opiates

… as we have noted before, there is mounting evidence that we need to move away from just “throwing more opioids” at patients with chronic non-malignant pain syndromes … as well as those with multidimensional pain. Some resources … Alberta Hospice Palliative Care Manual (see esp. pp. 12 ff. multidimensional pain) … McBeth’s recent article […]

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… Grady et. al. provide an excellent summary of the case for not using opiates for chronic non-malignant pain … “A partial explanation of why we got to this point is that the lessons learned from the undertreatment of pain in patients with cancer were generalized to patients with chronic pain and no clear end […]

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… Kross et. al. in “Social rejection shares somatosensory representations with physical pain” use functional MRI to show that “rejection [recent break-up of a relationship] and physical pain are similar not only in that they are both distressing—they share a common somatosensory representation as well.” Pain is what the patient says it is … but […]

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Journal Club Charles von Gunten moderates a panel discussing the new opioids available. Bottom line … we don’t need new opioids … we need everyone to correctly prescribe and take the ones we have now. (a nice summary and links re REMS is here)

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