scholarly journals Chronic Opioid Therapy Modifies QST Changes After Ketamine Infusion in Chronic Pain Patients

2017 ◽  
Vol 18 (12) ◽  
pp. 1468-1475 ◽  
Author(s):  
Dermot P. Maher ◽  
Yi Zhang ◽  
Shihab Ahmed ◽  
Tina Doshi ◽  
Charlene Malarick ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Opioid Therapy ◽  
Chronic Opioid Therapy ◽  
Ketamine Infusion ◽  
Chronic Pain Patients ◽  
Pain Patients

scholarly journals Chronic Opioid Therapy Utilization Following an Acute Pain Prescription Supply Restriction Law: An Interrupted Time Series Analysis

2021 ◽  
Vol 24 (6) ◽  
pp. 417-424
Keyword(s):  
Chronic Pain ◽  
Time Series ◽  
Acute Pain ◽  
Interrupted Time Series ◽  
Opioid Therapy ◽  
Interrupted Time Series Analysis ◽  
Chronic Opioid Therapy ◽  
Chronic Pain Patients ◽  
Time Series Analyses ◽  
Pain Patients

BACKGROUND: Florida House Bill 21 (HB21) was implemented in July 2018 to limit Schedule II opioids prescriptions for patients with acute pain to a 3-day supply. Little is known about the potential unintended effects that such opioid restriction policies may have on chronic pain patients, who are exempt from the law. OBJECTIVE: We aimed to evaluate the effect of HB21 on opioid utilization measures among a cohort of chronic opioid therapy (COT) patients. STUDY DESIGN: A quasi-experimental design with interrupted time series analyses. SETTING: Pharmacy claims from January 1, 2015 to June 31, 2019 from a large employer-based health plan in Florida. METHODS: COT patients were those who received a >= 70 days’ supply of opioids in the prior 90 days, representing 15,310 patients. Interrupted time series analyses were conducted to compare the following monthly measures among COT patients before and after HB21 implementation: 1) number of COT patients, 2) daily Morphine Milligram Equivalents [MMEs], 3) days’ supply of prescriptions. RESULTS: There was a significant 25% reduction in the trend (pre-HB21 RR: 0.95, 95% CI: 0.93, 0.96 versus post-HB21 RR: 0.70, 95% CI: 0.65, 0.76) and an 8% immediate decrease (RR: 0.92, 95% CI: 0.88, 0.97) in the monthly prevalence of COT patients after HB21 implementation. However, no significant change was observed in trends for monthly number of days supplied per prescription, monthly MMEs per COT patient-day, or total MMEs per prescription. LIMITATIONS: Our study used data from employer-based private health insurance and did not include a longer post-policy period to adjust for implementation lag. CONCLUSION: Fewer patients received COT after HB21; however, patients who continued to receive COT experienced no significant changes in their regimen. The study did not assess whether COT patients were appropriately tapered or if therapeutic alternatives were initiated for new chronic pain patients. KEY WORDS: Prescription opioids, health policy evaluation, chronic opioid therapy, drug utilization

scholarly journals The Marginalization of Chronic Pain Patients on Chronic Opioid Therapy

2009 ◽  
Vol 3;12 (3;5) ◽  
pp. 493-498
Author(s):  
John F. Peppin
Keyword(s):  
Chronic Pain ◽  
Tertiary Care ◽  
Case Series ◽  
Opioid Therapy ◽  
Specific Class ◽  
Care Hospital ◽  
Chronic Opioid Therapy ◽  
Chronic Pain Patients ◽  
Poor Treatment ◽  
Pain Patients

The realities of treating chronic pain do not reflect the attention that marginalization of patients taking opioids has received. Physicians continue the same prejudices and biases that were present decades ago. One theory proposed to explain this poor treatment has been titled, the “barriers to pain management.” The barriers are not treated as moral issues, but rather as clinical aberrations and do not explain continued poor treatment. However, the barriers do not explain certain types of cases where there appears to be specific unfounded concerns related to a specific class of medications, e.g, opioids. Four cases are presented, from the authors experience, illustrating the marginalization of chronic pain patients on chronic opioid therapy admitted to a tertiary care hospital. These types of cases have not been presented in the literature previously and illustrate the failure of the barriers to explain marginalization. In each of these cases mental status changes was the presenting problem. However, in each of these cases, these changes were not related to their opioids, but were explained by clear reasons, other than opioids. Regardless, in each case, the attending physician blamed the opioids, without further workup and stopped them reflexively. It is proposed that there may be more complex psychosocial issues involved in the marginalization of chronic pain patients. This case series illustrates a ubiquitous problem demanding further examination and discussion. It is hoped that this case series will create interest in further research in this area. Key words: Chronic pain, opioids, marginalization, bias, barriers

scholarly journals Doctor-Patient Trust Among Chronic Pain Patients on Chronic Opioid Therapy after Opioid Risk Reduction Initiatives: A Survey

2018 ◽  
Vol 31 (4) ◽  
pp. 578-587
Author(s):  
Karen J. Sherman ◽  
Rod L. Walker ◽  
Kathleen Saunders ◽  
Susan M. Shortreed ◽  
Michael Parchman ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Risk Reduction ◽  
Opioid Therapy ◽  
Chronic Opioid Therapy ◽  
Patient Trust ◽  
Chronic Pain Patients ◽  
Pain Patients

Efficacy of the Opioid Compliance Checklist to Monitor Chronic Pain Patients Receiving Opioid Therapy in Primary Care

2016 ◽  
Vol 17 (4) ◽  
pp. 414-423 ◽  
Author(s):  
Robert N. Jamison ◽  
Marc O. Martel ◽  
Chuan-Chin Huang ◽  
Dylan Jurcik ◽  
Robert R. Edwards
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Opioid Therapy ◽  
Chronic Pain Patients ◽  
Pain Patients

scholarly journals Cross Validation of the Current Opioid Misuse Measure to Monitor Chronic Pain Patients on Opioid Therapy

2010 ◽  
Vol 26 (9) ◽  
pp. 770-776 ◽  
Author(s):  
Stephen F. Butler ◽  
Simon H. Budman ◽  
Gilbert J. Fanciullo ◽  
Robert N. Jamison
Keyword(s):  
Chronic Pain ◽  
Cross Validation ◽  
Opioid Therapy ◽  
Opioid Misuse ◽  
Chronic Pain Patients ◽  
Pain Patients

Opioid induced hyperalgesia: A focus on opioid use in chronic pain

2013 ◽  
Vol 2 (12) ◽  
pp. 395-397
Author(s):  
Julie L. Cunningham
Keyword(s):  
Chronic Pain ◽  
Side Effects ◽  
Treatment Option ◽  
Opioid Therapy ◽  
Opioid Use ◽  
Chronic Pain Patients ◽  
Opioid Induced Hyperalgesia ◽  
Pain Patients ◽  
Established Treatment

Opioids are a well-established treatment option for chronic pain. However, opioid therapy is associated with many side effects, including opioid induced hyperalgesia (OIH). This article reviews studies which have evaluated OIH in chronic pain patients on opioids.

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