Justification of Morphine Equivalent Opioid Dosage Above 90 mg – Practical Pain Management – August 16, 2017
It is recognized that some patients with severe chronic pain require opioid dosages over 90 morphine milligram equivalents (MME) a day.
The Centers for Disease Control and Prevention (CDC) has stated in its opioid prescribing guidelines that physicians should evaluate and carefully justify the rationale for prescribing above this level.
In California, where we practice, also has written guidelines that require justification for a daily opioid dosage above 80 MME. Continue reading
Guidelines are wonderful. Guidelines are dangerous – KevinMD.com – ROBERT CENTOR, MD | July 2017
Over the past decade, I have thought often about the benefits and the problems of clinical guidelines. The first concept that attracted my attention was reading about conflicting guidelines.
Given the same data, different guideline committees would have significantly different recommendations. At the least, this problem raises questions about guideline validity.
It makes clear that committee perspective could influence recommendations.
This is exactly what happened when the CDC opioid prescribing guidelines were ghost written by addiction specialists from PROP. Continue reading
FDA Blueprint for Prescriber Education for Extended-Release and Long-Acting Opioids
The period for commenting ends Monday, July 10, so please take a moment to visit the site and express your objections.
Below is the comment I wrote: Continue reading
When Managing Pain Becomes a Criminal Offense: Advice for Health Care Professionals – Pain Medicine News – JUNE 7, 2017 – Jack Sharman
When does your patient care turn into your criminal trial?
That’s the question many physicians, nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs) and physician assistants (PAs) are asking in the wake of a tidal wave of prosecutions related to pain medicine.
This has been partly spurred on by the “opioid epidemic.”
There has been a sharp spike in convictions—either by guilty plea or by conviction after a trial—of health care professionals involved in pain medicine. Continue reading
INSIDER INFORMATION: Opiate Prescriptions – from drugs-forum.com – Richard_smoker, Mar 21, 2006
Interested in what your psychiatrist &/or pain control doc is thinking when you tell him you’re in pain?
Perhaps you will be shocked when you read what’s going through his mind. If you know what’s best for yourself (pun intended), then you will read the ‘suggestions’ herein very carefully.
Here it is. 2 back-to-back articles copied starting on pg. 1282, JOURNAL OF PALLIATIVE MEDICINE. Volume 8, Number 6, 2005.
Is It Pain or Addiction? – DAVID E. WEISSMAN, M.D. Continue reading
Back to the Future—the Tragedy of Unrelieved Pain and Suffering – PAINS – Pain Action Alliance to Implement a National Strategy – PAINS Project | Jun 15, 2017 |by Richard Payne, MD, Medical Director, PAINS Project
As a young doctor I attended a conference at MD Anderson Cancer Center titled “Treating Pain in a Drug Oriented Society.”
One of the conference keynote speakers, Dr. Kathleen Foley, called for the “decriminalization” of cancer pain, noting that (even back then) the American Medical Association,
- the American Pain Society,
- the American College of Physicians and
- the World Health Organization
recognized that opioid pharmacotherapy was the mainstay of treatment for patients with cancer experiencing moderate to severe pain. Continue reading
» call MORGAN & MORGAN ..tell your story… refer to chronic pain patient class action PHARMACIST STEVE June 19, 2017 by Steve Ariens
Chronic Pain Patients – Call Now
Morgan & Morgan Lawyers
Ask for the medical malpractice department.
Refer to chronic pain patient class action and tell your story. Continue reading
Lawmakers and practicing medicine without a license – Law Stack Exchange
Again and again we see lawmakers pass laws (generally in the context of abortion) that
- direct doctors to provide medically incorrect information or
- engage in acts which are medically unsound, or
- to not provide medical information beneficial to the patient.
How is this not engaging in the practice of medicine? Why are they not prosecuted for such behavior?
It turns out that lawmakers have special rights, known as legislative immunity (link to Wikipedia article with explanation), which allows them to enact laws. Continue reading
Top Scientists Revamp Standards To Foster Integrity In Research: Shots – Health News : NPR -April 11, 2017 – Heard on Morning Edition
It’s been 25 years since the National Academy of Sciences set its standards for appropriate scientific conduct, and the world of science has changed dramatically in that time. So now the academies of science, engineering and medicine have updated their standards.
The report published Tuesday, “Fostering Integrity in Research,” shines a spotlight on how the research enterprise as a whole creates incentives that can be detrimental to good research. Continue reading
Are Abuse-Deterrent Opioid Products A Double-Edged Sword? – Practical Pain Management – May 16, 2017 – By Jasmine Shah, PharmD and Ryan W Rodriguez, PharmD, BCPS
Solving the opioid epidemic is complex because of the multifactorial underlying causes. Complicating this issue is the need to maintain access to opioids for patients with chronic pain conditions for which prescription opioid analgesics are the only effective treatment.
Any attempts to mitigate opioid abuse must not have the unintended consequence of eliminating a viable treatment option for patients using opioid medications appropriately and experiencing meaningful clinical improvement. Continue reading