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Counterfeit medications are a cause of decreased wellness, increased morbidity, and even death. An anesthesiologist and interventional pain physician reviews the origin of counterfeit medications, describes some anti-counterfeiting technologies and considers prescriber responsibilities in reducing...
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Doctors Gourlay and Heit, specialists in the arena of pain and addition, explore some of the more common issues confronting the primary care clinician in the management of long-term opioid prescribing. The focus is on the challenges of the inherited patient. In part 2, we consider the issue of...
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Doctors Gourlay and Heit, specialists in the arena of pain and addition, explore some of the more common issues confronting the primary care clinician in the management of long-term opioid prescribing. The focus is on the challenges of the inherited patient.
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In response to the escalating crisis of opioid abuse and overdose fatalities, states are adopting dosage thresholds as part of their prescribing guidelines. A clinical pharmacist and public policy professor summarize the public health landscape that has spawned this response, and evaluate the impact...
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Beyond its role in treating opioid dependence, methadone has unique benefits that make it a viable option for chronic pain management. But with these come multiple pitfalls, for which the risks of methadone therapy may outweigh its benefits for some patients. Levorphanol shares all of the benefits...
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The inherited pain patient is really one of our greatest challenges in medicine because even if their pattern of pharmacotherapy is irrational, the vast majority only got there with the help of a physician, and I think we owe a special duty of care to patients who have iatrogenetically come to harm...
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Inherited patients usually come in with certain pharmacotherapy and you have to decide after your history and physical whether that pharmacotherapy is irrational or rational. Is it pharmacotherapy that you feel comfortable prescribing and continuing without change? Is it pharmacotherapy that you’re...
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We know more now about the risk factors and patients who may be good candidates for naloxone. These would include patients on higher doses of opioids, patients with complicated comorbidities like renal or hepatic disease, sleep apnea, and most obviously, those with active substance abuse, or a...
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Primary care practitioners need to be aware of some changes relating to the use of opioids to treat pain. State-licensing board guidelines are changing. There’s some new and good legislation regarding the use of naloxone kits to help people who might be at risk for opioid overdose or even...
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Patient screening and risk management in opioid therapy is really quite a challenge and requires significant knowledge of the medications particularly with high-dose opioids. First of all, you have to make a decision of whether or not, as the dose escalates, the patient should even be on opioids...