Opioid Prescribing: The Setting Matters, Long-Term Use Less Likely

Prescriptions for opioids written for patients in the emergency department are for smaller doses and of shorter duration than are prescriptions written elsewhere, say findings from a study led by Mayo Clinic. The same study concludes that these patients are less likely to become long-term opioid...

Why Breast Cancer Patients on Opioids Avoid Life-Prolonging Therapy

A new study conducted by researchers from the University of Virginia School of Medicine’s Department of Public Health services has uncovered a disturbing reason for breast cancer patients’ failure to complete the hormone therapy regimen that is considered essential for long-term survival following...

CDC Prescribing Guidelines: Federal Review is Biased and Inconsistent

The 2016 CDC guidelines on opioid prescribing have been faulted in some quarters for a lack of scientific basis, and an article earlier this week discusses a recent study of the federal review process used in their development. Led by past PAINWeek faculty member Daniel Carr, MD, MA, professor of...

Opioid Overdose Vaccine: Helping the Substance Use Disorder Epidemic

New research presented last week at the national meeting of the American Chemical Society may point the way to a more effective treatment response for overdoses of opioid combinations—including fentanyl combined with heroin--that are at the heart of the epidemic of substance use disorder. The new...

Opioid Induced Hyperalgesia: Exploring Myth and Reality

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...

The Challenge of the Inherited Pain Patient

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.

Cracking the Cryptomarket: How to Disrupt Drug-Dealing on the Darknet

Researchers from Ohio State University have completed what they report as the first study of the network structure of an encrypted online drug distribution network, examining patterns of behavior between buyers and sellers of illicit opioids. They report that first-time buyers on the so-called...

Public Policy and Pain Management

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.

Why is Primary Care Underusing Buprenorphine?

Buprenorphine was approved for the treatment of opioid use disorder in 2002, with the stipulation that prescribing clinicians obtain a waiver from the Substance Use and Mental Health Services Administration (SAMHSA), and with limitations on how many patients those authorized prescribers may treat in...

Medicaid Expansion as a Solution to Addressing the Opioid Crisis

Researchers from the Milken Institute School of Public Health at George Washington University recently completed a comparative analysis of the impact of Medicaid expansions on states’ abilities to respond to the opioid abuse crisis. By contrasting states that have expanded Medicaid coverage with...