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I think the pendulum has swung too far in the other direction. In the early 2000s, there was this increase in opioid prescribing and use that has led us to the predicament we’re in now with the opioid abuse and misuse epidemic, as they’re calling it. And now no one wants to prescribe them. For our...
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Urine toxicology is actually a big business in many fields of medicine, not just pain management. A lot of healthcare facilities, critical care units, emergency departments utilize tox screening as well. As of 2015, it was close to a 5 billion dollar business. A lot of new companies are offering...
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Chronic pain patients tend to be a little older and that in and of itself leads to a decrease in quality of sleep. Loss of quality sleep makes the pain seem a little worse and more difficult to deal with. So how can we treat both pain and sleep issues to break that cycle? And to make matters even...
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Approximately 1 billion people in the world are affected with migraine and the thought is that about 40% of them that are candidates for some type of preventative therapy. A sizable proportion of that 40% doesn’t actually receive the kind of preventative therapy that they need, and so that equates...
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What is medical marijuana? It depends on who you ask. If you ask heavy marijuana users, all marijuana is medical. If you ask the Food and Drug Administration, no marijuana is medical. It’s a very complex question because marijuana has 100-some odd constituents and the attention seems to be all about...
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The terms prescribing guidelines and prescribing rules are often used interchangeably although they really have separate meanings. Guidelines, by their nature, are voluntary recommendations. Whereas prescribing rules are mandatory. It’s important for prescribers to be aware of what exactly the rules...
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Practitioners need to understand that there are steps that they should be taking to minimize the potential of a bad legal outcome in the event of an investigation involving an overdose.
The liability for an overdose event tracks back to the practitioner’s adherence to licensing board requirements...
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The endocannabinoid system is something that most primary care physicians really have never heard of, and it’s a shame because the endocannabinoid 1 receptor is really the single most densely populated G-protein coupled 7 transmembrane domain receptor in the human brain. So why do we and all animal...
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If I ask patients how satisfied they are with their pain treatment, I think there’s an inverse correlation with whether they’re on opioids or not; and the higher the dose of opioids, the less satisfied they are. In general, I don’t think that they’re a great treatment. I think they’re reserved for a...
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Headache, by itself, is just a symptom. It’s like saying someone has arm pain; there are many causes of arm pain. There are over 300 different causes of headache; some of them are threatening, secondary headaches; some of them are not threatening but problematic--those are primary headaches. Once...