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The 2016 Centers for Disease Control and Prevention Guideline for Prescribing Opioids for Chronic Pain was controversial; did it change minds? Apparently it did get practitioners to think “nonopioids” more often. An article published in JAMA Network Open presented information based on cohort study...
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A patient asks you if medical marijuana would help with their rheumatic pain. What do you say? In a literature review published in Current Rheumatology Reports, researchers explored the efficacy of medical marijuana for the pain of rheumatic diseases. The study states, “Observational and survey...
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At the Society of Thoracic Surgeons’ 18th Annual Perioperative and Critical Care Conference, results from an examination of opioid prescribing for over 2,000 lung resection patients were presented. These patients were enrolled in an enhanced recovery after surgery (ERAS) protocol, which lead to...
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Guidelines. Meant to be helpful. But… they have both positive and negative impacts, and are sometimes misappropriated. Michael R. Clark, MD, MPH, MBA, talks about the good and bad of guidelines, and the importance of remembering that they are just that: a guide.
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Dr. Doug Gourlay and legal expert Jennifer Bolen discuss the intersection of medicine and law. What are the connections between carrying out licensing board directives on using opioids to treat pain, reasonably prudent medical decision-making, and documentation. Practitioners must never lose sight...
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An article in JAMA Network Open asked the question, “Have prescriptions for Schedule II opioids with high abuse potential, vs Schedule IV tramadol (lower abuse potential), decreased in the 18-month periods before and after publication of the Centers for Disease Control and Prevention opioid...
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The crisis of opioid overdose has led us to the challenge of balancing compassionate and effective treatment of pain against the risks of medication misuse, all in an environment of political and regulatory reactiveness. What are the core ethical principles to help ensure that the needs of patients...
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A perennial favorite among the sessions at PAINWeek is the exchange of perspectives by clinical pharmacy specialist and adjunct associate professor Jeffrey Fudin and Jeffrey Gudin, director of the pain management and palliative care center at Englewood Hospital. In this 2-part video, we offer some...
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Prescribing guidelines are being enshrined in state regulations, and sometimes are elevated in criminal proceedings as “standards of care”, despite lack of evidence that they are helping to alleviate the abuse crisis. Dr. Ziegler discusses intended and unintended consequences, and where we go from...
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A litany of unintended consequences has attended the introduction of prescribing guidelines aimed at curbing opioid use. In this segment, Drs. Barkin and Jay outline some of these, review aspects of the development process that may have contributed, and discuss some potential solutions and what it...