Medical News: Year in Review: Mitigating Opioid Risk - in Psychiatry, Addictions from MedPage Today
I feel that this is an important article to read, especially if you are taking opioides like Tramadol. I have been taking Tramadol since 1998 and I've never gone over the prescribed amount given to me by the doctor. I have tried the time release medications and found that they keep me awake all night. I never sleep when I have taken them. Please read this article and download the source PFD.
Saturday, January 8, 2011
Friday, January 7, 2011
Thursday, January 6, 2011
Pain Contracts Threaten the Doctor-Patient Relationship
This is an article that I believe should be required reading for those of us who are taking pain medications that contain opioids, no matter how little is really in it.
by Kevin Pho, MD
Doctors today are wary about treating chronic pain.
One of the main worries is precipitating fatal opioid overdoses. Indeed, according to the CDC, and reported by American Medical News, “fatal opioid overdoses tripled to nearly 14,000 from 1999 to 2006 … [and] emergency department visits involving opioids more than doubled to nearly 306,000 between 2004 and 2008.”
Requiring chronic pain patients to sign pain contracts is a way to mitigate this risk.
But how does that affect the doctor-patient relationship?
Indeed, a contract is an adversarial tool. Essentially, it states that a patient must comply with a strict set of rules in order to receive medications, including where and how often they obtain controlled substances, and may involve random drug testing. Break the contract and the patient is often fired from the practice.
A recent perspective piece from The American Journal of Bioethics discusses its effects:
“… what is becoming common practice in many pain specialty clinics is using a preprinted, standardized form that says, ‘If we’re going to treat or prescribe controlled substances to you, these are the conditions under which we’ll do so — and sign this document, and if you fail to do so, then we’ll fire you from our practice.’ ”
That kind of adversarial approach is “corrosive to the relationship” and threatens patients in need with abandonment.
To read the rest of this article please go to http://www.kevinmd.com/blog/2011/01/pain-contracts-threaten-doctorpatient-relationship.html#comment-153086
Wednesday, January 5, 2011
Medical News: Increased Activity Helps in OA - in Rheumatology, Arthritis from MedPage Today
Medical News: Increased Activity Helps in OA - in Rheumatology, Arthritis from MedPage Today
Increasing physical activity over two years can improve function and even walking speed among adults with osteoarthritis of the knee -- regardless of their level of activity, a large prospective study found.
The ongoing cohort study of more than 2,500 patients with knee osteoarthritis (knee OA) found that the average gait speed -- an objective measure of functional performance -- was 4 feet/second among patients reporting the lowest quartile of physical activity, compared with 4.2, 4.3, and 4.5 feet/second (P for trend <0.001)>
The ongoing cohort study of more than 2,500 patients with knee osteoarthritis (knee OA) found that the average gait speed -- an objective measure of functional performance -- was 4 feet/second among patients reporting the lowest quartile of physical activity, compared with 4.2, 4.3, and 4.5 feet/second (P for trend <0.001)>
Tuesday, January 4, 2011
Medical News: Fibromyalgia Linked With Restless Legs - in Pain Management, Fibromyalgia from MedPage Today
Medical News: Fibromyalgia Linked With Restless Legs - in Pain Management, Fibromyalgia from MedPage Today
Patients with fibromyalgia have a high prevalence of restless legs syndrome, which may contribute to the sleep disruption and fatigue they commonly experience, a cross-sectional study suggested.
The age- and sex-adjusted prevalence of restless legs syndrome among a cohort of fibromyalgia patients was 33% (95% CI 25.9 to 40.1) compared with 3.1% (95% CI 0 to 7.4,P<0.01)>
Moreover, patients with fibromyalgia had significantly higher scores on the Pittsburgh Sleep Quality Index, a validated tool for rating insomnia, at 10.6 versus 4.5 (P<0.01),> Journal of Clinical Sleep Medicine.
Monday, January 3, 2011
Medical News: ACR: Device Calms Fibromyalgia Symptoms - in Meeting Coverage, ACR from MedPage Today
Medical News: ACR: Device Calms Fibromyalgia Symptoms - in Meeting Coverage, ACR from MedPage Today
ATLANTA -- Electrodes placed on the scalp to deliver weak, high-frequency currents significantly reduced symptoms of fibromyalgia in a double-blind, sham-controlled trial, a researcher said here.
Mean decline from baseline in Fibromyalgia Impact Questionnaire (FIQ) scores after 11 weeks of treatment was 15.5 points (95% CI 8.7 to 22.3) -- about a 25% drop -- compared with a 5.6-point decline (95% CI 0.1 to 11.2) in patients receiving sham treatment (P=0.03 between groups), said Jeffrey Hargrove, PhD, of Kettering University in Flint, Mich.
"Compared to sham treatment, NICE [noninvasive cortical electrostimulation] yielded clinically significant improvements in pain, tenderness, and other typical features of fibromyalgia," Hargrove told attendees during an oral presentation at the American College of Rheumatology's annual meeting here.
Sunday, January 2, 2011
Medical News: FDA Panel Roundly Rejects CNS Drug for Fibromyalgia - in Product Alert, Prescriptions from MedPage Today
Medical News: FDA Panel Roundly Rejects CNS Drug for Fibromyalgia - in Product Alert, Prescriptions from MedPage Today
BETHESDA, Md. -- A federal advisory panel voted 20-2 to recommend that the FDA not grant approval for an expanded indication for sodium oxybate (Xyrem) -- also known as GHB -- to treat fibromyalgia.
A number of members on the Arthritis Advisory Committee and the Drug Safety and Risk Management Advisory Committees felt the potential for widespread abuse of the "date rape" drug was too great to warrant expanding the indication to a condition that affects an estimated 2% of the U.S. population.
Sodium oxybate, currently approved at a 500 mg/ml dose for narcolepsy-associated cataplexy and excessive daytime sleepiness, is a central nervous system depressant and carries a boxed warning against its use in combination with other similar drugs.
The label information also warns that sodium oxybate is a drug known to be abused. Sodium oxibate is a sodium salt of y-hydroxybutyrate, or GHB.
Subscribe to:
Posts (Atom)