Month: March 2017

How Does A Pain Center Treat Patients With Opioid Dependence?

It’s all over the headlines about the misuse of opioids and the addiction epidemic we have in this country. As such, general primary care doctors are struggling how to treat their patients with chronic pain these days and not contribute to or start them down the path of addiction. Pain center specialists are quick to admit that they have a delicate balance with their patients who are dependent on these drugs and how they treat them.

One of the biggest challenges that all doctors have is the lack of being able to estimate of how common problematic opioid for chronic pain patients can develop. The biggest majority of those who have chronic pain don’t go on to develop such an addiction.

But because so many have, creating the current epidemic, the medical industry needs to get a better understanding on how to effectively manage the risk of drug abuse.

A pain center doctor should take precautions and look for any potential risks of substance abuse before prescribing any medication to any patient with chronic pain. This would include looking at the patient’s medical history, their family medical history including any type of psychiatric disorders or substance abuse.

If any of these are present in a patient’s past, it doesn’t mean they should be automatically denied medication. But they should be educated and informed about the risk of drug dependence and then monitored closely for potential abuse.

Medication Isn’t Always The Answer

What more doctors and patients need to realize is that medication doesn’t always have to be the answer for chronic pain. There are the false assumption and misunderstanding that medication makes the pain disappear. But when it comes to chronic pain situations, that isn’t necessarily so. For many people, it only will reduce their pain. And this is where referral to a pain center is important.

Treatment Without Opioids

For those patients that have a substance abuse history, or psychiatric disorders, a pain center can provide many other ways to get that pain relief without using opioids. A pain center that works with a multidisciplinary approach can treat patients with chronic pain regardless of their history.

And there are medications that can be prescribed that are non-opioid drugs to go along with the other methods as well. Like antidepressants, anti-arrhythmic drugs, and anti-epileptic drugs, all of which are effective to treat chronic pain.

A pain center also offers physical therapy, psychological therapies, as well as occupational therapy. There are so many people suffering from chronic pain that is not receiving the services of a multidisciplinary pain center because it usually requires academic medical center resources and not all doctors have these resources. They can, however, collaborate with doctors that do.

After a doctor has taken in all the information about a patient and considers all the possible options that are available and believes an opioid treatment is needed, but the patient is opioid-dependent, there are some other medical options. Both buprenorphine and methadone have the benefits of being a strong analgesic and may be just what the patient needs.

When a pain center treats patients with chronic pain and has a substance abuse disorder, they will also include psychological counseling in the treatment plan. It may be group therapy or individual therapy, but when substance abuse overlaps with treatment for chronic pain, the behavioral and psychological skills are the same.

For pain doctors that work independent or with a pain center, an opioid contract is a common thing to request patients sign before they begin treatment. It is an effort to establish a clear understanding between the medical team and the patient that opioids are only allowed that the doctor prescribes and can only come from the pain center’s pharmacy or a designated pharmacy.

Heal Your Life With Homeopathic Medicine

This method of treatment believes that a substance that causes the symptoms of a disease in healthy people would cure similar symptoms in sick people.

All of us, unanimously agree with the fact that health is the supreme wealth. There is no alternative to a sound health condition when the mind, body, and soul are aligned in balance. But at the same time, diseases are also a reality which poses the threat to our health and even our survival. In comparison with the most number of treatments, Homeopathy has come up to be one of the most reliable ways for treatment in which there is no or a very least amount of side-effects.

Easy to Use

They are relatively easy to use than its allopathic counterparts. Homeopathic medicines are liquid concentrates which can be diluted in water or small sugar pills. These medicines are not bitter and people of all ages can take it easily without any feelings of disgust as in the case of allopathic medicines.

Cheap

They are relatively cheaper than other medicines like Ayurvedic and Allopathic. Some allopathic medicines are very costly and poor people are often unable to afford treatment. But a patient who is taking homeopathy treatment feels comfortable from the side of cost of his medicines.

No Side-Effects

It does not have any side-effects. One of the major worries for many patients is the reactive nature of allopathic or ayurvedic medicines. But they are mild on the body and does not have any apparent threat to the health.

High Success Rate

In comparison to allopathic medicines, homeopathic medicines have a high success rate, which means, that homeopathic medicines can treat even those diseases and ailments which fall short in front of allopathic medicines.

Homeopathic medicines cure a disease by stimulating the body to cure itself. Most of the homeopathic medicines are alcoholic concentrates with medicinal properties. One of the main reasons for such a high success rate of homeopathic treatment is that they cure the disease completely. Though the treatment is lengthier than usual but it cures the disease of its root so that it can never return in the future.

Preventive Medicine Failure: The Flint Michigan Example

The crucial role of preventive medicine is usually not quite apparent until there is a costly blatant failure as presently exemplified at Flint Michigan. The dangerous effect of lead poisoning on modern society is so well recognized that homes and public water supply systems built in the US in the last two decades have been totally free of lead pipes.

Older homes and public water supply systems have either been repiped or demolished for obvious safety reasons. Cities that are unable to identify all their old lead pipe connections use corrosion control to protect inner lining of city water pipes. When these basic preventive measures (Kemper, Alex et al, 2007) were overlooked in Flint Michigan, a huge water crisis quickly developed.

Flint City had been buying healthy Huron Lake water treated at Detroit water plants for over fifty years prior to 2013. But in 2013 the city voted to switch over to a cheaper water pipeline being built to Lake Huron. This caused Detroit City to abruptly cancel their water supply contract leaving Flint without water supply.

On April 25, 2014, in a desperate move to maintain water supply to 100, 000 Flint citizens Darnell Earley, an emergency city manager, appointed by Governor Rick Snyder, decided (Reissman, D.B. et al, 2001) to switch their water supply to the corrosive Flint river water, without corrosion control and against expert warning. Experts had recommended a short term contract renewal with Detroit City to by Flint City the time it needed for lead pipe replacement and corrosion control, at an estimated cost of 1.5 million dollars. But that recommendation was overtaken by even

Soon after the switch Flint households started reporting fowl odor from their their tap water, along with brown discoloration. The local DEQ tested and confirmed E. Coli in Flint watersystem. Chlorine was introduced into the water system to clear the bacteria, and citizens were reassured that the city water safe. By January 2015, a toxic level of chlorine byproducts, Total Trihalomethanes (TTHM) was reported in the Flint water system.

Between April and June 4014, Flint residents started reporting deeper browning of their tap water, hair loss, and neurological symptoms in their kids. The DEQ tested samples of Flint City water and said it met federal standards of < 5 parts per million of lead (Handler, Phoebe, etal, 2016). It even went as far as reporting to EPA that Flint City was compliant in their use of erosion control, which was not true.

Flint citizens became suspicious of their DEQ, and started conducting their own water testing and blood testing for lead (Carty Denise C. et al, 2016). The found toxic levels of lead in their tap water. Dr. Mona Hanna-Attisha a pediatrician at Hurley Medical Center, also discovered a rise in the number of school kids with high blood lead from 2.9% – 4.9% since the switch in April 2014. So they invited an expert, Dr. Edwards, a city water lead control advocate, from Virginia Tech to come and test their tap water samples. He confirmed toxic levels of lead in the water samples and notified the city council

In less than three months the toxic Flint river water had badly eroded the inner lining of the all the underground lead pipes delivering water to Flint City. Lead began leaching into the water city water system and turning the water progressively brown.

Media pressure from Dr Edward’s EPA report and The Rachel Maddow Show reports on MSNBC lead to the declaration of public health emergency in Flint City by Governor Rick Snyder on Ocober16, 2015. Even with the declaration of a disaster, Governor Rick Snyder allegedly would not reach out to the federal government for disaster relief fund, until presidential candidate Hillary Clinton called him out on MSNBC.

Flint citizens, who are predominantly blacks, took to the streets in protest against Governor Snyder, accusing him of racism. In an affect to contain the situation, the state government has now put the pediatrician who blew the whistle in charge of the Flint water crisis disaster control committee. But the citizens are still calling for the resignation of Governor Schnider.

Of all the complications of lead poisoning (Hou Shunngxing et al., 2016; Korfmacher.Katerina S., et al, 2016), the one that will cost Michigan State the most is the brain damage in school kids (Finkelstein, Myra et al, 2016). Those kids with low IQ and learning disorder will not only be a loss, but also a financial burden to the state economy for decades to come. Compare that to a couple of million dollars that would have contained the Michigan river leaching in the first place. This is a good example of what preventive medicine should not be in the 21st century.

References:

Kemper, Alex R., Rebecca L. Uren, and Sharon R. Hudson. “Childhood Lead Poisoning Prevention Activities Within Michigan Local Public Health Departments.” Public Health Reports 122.1 (2007): 88-92. Print.

Hou, Shuangxing et al. “A Clinical Study of the Effects of Lead Poisoning on the Intelligence and Neurobehavioral Abilities of Children.” Theoretical Biology & Medical Modelling 10 (2013): 13. PMC. Web. 1 Feb. 2016.

Korfmacher, Katrina S., and Michael L. Hanley. “Are Local Laws the Key to Ending Childhood Lead Poisoning?” Journal of health politics, policy and law 38.4 (2013): 757-813. PMC. Web. 1 Feb. 2016.

Carty, Denise C. et al. “Racism, Health Status, and Birth Outcomes: Results of a Participatory Community-Based Intervention and Health Survey.” Journal of Urban Healthâ�¯: Bulletin of the New York Academy of Medicine 88.1 (2011): 84-97. PMC. Web. 1 Feb. 2016.

Finkelstein, Myra E. et al. “Lead Poisoning and the Deceptive Recovery of the Critically Endangered California Condor.” Proceedings of the National Academy of Sciences of the United States of America 109.28 (2012): 11449-11454.PMC. Web. 1 Feb. 2016.

Reissman, D B et al. “Use of Geographic Information System Technology to Aid Health Department Decision Making about Childhood Lead Poisoning Prevention Activities.” Environmental Health Perspectives 109.1 (2001): 89-94. Print.

Handler, Phoebe, and Daniel Brabander. “Increased Incidence and Altered Risk Demographics of Childhood Lead Poisoning: Predicting the Impacts of the CDC’s 5 µg/dL Reference Value in Massachusetts (USA).” International Journal of Environmental Research and Public Health 9.11 (2012): 3934-3942. PMC. Web. 1 Feb. 2016.

Health Benefits Of Camphor

Every time we hear about camphor the first thing comes in everyone’s mind is that this is an important ingredient used in Indian households for religious ceremonies. In general, it is a waxy, flammable product with a strong odor. You can use this product in various ways like in religious ceremonies, in the form of essential oil, as a room freshener or in many other ways.

This is well-known for spreading positivity because it has a strong healing power. It is made from the wood of the camphor tree. Apart from this, it also has some health benefits which are lesser known and is as follows.

Digestive problem: If you or any of your known one suffering from the gas or a digestion problem so nothing is much better than the camphor. It helps you to get relief from a digestive problem like diarrhea, gastroenteritis.

Inflammation: It has vast anti-inflammatory properties which make it useful in various ointments or oils. You can apply camphor oil on the affected area and it will reduce the pain, itching or swelling as well. It helps to get relief from a pimple and acne as well. But one of the important things to consider is that never put camphor directly on your wounds because it becomes poisonous after meeting with your blood so always uses it with the guidance of experts.

Improve blood circulation: It works effectively in stimulating and improving blood circulation which is good for your heart and health as well. This will help to stay your heart health and keeps your body absolutely fit and fine.

Nerve disorders: It is scientifically proven that camphor is an effective treatment for nervous disorders, epilepsy and muscular contraction. So you can take camphor to get relief from these problems, but only after consulting a doctor.

Stimulate hormones: One of the major benefits of camphor is that it works as an effective hormone stimulator that helps in increasing libido as well as sex drive.

From above, now you may know its health benefits, but one thing to always keep in mind is that never apply camphor directly on your skin always dilute it with olive oil, coconut oil or almond oil otherwise, it may be dangerous. Another important thing to remember while using camphor is that never applies or uses it without taking the advice of a doctor. This is a beneficial product if you use it with caution.

How Can A Pain Management Doctor Help The Epidemic Of Opioid Overdosing?

Opiates or Opioids as they are more commonly known are and important prescription medication for any pain management doctor. However, in the last 10 years or so, they have become an abused, misused and overused medication that has sadly, been related to addiction and even death.

There Are Several Questions

When this epidemic is discussed among those in the medical industry, in particular, the pain management area, there are two questions that come to the surface: How is this happening? Who is letting it happen? What are can be done about it?

The biggest players in this epidemic are doctors and the pharmaceutical industry. So what responsibility should a pain management doctor take toward curbing and correcting this epidemic? What accountability should the pharmaceutical companies have? If there are any solutions, what are the best ones?

The CDC has recently issued the first set of guidelines for prescribing opioids. This guide is focused toward primary care physicians and has become the national standards for prescribing these painkillers. And while it is too late for millions, it is a positive step taken in the right direction.

What Are Opiates?

Derived from morphine, found as far back as the 3rd century B.C., they are a powerful painkiller. Common names for this drug are hydrocodone and oxycodone. It is believed that the Sumerians nurtured poppies and removed opium out of the seed capsules.

Opiates not only provide relief from pain, the sole intention of any pain management doctor, but they produce euphoria as well. It is that euphoric feeling that leads to abuse of the drug. Opioids are expensive and harder to acquire than the euphoric drug, heroin.

After years of using opioids, even months, a user will develop a tolerance to them. As such, they need a higher dosage in order to get the same level of relief. If their pain management doctor doesn’t approve a prescription for a higher dosage, they will resort to heroin. In fact, it is believed that 4 out of 5 opioid users have become heroin users.

The number of deaths from heroin overdose almost quadrupled between 2000 and 2013 in America. And when it comes to death from injury, opioids are the most common cause in this country.

Over 15,000 people die each year according to the CDC due to opioid medication overdoses. It is estimated that there are over 800 recreational users for each person that dies with over 30 ER visits due to opioids that result in 10 hospital admissions.

What Can Be Done?

One of the first steps is for every pain management doctor and other professions in the industry to question their patients thoroughly about any past or current alcohol or drug use. They should also check any prescription drug monitoring program that is available to them.

And the biggest step of all is to prescribe the lowest effective dose of any opioid to begin with and for only the amount that will most likely be needed. If a patient is complaining of pain after the prescription is finished, then a different type of pain management may be needed.

Every pain management doctor needs to be educated on opioids so that they can be better able to monitor their patient’s safety and recommend alternatives for pain management. The training of physicians should include the importance of developing a treatment plan in writing and create a medication agreement that the patient and them both sign, designating one physician as the sole prescribing doctor for pain medication.