers Tanya, 29, a Russian cancer patient. “It won’t disappear if a tooth is pulled out or if drops of medicine are squeezed into your ear. If you don’t relieve the pain somehow, it eats you up right to the end. It’s absolutely unbearable.”   Continue reading

DEA Statement Promoting Pain Relief

Promoting Pain Relief and Preventing Abuse of Pain Medications: A Critical Balancing Act – A joint statement from 21 health organizations and the Drug Enforcement Administration (DEA).

In this PDF file from October 2016, I found surprisingly patient-centered statements endorsed by the DEA, like:

“For many patients, opioid analgesics… are the most effective way to treat their pain, and often the only treatment option that provides significant relief.”

…share a responsibility for ensuring that prescription pain medications are available to the patients who need them

However, I don’t see any indication the DEA is following its own “consensus statement”.   Continue reading

Misconceptions About Opioid Use

Misconceptions about opioid use: A Medicine X discussion | Scope Blog | By Jennifer Huber on September 17, 2017

We often hear about the “opioid crisis” and its devastating effects. But, argued panelists at a Stanford Medicine X session on the topic yesterday, the issues are often oversimplified in public discussion and by the media, which stigmatizes opioid users and contributes to misconceptions.

The afternoon panel — which Larry Chu, MD, moderator and executive director of Medicine X, deliberately called “Opioids in America” instead of “The Opioid Crisis” — offered a broad range of perspectives from patients and physicians. 

Among the misconceptions discussed by the panel:   Continue reading

New CVS Opioid Policy: Rx Limits & Nonmedical Switching

New CVS Opioid Policy Raises Concerns Over Prescription Limits, Nonmedical Switching – Sept 2017 – Donald M. Pizzi

CVS Caremark’s announcement that it is adopting an “enhanced opioid utilization management policy” in early 2018 (see Public-Health Experts Are Skeptical of the CDC’s New Anti-Opioid Campaign) has some in the pain community concerned that the pharmacy chain is dictating medical [care] to and potentially taking important medication options away from those who need them.

Chief among its features is a seven-day limit on the opioid medications it dispenses “for certain acute prescriptions for patients who are new to therapy.”

Remember, this 7-day limit is only for *new* prescriptions and does not apply to long-term prescriptions for chronic pain.   Continue reading

Prescribed Opioids After Surgery Often go Unused

Study: Many Patients Don’t Use Prescribed Opioids After Surgery – Pain Medicine News – Oct 2017

A new study found that over two-thirds of patients did not use opioids prescribed to them postoperatively.

If opioids were as addictive as advertised, we wouldn’t be seeing opioids unused. The fact that patients may take only a few of their prescribed opioids contradicts the assertions that merely a taste of opioids causes almost everyone to become addicted.

How does the anti-opioid leader of PROP, Kolodny, explain that?  Continue reading

Underlying Factors in Drug Overdose Deaths

Underlying Factors in Drug Overdose Deaths | Substance Use and Addictive Disorders | JAMA | The JAMA Network – October 11, 2017
JAMA Viewpoint:  Deborah Dowell, MD, MPH; Rita K. Noonan, PhD; Debra Houry, MD, MPH

This is the “viewpoint” of the very influential Dr. Houry,  the Director of the National Center for Injury Prevention and Control (NCIPC) at CDC, who has been instrumental in restricting prescription opioids.

Since 2010, overdose deaths involving predominantly illicit opioids (heroin, synthetic nonmethadone opioids, or both) have increased by more than 200% (Figure).

Continue reading