Articles

A Systematic Approach to the Use of Opioids in the Treatment of Chronic Pain

Many clinicians may have reluctance to prescribe opioids for patients in pain outside of the most controlled of situations (i.e., when the patient is a hospital inpatient). This phenomenon is fairly well accepted by clinicians and patients, and is often the result of some combination of a variety of factors: – Clinicians who are not experts… Read more »

Opioid REMS Update 2013

When we last covered the topic of the FDA’s intended plans for curbing opioid risk, we felt confident that one thing was for sure – education would likely be a key ingredient of the ultimate implemented solution. As it turns out, our assumption was correct. As we mentioned in our opioid REMS update 2012, on Tuesday, April… Read more »

New Approaches to Combating Abuse of Opioids

Opioids play an important and omnipresent role in the treatment of moderate to severe acute and chronic pain. The fact of the matter is that in patients with acute pain, such as postoperative pain, opioids are utilized as the first-line treatment at least 98% of the time. Opioids are also recognized as the cornerstone of… Read more »

FDA Announces New Safety Measures for Extended-Release and Long-Acting Opioids

On September 10, 2013, the Food and Drug Administration (FDA) announced a number of changes that are intended to increase the safety of extended-release and long-acting (ER/LA) opioid medications. This announcement applies to all currently marketed ER/LA opioids, and implements two specific approaches to achieve the goal of combatting “the crisis of misuse, abuse, addiction, overdose, and death” according… Read more »

APS/AAPM Clinical Guidelines for Chronic Opioid Therapy in Patients with Noncancer Pain

The basis for the long-term use of opioids in the treatment of cancer pain has been fairly well established. Alternatively, a variety of controversies and differences of opinion have surrounded the use of opioid therapy when treating chronic noncancer pain. Issues range from the scientific basis for efficacy, safe and appropriate use, to health care… Read more »

The Logic of Pain Management

The arbitration of pain, one of the human body’s natural defense mechanisms, and alleviation of patient suffering present an interesting clinical challenge for the clinician. There are few medical conditions where the input of the patient is as crucial to the desired outcome of therapy as that of the clinician. Indeed, most common ailments appropriately… Read more »

Fibromyalgia Syndrome

Fibromyalgia, short for what is actually fibromyalgia syndrome, is one of those diagnoses that can often present specific challenges to primary healthcare providers, as it is surrounded by a swirl of controversies; some legitimate, some founded in what many consider “old-fashioned thinking”. Admittedly, when the criteria for defining a medical condition is itself a source… Read more »

Opioid-Induced Constipation

Globally, it was estimated that a total of 365 million prescriptions were written for opioids in 2005, with 235 million of those written in the United States. A significant proportion of them were for the treatment of chronic pain. In the USA, 20% of prescriptions for opioid therapy were for over 30 days’ duration1. Today,… Read more »

Osteoarthritis Overview

Data from 2003-2005 from the National Health Interview Survey showed some impressive information about the prevalence or arthritis in the United States. Forty-six million American adults reported doctor-diagnosed arthritis, making arthritis one of the nation’s most common health problems. Not only is arthritis highly prevalent among U.S. adults, it is the leading cause of disability… Read more »

What Role Does Spirituality Play in Pain Management?

When treating chronic pain patients, clinicians might focus primarily on the biomedical dimensions of pain care and management. Living with a chronic condition requires patients to find a path to living as full a life as possible. For some patients, an improved quality of life is achieved through spiritual practice. Incorporating spiritual discussions into patient… Read more »