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A specialist in pain and substance abuse discusses findings from the research on vulnerable populations in the pain community. Patients with pain and concurrent substance use disorders are particularly at risk for depression and suicidal ideation. To what degree does this underlie the problem of...
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The relationship between addictive behavior and prescription pain medication is a really complex one. It’s almost always hard to predict. There are some obvious clues, like a previous history of substance abuse, or potential clues such as a family history of substance abuse, or maybe some...
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There’s a large focus right now on drug testing and claims for clinical laboratory services related to drugs of abuse testing. The payers are interested in this area because there’s been quite a significant amount of fraud and abuse identified through payer investigative techniques. So the payers...
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There’s a robust body of literature on the comorbidity of depression, anxiety and chronic pain. Approximately 50 percent of patients who suffer from chronic nonmalignant pain suffer from some degree of depression. With respect to pain patients and suicidal ideation the prevalence is anywhere between...
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Clinicians must be prepared to recognize that addiction is a disease and it’s a very serious and fatal disease, which is often written off as a weakness or poor moral character, or something like that. Only by recognizing it as a disease can they really help their patients through compassion...
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The evaluation of these patients by providers, physicians, physician assistants, nurse practitioners, and all those who work in a medical team, is a challenge and therefore we need to standardize the approach. We need to recognize that we’re dealing with a chronic illness that requires a team...
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The conclusion of a 2-part discussion. Some specific limitations of UTD as a clinical tool are examined. Drs. Gourlay and Heit also consider the role of opioids in chronic pain management, with balanced regard for the risks of pain and addiction.
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Part one of a 2-part discussion. The concept of patient-centered UDT as a clinical tool for monitoring adherence is considered. Drs. Gourlay and Heit also offer some guidelines for practitioners on who and when to test.
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The Iceberg Cometh
Dr. Passik is Director, Clinical Addiction Research and Education, Millenium Laboratories Clinical Education, San Diego, California. He has over 25 years’ experience in clinical practice as a pain psychologist specializing in addiction medicine. He is also a longtime member of...
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It’s important to start at the beginning and screen patients for indicators that could be suggestive of abuse, misuse, diversion, and unintentional use. We can use actual validated instruments to screen for patients who may have some issues with misuse and abuse and diversion. It is an important...