“Life is pain…anyone who tells you differently is selling something” William Goldman, The Princess Bride Pain and addiction are intertwined. Prescribed medication for pain can be a route into addiction. In practice I regularly see people on multiple medications for pain, making treatment of their addiction challenging. Last year Public Health England found that one in four … Continue reading Pain management – cat among the pigeons
Tag: Opioid
Mind Over Matter: Beating Pain and Painkillers
Findings were recently published on a study of a mindfulness based intervention for chronic pain and opioid misuse. To test the treatment, 115 chronic pain patients were randomly assigned to eight weeks of either MORE or conventional support group therapy, and outcomes were measured through questionnaires at pre- and post-treatment, and again at a three-month … Continue reading Mind Over Matter: Beating Pain and Painkillers
no hint of opinion here
To me, the most important line in the NY Times Suboxone series was this one, "[Dr. Sullivan] considered opioid addiction "a hopeless disease'". We believe that maintenance approaches are rooted in the belief that most opiate addicts are not capable of recovering in the same manner that doctors recover. Most of the arguments for maintenance treatments … Continue reading no hint of opinion here
Methadone with and without counseling
Drug and Alcohol Findings reviews research on the impact of counseling for methadone patients. While across the board there was significant improvement, being assigned to standard/enhanced versus interim (no counseling) programmes did not further improve retention, illicit drug use and related problems, or make much difference to criminal activity. There was no evidence that interim … Continue reading Methadone with and without counseling
Suboxone diversion?
A recent study looking at diversion of buprenorphine finds that: While 9% reported recent street-obtained buprenorphine use, only a small minority reported using buprenorphine to get high, with the majority reporting use to manage withdrawal symptoms. The use of street-obtained buprenorphine primarily to avoid withdrawal fits with Dawn Farm's experience, though the percentage would be … Continue reading Suboxone diversion?
Buprenorphine compliance rates
The following abstract popped up today. The purpose of the study was to look at factors associated with completion of the 6 month, primary care based program. What struck me was the completion rate--35.7%. For all the crowing about ORT, this seems really low. (And, they said this completion rate is consistent with prior studies.) … Continue reading Buprenorphine compliance rates
“It works!”, Ctd
A new study of buprenorphine implants find that implants work as well as oral dosing and outperform placebo. What does that mean? If I'm reading it correctly, it means that the average subject receiving the implant tested positive for opioids 68.8% of the time compared to 86.6% for the placebo subjects. (If I'm misreading it, … Continue reading “It works!”, Ctd
Buprenorphine and emotional reactivity
The following article was shared with me by a reader. Not surprisingly, the emphasized portion below caught my eye. [emphasis mine] Abstract Addictions to illicit drugs are among the nation’s most critical public health and societal problems. The current opioid prescription epidemic and the need for buprenorphine/naloxone (Suboxone®; SUBX) as an opioid maintenance substance, and its … Continue reading Buprenorphine and emotional reactivity
Solving the prescription opioid problem
I've posted several times recently on the problem of opioid over-prescription and overdose. Some might assume that I want some regulatory or statutory intervention to address the issue. Truth is, I've got more questions than answers and I would not support a response that forces us to choose between treating pain and preventing addiction and … Continue reading Solving the prescription opioid problem
Overprescription of opioids is bad medicine
Keith Humphreys points out that the problem with the explosion of prescriptions for opioids isn't just addiction and overdose. They are often just not good medicine. Opioids typically have a miraculous effect on acute pain, but this does not necessarily translate to chronic pain relief, particularly as tolerance sets in over time. Even more disturbing, … Continue reading Overprescription of opioids is bad medicine
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