Pain management

471 articles · Since 2014

Articles, page 21

We are suffering the grave consequences of a single survey question

July 6, 2016Jul 6, 201612

“You’re nothing but a punk ass kid. And you’ll die a punk ass kid!” With that, she stormed out of the exam room, leaving me sitting on a stool, slamming the door behind her. Apparently she walked straight up to…

“You’re nothing but a punk ass kid. And you’ll die a punk ass kid!”

With that, she stormed out of the exam room, leaving me sitting on a stool, slamming the door behind her. Apparently she walked straight up to the front desk and asked to file a complaint about me, but left prior to receiving the paperwork.

Most all physicians will immediately know what the interaction involved. I hadn’t been mean …

Health policy

The health care system that failed Prince needs an immediate intervention

Shruti Kulkarni, JD

July 4, 2016Jul 4, 20169

It has now been confirmed that Prince’s untimely death resulted from an overdose of the drug fentanyl. It is unclear whether the lethal dose of fentanyl was a prescription medication or a counterfeit “analog” drug from the illicit market. Regardless,…

It has now been confirmed that Prince’s untimely death resulted from an overdose of the drug fentanyl.

It is unclear whether the lethal dose of fentanyl was a prescription medication or a counterfeit “analog” drug from the illicit market. Regardless, the facts are now clear enough to know that the U.S. health care system failed Prince in the same ways it is failing the 78 Americans who die every …

Patient voices

I live a life in which pain plays a constant role

Ronna Edelstein

July 3, 2016Jul 3, 201626

When my friend Madeline turned seventy, she celebrated in a big way: She walked a half-marathon; she hosted a cabaret for family and friends at which she sang and told stories; she traveled to China. Now, six years later, this dynamic woman has become a virtual prisoner in her apartment. She has undergone back surgery, suffered a nearly fatal intestinal infection and, after a fall, had bolts and screws placed …

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Drugs and prescribing

Did Prince die because he had bad doctors?

Peter Ubel, MD

June 30, 2016Jun 30, 201614

Prince died of an opioid overdose. A tragic and avoidable fate but, even more tragically, one that is becoming increasingly common in the United States. Some people who overdose live on the edge of society–homeless and with no access to good medical care. Prince, by contrast, had several mansions and a number of physicians actively involved in his care, physicians aware of his problem with opiates. …

Physician voices

The widespread use of fentanyl escalates the risk of overdose

Karen S. Sibert, MD

June 30, 2016Jun 30, 20162

A fentanyl overdose led to the recent death of musician and singer Prince, according to the medical examiner’s report released June 2. The drug seems likely to become as notorious as propofol did after the death of Michael Jackson in…

For all of us in anesthesiology who’ve been using fentanyl as a perfectly respectable anesthetic medication and pain reliever for as long as we can remember, …

Drugs and prescribing

The opioid disaster: Stop criminalizing doctors

Cindy Perlin, LCSW

June 29, 2016Jun 29, 201621

It’s an unmitigated disaster. One hundred million pain patients. Millions addicted to opioids, hundreds of thousands dead. Pain patients abruptly cut off medication they’ve depended on, sometimes for decades, and offered nothing to replace it. Doctors, fearful of prosecution for overprescribing, dropping pain patients like hot potatoes. Pain patients unable to find any doctor that will treat them. Patients turning to heroin when they can’t get their prescription painkillers. Articles …

Physician voices

Addressing racial bias in the treatment of pain

Leigh-Ann J. Webb, MD

June 21, 2016Jun 21, 2016

The opioid (painkiller) epidemic, with its seemingly indiscriminate reach, has embraced an alarming number of Americans. In the most recent statistics available, two million Americans either abuse or are dependent on prescription opioids. Even the death of internationally acclaimed artist,…

Physician voices

Blame the politicians and bureaucrats for our opioid abuse crisis

Richard Young, MD

June 5, 2016Jun 5, 201621

Prescription opioid abuse is on the political radar. “Painkillers” are a recognized cause of thousands of deaths a year. But what to do about it? A FDA panel recently recommended mandatory training for physicians who prescribe opioids. Congress passed a…

Prescription opioid abuse is on the political radar. “Painkillers” are a recognized cause of thousands of deaths a year. But what to do about it?

A FDA panel recently recommended mandatory training for physicians who prescribe opioids. Congress passed a bill calling for more education, presumably physicians as a prime target. We’ve actually been down this road before, but possibly not how you think.

The politicians and pundits used to …

Physician voices

The opioid crisis: Does empathy make physicians more vulnerable?

Jay Baruch, MD

June 4, 2016Jun 4, 20162

It was Saturday evening, and Audrey G lay awkwardly on an emergency department stretcher in search of a comfortable position. She suffered from chronic hip pain, the unfortunate and unexpected effect of pelvic surgery. But her real chief complaint involved her drug-abusing husband, who that morning stole her recently filled bottle of oxycodone, an opioid pain medicine. Her story included the surgeon who doubted her pain and a year of …

Physician voices

An open letter to Macklemore about the opioid epidemic

Eric Beam, MD

June 3, 2016Jun 3, 20162

Dear Macklemore, Recently, you -- the white-rapping, thrift-shopping, LGBT-activist-ing, Grammy-winning 2013 phenom -- teamed up with President Obama to deliver a message to the country about the current opioid epidemic. Now let me preface this by saying, I like you,…

Dear Macklemore,

Recently, you — the white-rapping, thrift-shopping, LGBT-activist-ing, Grammy-winning 2013 phenom — teamed up with President Obama to deliver a message to the country about the current opioid epidemic. Now let me preface this by saying, I like you, Macklemore. I like the mixture of equal parts political, earnest and downright goofy that you bring to your music. I like that you seem genuinely …

Patient voices

10 indispensables for those with chronic pain and illness

Toni Bernhard, JD

May 30, 2016May 30, 2016

This piece is based on personal experience and on the thousands of emails I’ve received from those who live day-to-day with chronic illness (which includes chronic pain). 1. Email. I know the joy of hearing the actual voice of a…

This piece is based on personal experience and on the thousands of emails I’ve received from those who live day-to-day with chronic illness (which includes chronic pain).

1. Email. I know the joy of hearing the actual voice of a loved one. That said, email is the principal way I communicate with people.

It’s hard for me to talk on the phone. It saps my energy quickly, partly because of the need for …

Drugs and prescribing

I am a doctor, but I didn’t cause the opioid epidemic

Tanya Feke, MD

May 26, 2016May 26, 201629

Let's get this straight. I am a doctor, but I didn't cause the opioid epidemic. That is not exactly what you hear in the media these days. After all, doctors are the ones with the prescription pads, and someone must…

Let’s get this straight. I am a doctor, but I didn’t cause the opioid epidemic. That is not exactly what you hear in the media these days. After all, doctors are the ones with the prescription pads, and someone must be to blame.

The truth is that death from opioid abuse is on the rise. The Centers for Disease Control and Prevention (CDC) has …

Drugs and prescribing

Drug addiction is a problem that requires treatment, not punishment

Chinazo O. Cunningham, MD

May 21, 2016May 21, 20166

When I meet strangers, and they ask what I do for a living, the conversation tends to go something like this: I tell them I’m a physician. They ask what type. I say that I am a general internist, but I focus mainly on addiction…addiction to prescription opioids (painkillers) and heroin. Invariably, people will say something like, “This has become such a big problem.” I agree, but then they will …

Conditions and diseases

An open letter to America’s physicians on the opioid epidemic

Steven J. Stack, MD

May 16, 2016May 16, 20168

The medical profession must play a lead role in reversing the opioid epidemic that, far too often, has started from a prescription pad. For the past 20 years, public policies -- well-intended but now known to be flawed -- compelled…

ama_logo The medical profession must play a lead role in reversing the opioid epidemic that, far too often, has started from a prescription pad.

For the past 20 years, public policies — well-intended but now known to be flawed — compelled doctors to treat pain more aggressively for the comfort of our patients. But today’s crisis plainly tells us we must be much more cautious …

Physician voices

A family physician duped by a patient on chronic opioids

Hans Duvefelt, MD

May 12, 2016May 12, 201613

A woman in her mid-thirties with a terrible limp and a past surgical history in the dozens became my patient two years ago. Her prosthetic left leg served her well, but her right leg was moving awkwardly because of advanced…

She was on long-acting morphine and short acting oxycodone. Her Social Security disability insurance didn’t cover the long-acting form of oxycodone.

She told me several …

Conditions and diseases

Is the government’s National Pain Strategy doomed to fail?

Kenneth Lin, MD

April 21, 2016Apr 21, 201614

Over the past few months, the federal government has mobilized against what is being called "the opioid crisis": a national epidemic of fatal overdoses that in 2014 claimed more than 14,000 lives, the most ever recorded. Since most of these…

Over the past few months, the federal government has mobilized against what is being called “the opioid crisis“: a national epidemic of fatal overdoses that in 2014 claimed more than 14,000 lives, the most ever recorded. Since most of these opioids were originally prescribed by physicians to treat pain, the Centers for Disease Control and Prevention recently finalized a guideline containing recommendations …

Drugs and prescribing

How the medical profession can solve the opioid crisis

Robert Pearl, MD

April 14, 2016Apr 14, 201624

Opioids, also known as opiates, serve as important prescription medications in medical practice. But within the last decade or so, because of their overuse, misuse and abuse, they’ve also emerged as a leading cause of addiction and death. Sadly and…

Sadly and surprisingly, those most instrumental in creating this epidemic — however unwittingly — are physicians and the pharmaceutical industry.

The question is, how could this crisis have happened? What responsibility should physicians take, …

Physician voices

Why I stopped prescribing narcotics, and never looked back

Alan G. Berg, DO

April 10, 2016Apr 10, 20169

I was never a big prescriber of narcotics. I grew up “country,” in a tougher world where your parents taught you to accept pain as a part of life. Pain is how you know you’re still alive. They’d tell me, “if you’re hurtin’ you ain’t dead yet.” You fell down; it was going to hurt. You learned not to fall. Twisted your ankle doing something stupid (and it was always …

Drugs and prescribing

If all we talk about are pills for pain, we are having the wrong conversation

Stefan Kertesz, MD

April 8, 2016Apr 8, 20164

“Does anyone have thoughts about Mr. Jones?” I ask around the table. My primary care team sees veterans who were recently homeless. Many have been severely injured, and half have chronic pain. We have wise nurses, a committed social worker,…

And here we are today we have Mr. Jones. A bit about his case. He has a history of shoulder pain dating …

Drugs and prescribing

All primary care doctors need a buprenorphine waiver. Here’s why.

Alicia Agnoli, MD, MPH

April 8, 2016Apr 8, 20167

Over 2 million Americans abuse or are dependent on prescription pain medications. These patients are in the office of every physician in the country, but only 3 percent of primary care providers offer them treatment. Many patients are being given…

Many patients are being given a sympathetic apology, a hotline to call, or a dead-end referral. Some of them are being sent to methadone clinics, which are often impractical, already-full, or deeply stigmatized. Others make their …

Pain management

Articles, page 21

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