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New discoveries in pain management have been slow to emerge, but there have been recent advances in existing medications and analgesic devices, as well as promising new molecules and formulations on the horizon. Dr. Gudin sounds a hopeful note for the future of pain practice.
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There are some common rules that private and governmental agencies use to score prescribing patterns, and that can be referred to various law enforcement agencies for follow-up. Dr. Gonzalez, with the National Association of Drug Diversion Investigators, outlines how these algorithms are used, and...
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Providers who do not understand medical necessity for drug testing, controlled medication prescribing, and substance abuse treatment are at risk as payers increasingly scrutinize these areas. Attorney Jennifer Bolen outlines some "pearls and pitfalls" for clinicians. Watch for important tools you...
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Up to 40% of patients who undero spinal surgery for lower back pain will develop postlaminectomy syndrome, or failed back surgery syndrome (FBSS). Dr. Josihi outlines the pathology, causes, diagnosis, and treatment options that primary care should know about.
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With respect to long-term opioid therapy, prescribing clinicians are faced with a miasma of data, a chorus of regulatory dictates, and the needs of their patients for better pain management. Dr. Clark examines the dilemma confronting providers, and offers practical insight to frontline practitioners...
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Dr. Cheatle reviews some medication and non-medication treatment options for addressing substance use disorder. The message to primary care: a multimodal approach works best, and treatment of the SUD without attention to management of the patient's underlying pain is the likely route to relapse.
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Patients with chronic pain and substance use disorders often have accompanying psychiatric and medical disorders that place them at elevated risk for suicide. Dr. Cheatle, a professor of psychiatry, discusses the epidemiology of suicidal ideation in this population and offers some guidance in...
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Dr. Pryzbylkowski reviews some alternatives to opioids for pain management at different points in the surgical spectrum that can promote improved patient outcomes and mitigate the risk of adverse effects from long term opioids.
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Dr. Pryzbylkowski outlines some key points on the engagement of toxicology screening in the practice, both for pain management and other fields of medicine. Documenting medical necessity will help you stay on the right side of reimbursing entities.
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A culture of "neuromysticism" has arisen around medical marijuana, breeding confusion for patients and clinicians alike. The dearth of quality research on safety and efficacy is a significant contributor to the situation. Dr. Schatman talks about what we know, what we don't, and where cannabinoids...