Pain in Opioid-Addicted Patients Entering Addiction Treatment
Pain and addiction share some common physiologic pathways in the brain, especially those involving opioids, and each may affect the other. That is, the presence of pain may influence the development and course of opioid addiction, and vice versa (Compton and Gebhart 2003). These interactions may complicate therapy for opioid addiction. For example, opioid-addicted persons More Info »
Methadone Cardiac Concerns
Some patients in methadone maintenance treatment (MMT) programs may have conditions or behaviors associated with increased risks of arrhythmia, including: abuse of cardiotoxic substances, cardiovascular disease, electrolyte imbalances, and prescribed medications that may foster cardiac repolarization disturbances. Furthermore, recent data suggest that in some individuals methadone – alone or, more commonly, in combination with other More Info »
Methadone-Drug Interactions (Medications, illicit drugs, & other substances)
Each year in the U.S. there are innumerable adverse drug reactions, broadly defined as any unexpected, unintended, undesired, or excessive response to a medicine. Such reactions may require discontinuing or changing medication therapy. Furthermore, greater than 2 million of those are serious reactions resulting in hospitalization and/or permanent disability, and there are more than 100,000 More Info »
Opioid Tapering: Safely Discontinuing Opioid Analgesics
Severe hurricanes in the Gulf Coast during 2005 caused many hardships for patients and healthcare providers alike. An important concern coming to light during this time of crisis was the inability to obtain prescription medications, including opioid analgesics. Patients with chronic pain and their healthcare providers faced the daunting task of either somehow procuring the More Info »
Commonsense Oxycodone Prescribing & Safety
Oxycodone is FDA-approved for treating moderate to severe pain that is either acute or chronic in nature. It has been widely used in pain management practice for decades but has recently been receiving much negative attention due to abuse, overdose, and deaths associated with the controlled-release formulation. So, in the overall approach to pain management, More Info »
Opioid Safety in Patients With Renal or Hepatic Dysfunction
It has been estimated that up to one-third of patients with renal dysfunction (defined as creatinine clearance [CrCl] < 50 mL/min) also receive opioids to relieve pain [Davison 2003]. Use of opioids in these patients can present a challenge because adequate pain control is necessary while balancing the risk of overdose due to altered drug More Info »
Managing Opioid-Induced Constipation
Constipation is a frequent side effect of opioids since these agents decrease peristaltic activity in the gastrointestinal (GI) tract. Because of the mechanisms involved in opioid-induced constipation, some treatments that may be applicable for common, functional constipation are inappropriate for ambulatory-care patients prescribed opioid analgesics. Also in these patients, the distress of constipation may add More Info »
PAINS Policy Brief #4: Opioid Treatment Agreements or “Contracts”
Pain care in the United States presents a complex set of challenges. On the one hand, there is ample documentation that pain, especially chronic pain, is often not well managed, and that as the Institute of Medicine has stated, we need a “cultural transformation in how pain is judged, managed and treated” to advance pain More Info »
PAINS Policy Brief #3 Summary: Pain & Policy Studies Group Report Card
Summary for policy brief List of current legislative barriers for each state This policy brief is a product of the Pain Action Alliance to Implement a National Strategy (PAINS), in collaboration with the Center for Practical Bioethics, the American Academy of Pain Management (AAPM), and the Pain and Policy Studies Group (PPSG) at the University More Info »
PAINS Policy Brief #3: Pain & Policy Studies Group Report Card
Healthcare practice, including pain management, is governed at the state level and not by federal laws. Numerous barriers continue to affect the provision of pain care. A prevalent barrier is the presence of state policies that create undue restrictions or practice ambiguities. Healthcare professionals need to understand the state statutes and regulatory policies that govern More Info »