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A specialist in addiction medicine offers guidance in identifying opioid misuse and the appropriate means of withdrawing patients from long term opioid therapy. The longer term management and rehabilitation of these patients is also considered.
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The existence of opioid induced hyperalgesia as a side effect of chronic opioid therapy has been debated. A pain specialist offers his perspective on its reality and manifestations, and what the primary care clinician can do in response.
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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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Dr. McPherson comments on recent consensus guidelines for methadone prescribing, with background on the properties of this analgesic that render it both an attractive and challenging opioid for pain clinicians. Special considerations for patients with advanced illness are also discussed.
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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...
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Effective use of naloxone for opioid overdose requires, first, the ability to recognize the symptoms and signs of opioid induced respiratory depression. All healthcare providers, responders, and patients need education in identifying overdose emergencies. Stakeholders also need to keep abreast of...