Search Results - Expert Opinion Videos

Search results within Expert Opinion Videos for: opioid therapy
Increasing concern over long-term opioid therapy for chronic noncancer pain has prompted interest in opioid sparing alternatives. Is cannabis useful as an opioid sparing approach to pain management? Dr. Badiola considers the evidence. ...
The complex problems that opioid issues bring about are not easily solved. Jeremy A. Adler, MS, PA-C, of Pacific Pain Medicine Consultants, warns against looking for a single solution. ...
What if health insurance companies don't step up to the plate? Jeremy A. Adler, MS, PA-C, of Pacific Pain Medicine Consultants, warns against looking for a single solution. ...
Multidrug therapy has been part of the chronic pain treatment armamentarium for many years. In this segment, Dr. Argoff reviews the concept and offers guidance on its engagement. ...
Dr. Date works at a county hospital in San Mateo, California, where opioids are just one of the tools in the pain management toolbox. ...
Dr. Date works at a county hospital in San Mateo, California, where a lack of practitioners and the limited resources of patients contribute to the pain management difficulties in this setting. ...
In addition to other shortcomings, current prescribing guidelines are particularly ill-suited to the needs and challenges of patients already on opioid therapy. Drs. Heit and Gourlay discuss the roots of the problem and the role of primary care as talented amateurs in addiction medicine. ...
Spinal manipulative therapy is far from new, but questions remain over effectiveness in comparison to other treatment options, as well as the patients for whom it may be most beneficial. Dr. George reviews the current research, and what remains to be learned. ...
Virtual reality (VR) has been in the treatment armamentarium for some decades, but the technology has been cost-prohibitive for many practitioners. Dr. Jones outlines some recent advances that are changing the cost/benefit landscape, and discusses recent clinical evidence for VR in pain management. Reimbursement remains an issue, but VR is ...
Can opioids be rationally prescribed for chronic pain? Dr. Stacey considers some of the components of getting there, including strengths and limitations in the current CDC guidelines, the practice of tapering; elements of patient assessment, red flags to watch for, and the proper role of opioids in the multimodal treatment ...
Despite its widespread use as a treatment modality for pain, the results of controlled trials of acupuncture efficacy have returned mixed results. Dr. Harris reviews the evidence including emerging approaches that may help to determine if analgesia from acupuncture derives from placebo or from action on receptor activity and neurotransmitter ...
Dr. Napadow discusses some recent advances in neuromodulation that have advanced the utility of the modality for the treatment of chronic pain conditions. Transcutaneous Vagus Nerve Stimulation is one such promising approach that has shown clinical benefit in the treatment of migraine. New wearable technologies are the promise of the ...
Although recent CDC guidelines have focused on opioids for chronic pain management, little attention has gone to the perioperative setting as a potential contributor to the prescription drug crisis. Dr. Bottros gives his perspective on opioids and other alternatives for postoperative pain. ...
A specialist in public policy and bioethics considers the conundrum of gaining insurance coverage for this cost-efficient but expensive paradigm change to prescribing decisions, as well as some of the ethical issues associated with the practice of pharmacogenomic testing. ...
Successful treatment of chronic pain means going beyond the pharmacologic options to embrace self-care, psychological and psychosocial factors, functional restoration, and alternative medicine. Dr. Pohl provides an exploration, and outlines some ideas for primary practitioners to engage. ...
Opioid induced respiratory depression is associated with over 16,000 deaths in the US each year, and the risks of opioid therapy are not fully understood by many prescribers. Dr. Fudin reviews some of the unanticipated concerns, with a focus on assessing and managing risk for respiratory depression. ...
Drs. Hah and Prasad review the current evidence on long-term opioid therapy for chronic non-cancer pain, and discuss some approaches to achieving a successful transition to pain management without opioids. ...
An experienced pain management nurse practitioner brings some succinct observations on the proper role of electronic health recordkeeping and opioid risk evaluation to guide in coprescription of naloxone. ...
Recent guidelines from the CDC strongly urge a reduction in opioid prescribing in favor of a multidisciplinary approach for the treatment of chronic pain. Dr. Silverman discusses how frontline practitioners can contextualize this information to help patients achieve better functionality and quality of life. Interventional medicine may be part of ...
The recently released CDC prescribing guidelines and recommendations from the National Pain Strategy refer to pain psychology as on the critical path to the management of pain. Drs. Mackey and Darnall discuss this role and what needs to be done to bring this treatment modality within the reach of patients ...
Dr. LaPietra engages her expertise in acute pain management to outline some effective treatment modalities for use in the emergency room. She also comments on recently published CDC prescribing guidelines for opioid medications, and how they may refine the practice of pain management. Collaboration between the emergency department and the ...
A professor of physical medicine and rehabilitation discusses the treatment of neuropathic pain and what the primary care clinician should know and do. Addressing the whole patient via an interdisciplinary team is the key to better outcomes. Specific points on Fibromyalgia, CRPS, and Ketamine as therapy are also considered. ...
The legal landscape for prescribers of controlled medications for pain and addiction is fraught with risk. Attorney Michael Barnes outlines best practices for prescribing clinicians to protect their patients from harm and themselves from criminal and civil liability. ...
Morphine equivalent daily dose (MEDD) has been routinely used in clinical practice and as a research variable. Dr. Schatman discusses some of the ethical concerns attending the use of this flawed concept, for both clinical guidance and research validity. ...
Dr. Christo outlines some common procedures used for pain reduction, including a basic description, and the supporting evidence base. Also considered are patient presentations that may be most suited to one or another of these modalities. ...
Concern over opioid abuse is amplifying interest in opioid induced hyperalgesia among governing bodies and payor organizations. Dr. Harden discusses the current state of the science surrounding OIH, including terminology, technology/methodology, and existing evidence. Additionally, he offers some observations on the 2016 CDC prescribing guidelines for primary care practitioners. ...
Chronic pain can lead to inactivity, functional impairment, and reduced quality of life. Dr. Abaci discusses the complex central nervous system changes that can accompany chronic pain syndromes, and how exercise can mitigate these effects. While individual patient presentations differ, the core concepts of rehabilitation can be engaged by every ...
In addition to other shortcomings, current prescribing guidelines are particularly ill-suited to the needs and challenges of patients already on opioid therapy. Drs. Heit and Gourlay discuss the roots of the problem and the role of primary care as talented amateurs in addiction medicine. ...
Public policy reaction to the opioid crisis has significant implications for practitioners and their patients with pain. Attorney Michael Barnes looks at the current federal and state-level regulatory picture, and at some benefits, drawbacks, and unintended consequences of regulatory response. ...
At PAINWeek 2016, a panel of medical, legal, and pharmacy specialists convened to offer their views on the recently introduced prescribing guidelines for chronic pain from the CDC. In this segment, Dr. Ziegler and Dr. Fudin summarize some of the concerns voiced over the guideline development process, and the utility ...
PAINWeek faculty member Gary Jay discusses what's going on with opioid prescribing today, and why some doctors may be prescribing opioids when they might do better with another medication. ...
Pharmacotherapy and polypharmacy pose special risks for elderly patients, and the use of interventional strategies is increasingly recognized as important for this population. Dr. Bottros reviews some options to consider. ...
Will recently released prescribing guidelines from the CDC advance the cause of rational opioid therapy? Will they lead to better pain practice and better patient outcomes? Dr. Argoff considers the good, the bad, and the ugly... ...
A clinical pharmacy specialist turns the spotlight on an option for chronic pain management that many clinicians may not have considered. Buprenorphine offers advantages to patients who are indicated for opioid therapy, but are at risk for adverse effects, While reimbursement is an issue, it remains an option for providers ...
One approach to maintaining the balance between risks and benefits of opioid therapy for chronic pain has been the development of abuse deterrent formulations. A pain management PA provides an overview of abuse deterrent technologies, both existing and emerging.While developments are encouraging, they are but one part of the solution. ...
Evidence based biobehavioral therapies, including cognitive behavioral therapy (CBT) and biobehavioral training are indicated for a variety of chronic pain conditions, including fibromyalgia and migraine headache. Dr. Buse, a psychologist, researcher and professor of medicine, outlines what primary care should know about the options, using migraine as a presentation example. ...
Special K is often thought of as a drug of abuse, but it also may be a valid opioid replacement. ...
We begin the week on The Daily Dose with a special report from the online journal STAT that reviews the dimensions of the crisis in opioid prescribing for patients with chronic pain. While not breaking new ground in the discussion, the report offers a... ...
In an environment of escalating scrutiny over controlled medications, frontline practitioners who prescribe them for pain therapy need to take the appropriate steps to demonstrate "prescribing for a legitimate medical purpose while acting in the usual course of professional practice." Jennifer Bolen, JD, longtime PAINWeek faculty member, and founder of ...
A specialist in addiction medicine offers guidance in identifying opioid misuse and the appropriate means of withdrawing patients from long term opioid therapy. The longer term management and rehabilitation of these patients is also considered. ...
Chronic pain patients who fail standard treatments represent a growing problem, and a dilemma for health care providers. A pain specialist and senior PAINWeek faculty member discusses what we know about treatment failure, and outlines some elements... ...
This segment introduces the concept of virtual reality and offers an exploration of its utility in combination with other cognitive behavioral therapies in pain management. ...
The existence of opioid induced hyperalgesia as a side effect of chronic opioid therapy has been debated. A pain specialist offers his perspective on its reality and manifestations, and what the primary care clinician can do in response. ...
Dr. Reid reviews some of the age-related complications of geriatric pain management, and discusses the safety and efficacy of both pharmacologic and alternative treatment modalities. The value of collaborative models of care delivery for this patient... ...
Why is complex regional pain syndrome a frustrating and challenging patient presentation? This segment outlines some of the reasons, and offers some pointers on diagnosis and treatment. ...
In this segment, a former law enforcement professional and credentialed pharmacist considers the world of illicit pharmaceutical trafficking from the juncture of prescribers, investigators, and the legal system. What is happening, and how can the... ...
A number of validated risk assessment tools are available to the prescribing clinician, and their use is increasingly important in the current environment for opioid therapy. A clinical psychologist and Certified Pain Educator summarizes what the... ...
Counterfeit medications are a cause of decreased wellness, increased morbidity, and even death. An anesthesiologist and interventional pain physician reviews the origin of counterfeit medications, describes some anti-counterfeiting technologies and... ...
Doctors Gourlay and Heit, specialists in the arena of pain and addition, explore some of the more common issues confronting the primary care clinician in the management of long-term opioid prescribing. The focus is on the challenges of the inherited... ...
Doctors Gourlay and Heit, specialists in the arena of pain and addition, explore some of the more common issues confronting the primary care clinician in the management of long-term opioid prescribing. The focus is on the challenges of the inherited... ...
Most workers compensation claims involve pain treatment, and most of that therapy involves pharmaceuticals. Dr. Foster overviews the trends and treatment guidelines that primary care practitioners should be aware of, to achieve the best outcomes for... ...
Beyond its role in treating opioid dependence, methadone has unique benefits that make it a viable option for chronic pain management. But with these come multiple pitfalls, for which the risks of methadone therapy may outweigh its benefits for some... ...
High-quality research on the safety and efficacy of medical cannabinoids as pain therapy has long been impeded by an adverse regulatory environment. Even as the prominence of medical marijuana continues to grow--in part due to the public health... ...
In response to the escalating crisis of opioid abuse and overdose fatalities, states are adopting dosage thresholds as part of their prescribing guidelines. A clinical pharmacist and public policy professor summarize the public health landscape that... ...
Prescription Drug Monitoring Programs (PDMPs) are widely available, but not yet uniformly used. A clinical pharmacist and associate professor evaluates the current landscape, and what can be improved to enhance their utility in curbing substance... ...
Stem cell therapy is among the newest innovations in the management of chronic pain and degenerative disease, and offers the most promising outlook in terms of success and prognosis. The technique of stem cell extraction is easy and can be done... ...
Dr. McPherson comments on recent consensus guidelines for methadone prescribing, with background on the properties of this analgesic that render it both an attractive and challenging opioid for pain clinicians. Special considerations for patients... ...
Clinicians involved in pain management face a practice environment that is in constant flux. In this segment, an attorney with deep experience in the medico-legal issues confronting pain practitioners outlines steps that they can take to stay current... ...
Although prescription medications are of great benefit to many patients with chronic non-cancer pain, there are significant complications for patients who are either addicted or in recovery. Dr. Durham, a clinical pharmacist, professor of pharmacy,... ...
Must opioid therapy work for everyone to be a valid part of the treatment armamentarium? Dr. Passik considers some of the consequences of "absolutist thinking" that are leading members of the pain community to unnecessarily harsh self-judgements.... ...
A specialist in pain and substance abuse discusses findings from the research on vulnerable populations in the pain community. Patients with pain and concurrent substance use disorders are particularly at risk for depression and suicidal ideation. To... ...
Effective use of naloxone for opioid overdose requires, first, the ability to recognize the symptoms and signs of opioid induced respiratory depression. All healthcare providers, responders, and patients need education in identifying overdose... ...
A clinical professor of pharmacy offers some insights for primary care on best practice in opioid prescribing. Dr Atayee discusses the importance of risk assessment, competence in dosing and titration, and alternate routes of administration,... ...
The role of diet in provoking inflammation and subsequent pain is substantially underappreciated. Dr. Blatman offers pointers to frontline clinicians on what to look for and how to educate patients on the importance of nutrition and dietary selection... ...
A panel of legal and compliance experts discuss some of the issues confronting prescribers of controlled substances in the management of patients who may be abusing and/or diverting their medications. How should clinicians negotiate the terrain... ...
Dr. Atayee overviews some recently approved medications for treatment of opioid-induced constipation, nausea from chemotherapy, and insomnia. Clinical evidence is scarce, but all bear further investigation. ...
A specialist in orthopedic regenerative medicine overviews a therapeutic option for musculoskeletal pain that carries a low risk profile while delivering high success rates. In use for many years, newer advanced forms of prolotherapy are now part of... ...
Dr. Mackey summarizes his PAINWeek presentation on the mechanisms and impact of neuropathic pain, with guidance on clinical assessment and approaches to treatment with emphasis on pharmacological options. ...
By advancing from a problem/solution perspective to a holistic life coaching approach in the management of chronic pain, both clinician and patient can achieve better, more satisfying, longer lasting outcomes. ...
Dr. Schatman critiques the present state of affairs in medical marijuana and illuminates a more promising path for exploration in pain therapy. ...
A professor of occupational therapy discusses VTE and the various reasons why the clinician may overlook the diagnosis when patients present with the classic symptoms of pain. ...
Dr. Robeck describes her clinical experience with group interaction in the provision of pain care and addiction management in the VA setting. ...
A nurse practitioner and Certified Pain Educator discusses some of the changes in the healthcare landscape and complexities of medical practice that confront nurse practitioners as part of the pain management team. ...
An epidemiologist looks at opioid therapy from the perspective of dose vs risk relationships, and comments on how communities can better harness local initiative and interest to combat overdose events. ...
Drs. Carter and Schatman consider the consequences that would accrue from the removal of opioids from the therapeutic options for chronic pain. The segment also discusses the characteristics of a "better" opioid, and the research understanding... ...
Drs. Carter and Schatman consider the consequences that would accrue from the removal of opioids from the therapeutic options for chronic pain. The segment also discusses the characteristics of a "better" opioid, and the research understanding... ...
Dr. Argoff comments on the appropriate role of opioid analgesics as part of therapy for chronic noncancer pain, with observations on protecting legitimate access while preventing abuse. ...
What would the world be like without opioids? Dr. Clark hypothesizes on the implications for patients with pain, and on what the characteristics of a "better" opioid might include. ...
In this 2-part segment, Dr. Passik discusses some of the lessons learned during and following the Decade of Pain Control and Research, and implications for the appropriate engagement of opioid therapy in chronic noncancer pain management. Click... ...
In this 2-part segment, Dr. Passik discusses some of the lessons learned during and following the Decade of Pain Control and Research, and implications for the appropriate engagement of opioid therapy in chronic noncancer pain management. Click... ...
Medical cannabinoids are legal in several states, yet there is prescriber resistance to their use. This segment examines some reasons, and discusses the MOA and appropriate patient scenarios for this therapy. Recorded at PAINWeek 2013. ...
Proper documentation is both an ethical and legal duty of healthcare providers, particularly with respect to opioid therapy. Attorney Bolen discusses critical documentation skills, and outlines common mistakes that clinicians may make in maintaining... ...
A discussion of the evolving medical/administrative/legal landscape that confronts prescribers of opioid medications. Attorney Furman offers additional advice on how clinicians can protect their practices. ...
Dr. Argoff comments on the appropriate role of opioid analgesics as part of therapy for chronic noncancer pain, with observations on protecting legitimate access while preventing abuse. ...
A pharmacist perspective on the pros and cons of opioid treatment agreements ...
An occupational therapist and attorney explains this experiential tool for pain management and how it integrates into a clinician's therapeutic plan. ...
Observations on the effectiveness of music as an element of pain therapy. ...
Pelvic pain affects one-quarter of reproductive age women. Dr. Fitzgerald discusses the impact of pregnancy on pelvic pain, and the role of rehabilitation strategies in treatment. ...
An examination of intrathecal drug therapy- the benefits, and clinical considerations of patient selection and managing treatment expectations. ...
A summary of acupuncture and auricular therapies as alternative medicine techniques, and the role of stress and anxiety in pain progression. ...
Dr. McPherson discusses what the primary care clinician should know about initiating methadone therapy, including an outline of some of the precautions that should be considered with this opioid. ...
Dr. McPherson is an acclaimed professor of pharmacy, primary care practitioner and consultant in hospice and palliative care. This segment explores topical and transdermal pain relievers. ...
Chronic pain can be significantly influenced by psychological factors, and proper recognition and treatment can contribute to clinical success. ...
Dr. McPherson is an acclaimed professor of pharmacy, primary care practitioner and consultant in hospice and palliative care. This segment examines some adverse events that are associated with opioid analgesics. ...
Dr. Walker is an assistant professor of pharmacy practice, and a practitioner in palliative care. Here, she discusses the issue of drug interactions in the palliative care setting. ...
Dr. McPherson is an acclaimed professor of pharmacy, primary care practitioner and consultant in hospice and palliative care. In this segment are her observations on patient prescriber agreements for opioids. ...
Dr. McPherson has published extensively on the topic of opioid conversion calculations. In this segment, she speaks to why this is an important skill set for prescribing clinicians, and summarizes the key steps in the conversion calculation process. ...
Awareness and engagement of instructional design methodologies can be of significant benefit to clinicians engaged in pain management. Pain education is a critical component of pain therapy, and Dr. McPherson discusses how these principles can... ...
An examination of some of the gender based differences in the experience of pain, and in response to treatment modalities. ...
An in-depth, 4- part examination of opioid risk assessment in the primary care setting; the need, the tools; the clinician responsibilities. ...
An in-depth, 4- part examination of opioid risk assessment in the primary care setting; the need, the tools; the clinician responsibilities. ...
An in-depth, 4- part examination of opioid risk assessment in the primary care setting; the need, the tools; the clinician responsibilities. ...
An in-depth, 4- part examination of opioid risk assessment in the primary care setting; the need, the tools; the clinician responsibilities. ...
A 2- part examination of some of the chronic pain syndromes that are common in older adults, and the special considerations relating to pharmacology that arise from the physiology of older patients. ...
A 2- part examination of some of the chronic pain syndromes that are common in older adults, and the special considerations relating to pharmacology that arise from the physiology of older patients. ...
Dr. Passik comments on the debate over opioids as appropriate for chronic non-cancer pain, identifying some shortcomings in the arguments from both sides. ...
Dr. Jay discusses some of the issues confronting patients and clinicians in the current environment of cancer pain therapy. ...