Netvouz / docalex / tag / opioid

Chronic Pain in Veterans

docalex — Fri, 26 Oct 2007 02:26:45 GMT

Table of Contents: Introduction // Opiophobia and Opioignorance // Modern Understanding of Chronic Pain // Risk of Addiction in Opioid Therapy // Treatment and Outcomes // Undertreatment of Pain is a National Scourge // Footnotes

Dear VA - This is Pain 'Care'?

docalex — Thu, 01 Nov 2007 19:16:48 GMT

... A few months ago, a new group of what I call “Narco-Nazis” arrived at the VA, and forced all pain patients to sign a draconian pain contract on threat of losing all care. ...

PRN in World of Pain - Videos

docalex — Mon, 03 Sep 2007 04:46:35 GMT

This is an addendum to my recent post: PRN on Video, which provided links to the three PRN related videos in the ‘See also’ section, above.

To these:

- Siobhan, Ronan, Dr. Cole and Dr. Siegle on Fox
- AP interview with veteran James Fernandez
- The Chilling Effect - documentary by S. Reynolds

I add this short video of Siobhan Reynolds speaking about her husband, Sean Greenwood, co-founder of the Pain Relief Network, and chronic pain patient who died, in agony, earlier this year. This clip is part of the Associated Press media package, ‘World of Pain.’

Treatment of Pain and Substance Abuse

docalex — Fri, 16 Nov 2007 03:59:11 GMT

When specialists and academics and researchers come together to discuss common barriers to optimal pain management, they have found opioid therapy complicated, in both the pain medicine and addiction medicine fields, by misapprehensions and myths. Portenoy and Payne identified “Four types of phenomena that exemplify the accommodations that must be made to further [the goal of dissemination of accurate and up to date information to the fields].” 2 I will consider these briefly, excerpting from “Pain Specialists and Addiction Medicine Specialists Unite to Address Critical Issues.” 3

Utah / Feds Boldly Move Toward Solution to Addiction

docalex — Sun, 25 Nov 2007 01:04:11 GMT

Excerpt: So, what have we got? We have local officials running around preparing for a hypothetical law enforcement problem the policeman is hyping. Through some horrific leap of irrationality and probably criminal negligence, state and local officials have taken law enforcement’s worst case scenario - that the doctor was a drug dealer, all of his “patients” criminal addicts, all the meds all of them were ever prescribed were 100% diverted to high school students leading to generations of misery and crime for sure - and blotted out any notion that there might be a medically directed public health approach to consider. And no criminal charges [against Dr. William Stack] have even been filed yet.

End-of-Life Pain Management: - a Criminal Offense?; Robert Weitzel, M.D.; 2003

docalex — Sat, 06 May 2006 17:10:48 GMT

End-of-Life Pain Management: - a Criminal Offense?; Robert Weitzel, M.D.; Journal of American Physicians and Surgeons Volume; 8(4); 2003.

Red Flags and the Standard of Care

docalex — Mon, 03 Sep 2007 01:59:37 GMT

In summary, in opioid-treated chronic pain populations, ADRBs are very common, addiction as a consequence of treatment is very uncommon, undertreatment of chronic pain is very common, and pain experts lack uniformity in interpreting the relative importance and significance of various ADRBs. Given this context, leaping to a conclusion that any particular behavior is caused by substance abuse or diversion of prescribed medication is unwarranted and represents a failure to employ a proper medical evaluation process.

American Pain Society – Pain Assessment and Treatment in the Managed Care Environment

docalex — Wed, 24 Oct 2007 18:26:54 GMT

The American Pain Society (APS) offers this statement in an effort to improve pain management for people receiving care through managed care organizations (MCOs)* and to assist MCOs in advancing the quality of pain management services and the patient satisfaction and clinical outcomes for people receiving those services.

Opioids, Attachment, and Compulsion - The Compulsion to Repeat the Trauma; by j7uy5; 2004-06-24

docalex — Mon, 03 Sep 2007 04:32:14 GMT

Good, very readable, review of literature on the role of the opioid receptor system in the neurobiology of attachment, compulsion, and PTSD symptomotology. Covers, briefly, receptor theory, naltrexone research especially regarding self-injurious behavior. Good links to full text primary sources.

The American Geriatrics Society

docalex — Wed, 24 Oct 2007 18:23:13 GMT

Persistent Pain Guidelines - AGS Guideline on the Management of Persistent Pain in Older Adults - The AGS Expert Panel on Persistent Pain