Patients who saw a physical therapist first had lower utilization of high-cost medical services and lower opioid use. They also had significantly lower out-of-pocket costs, with costs shifting towards provider settings.
A large observational study found opioid-related adverse drug events (ORADEs) were common among hospitalized patients undergoing surgery and endoscopy procedures. ORADEs were associated with worse patient outcomes, including increased risk of inpatient mortality, longer hospital stays, and higher costs.
A recent study published in the American Journal of Preventive Medicine found that fatal drug overdoses among young non-Hispanic white adults accounted for 62% of mortality rate growth between 1999 and 2015. The study highlights the rapid rise in lost life years and mortality rates for this population, particularly those aged 22-39 years.
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A new study published in Anesthesiology found that liposomal bupivacaine, a long-acting local anesthetic, did not reduce opioid prescriptions or complications after total knee replacement surgery. The study included over 88,000 patients and found no significant benefit from adding liposomal bupivacaine to multimodal pain management reg...
Clinicians in safety-net hospitals feel morally distressed by policies preventing them from performing hemodialysis to undocumented immigrants, except in emergency situations. Emergency-only hemodialysis has a high mortality rate and is associated with burnout among clinicians.
A large-scale study found that inpatient opioid use and insufficient weaning before discharge may increase outpatient opioid prescriptions. Nearly half of patients who received opioids during hospitalization were more likely to report outpatient opioid use within 90 days.
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The US mental health system struggles to deliver behavioral healthcare to populations in need due to significant human resource issues. Research reveals substantial shortages of psychiatrists, psychologists, and other mental health professionals, particularly in rural areas.
A new study from St. Michael's Hospital found that nearly one-quarter of initial opioid prescriptions in Ontario had doses exceeding the suggested threshold of 50 milligram morphine equivalents. Dental pain accounted for a significant number of these prescriptions, while postsurgical pain patients often started on higher daily doses.
A new study reveals that pharmaceutical payments to doctors increase their opioid prescribing rates, with a 9.3% spike in opioid claims among those who received marketing in 2015. The study recommends regulatory limits on payments to curb the problem.
A pilot study at Yale University found that reducing IV opioid dosing by 84% and switching to non-IV methods resulted in similar or improved pain scores for hospitalized patients. The study's findings suggest that less is more when it comes to prescription opioids for hospital patients.
A study found that nonresearch payments from pharmaceutical industry marketing of opioid products were associated with higher opioid prescribing rates. The research used two U.S databases to identify all nonresearch payments and gather information on opioid prescriptions written by physicians for Medicare beneficiaries in 2015.
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Researchers are studying how stress produces pain and developing a potential treatment for stress-related chronic pain conditions. The team, led by Dr. Frank Porreca, will analyze neurons in the amygdala that respond to stress through signaling at the kappa opioid receptor.
The largest health burden from substance use is attributed to tobacco smoking, with nearly one in seven adults worldwide smoking. In contrast, illicit drug use is less common, with fewer than one in twenty people using cannabis in the past year.
Researchers funded by NIH find that opioids produce effects by binding to receptors inside neurons, not just on surface, providing new insights into pain medication development. The discovery may help guide design of safer pain relievers without addiction risks.
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A multidisciplinary panel of experts discussed the role of medicinal cannabis in alleviating chronic pain and easing the opioid crisis. Despite strict federal laws, state laws allowing medicinal cannabis have impacted communities most affected by opioid use.
A study found that providing clinicians with timely and actionable feedback on their opioid prescribing data significantly decreases future opioid prescribing among those who underestimate their baseline prescribing. This intervention may help combat the opioid epidemic by addressing inaccurate provider self-awareness.
A recent study from the University of Michigan found that racial disparities in opioid prescribing have decreased, with blacks and whites now receiving equal numbers of opioid prescriptions. However, blacks are at a higher risk of addiction due to prescription narcotic exposure.
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A study presented at the AATS 98th Annual Meeting found that patients used far fewer opioids than were prescribed after open and laparoscopic hiatal hernia repair. The study identified several factors contributing to over-prescribing, including inadequate patient education and improper use of adjunct pain medications.
A survey of 138 medical marijuana users aged 61-70 found that most patients significantly reduced their chronic pain and dependence on opioid painkillers. The results suggest that medical marijuana could be an effective solution to curb the opioid epidemic in older adults.
A new study led by Johns Hopkins researchers found that only a small percentage of patients use nonopioid pain relievers to supplement opioid pain management after spine and joint surgery. Patients also improperly store and dispose of opioids.
A new study at Boston Medical Center aims to bridge a gap in care for patients with substance use disorders by linking them with trained peer recovery coaches. The project, Project RECOVER, will provide support and sustain recovery for up to six months through interventions delivered by certified peer coaches.
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A study published in the Journal of Addiction Medicine found that opioid-related deaths among young adults in Ontario nearly tripled from 2000 to 2015. The rate of opioid-related deaths in this age group increased dramatically, with over 1 in 9 deaths being opioid-related by 2015.
A recent study found that Veterans Health Administration (VHA) facilities have varying care practices for military veterans with chronic pain, leading to inconsistent rates of long-term opioid therapy. Facilities with a wider range of non-opioid treatment options had lower rates of opioid use among veterans.
Recent opioid use is associated with an increased risk of falls in older adults and a higher risk of death during hospital stays. Researchers found that patients who had filled an opioid prescription before injury were 2.4 times more likely to have fallen, resulting in injury and higher mortality rates.
Researchers at the University of Michigan have developed a new compound that could offer pain-relieving properties without the risk of addiction. The compound interacts with two types of opioid receptors, one responsible for pain relief and another that can reduce addiction liability.
A Mayo Clinic survey found that nearly a third of patients did not use any opioids prescribed after surgery, with only 8% disposing of their remaining medications. The study suggests that patient factors such as age and pain score can influence opioid use, highlighting the need for tailored prescribing guidelines.
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A new analysis found that opioid pain medications may pose higher risks of altered mental status, falls, and fractures in patients undergoing hemodialysis. Opioid use was associated with increased risks even at lower doses and with certain types of medication recommended for this population.
A systematic review of over 460 studies suggests that ibuprofen and acetaminophen are better options for relieving acute dental pain. The combination of 400mg ibuprofen and 1000mg acetaminophen was found to be superior to any opioid-containing medications.
A study by University of Texas Medical Branch researchers found that opioid-related hospitalization rates increased among Medicare patients without prescribed opioids after the 2014 federal change limiting hydrocodone product dispensing. This increase may indicate illegal use of these drugs.
A multicenter database study of adults undergoing spinal deformity surgery found that daily opioid users had longer ICU stays and more severe postop disability compared to non-opioid users. The study highlights the need for preoperative counseling and alternative pain management strategies for patients at risk of daily narcotic use.
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A new study by the University of Colorado Boulder found that post-surgical opioids can lead to chronic pain in rats for more than three weeks. The researchers discovered that opioids stimulate specialized immune cells in the spinal cord, making them more reactive to pain, and that gradual tapering has no effect on the prolonged pain.
Naloxone has been shown to reduce brain inflammation and improve neurological function in rats after a stroke, with a potential new treatment avenue for stroke patients. Further study is warranted to investigate naloxone's effectiveness in humans.
A VA study found that electronic medication alerts can reduce the risk of dangerous drug combinations by 25% for patients with substance use disorder, sleep apnea, and suicide risk. The alerts also improved coordination between primary care and mental health services.
A new Consensus Statement provides 16 recommendations to improve safe opioid use in non-cancer hospitalized patients with acute pain. The guidelines emphasize limiting opioid use, using lowest effective doses and immediate-release formulations, and educating patients about non-opioid alternatives.
Two studies investigate the correlation between state-legal cannabis use and opioid prescription rates among Medicaid enrollees and Medicare Part D recipients. The findings suggest that implementing medical cannabis laws may lead to a decrease in opioid prescribing rates and spending.
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A study found that 65% of emergency department physicians underestimated their opioid prescription rates, but rates decreased after they saw their actual data. The researchers believe this change was due to the shock of seeing the reality of their actions versus their perceptions, priming them to make a change.
A recent study by the University of Eastern Finland found that initiating opioid analgesics reduces the use of antipsychotics and benzodiazepines in persons with Alzheimer's disease. This decrease was observed without worsening behavioural and psychiatric symptoms.
The introduction of tamper-resistant oxycodone in Australia led to a decrease in dispensing rates for higher-strength formulations among people under 65 years old. However, poisonings from injected oxycodone remained unchanged despite this shift.
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A nationwide survey found that oral and maxillofacial surgeons prescribed more opioids after hydrocodone-containing products were rescheduled in 2014. The study also showed a significant reduction in phone calls requesting refill authorizations after switching to more potent pain medications.
A study analyzing hospital data from 2012-2014 found that 1.5% of patients hospitalized for periapical abscess had opioid abuse/dependence, with certain demographics showing increased risk, including younger adults and those without private insurance.
A study at the University of Minnesota School of Dentistry found a significant decrease in opioid prescriptions after implementing an opioid prescribing protocol. The analysis showed a 47.1% reduction in total opioid prescriptions and tablets per prescription written.
Patients taking chronic opioids before spinal fusion are at increased risk of complications, including wound complications, emergency visits, and repeat spinal fusion surgery. Long-term opioid use also associated with higher odds of constipation and increased healthcare costs.
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A new Series in The Lancet highlights the extent to which low back pain is mistreated, with patients often receiving education and advice instead of evidence-based treatments. Key findings include high rates of opioid prescription and limited exercise prescriptions, even in countries with high-income counterparts.
A growing burden of uncontrolled pain in low- and middle-income countries is highlighted, with only 6.7% of medical opioids available to these regions. Experts outline strategies for improving access to pain treatment, including education in multidisciplinary pain medicine and balancing regulation of opioids.
A study found that adolescents with mental health conditions and treatments were more likely to transition from initial opioid prescriptions to long-term opioid therapy. The study analyzed data from over 1.2 million adolescents aged 14-18 with first-time opioid prescriptions between 2003 and 2014.
A mandatory educational session on opioid abuse and new prescribing guidelines led to a significant decrease in opioids prescribed after hand surgery. The study found a 45% reduction in opioids prescribed, suggesting that similar standardized education and guidelines could reduce over-prescription nationwide.
A randomized clinical trial found that opioid medications did not improve pain-related function over 12 months compared to nonopioid medications. Nonopioid medications resulted in less intense pain and fewer medication-related symptoms.
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Two studies showed that pre-operative counseling and non-opioid pain relievers can significantly reduce post-surgery opioid use, resulting in a two-thirds decrease in opioid consumption. Patients who used non-opioids experienced an equivalent pain experience with fewer adverse events compared to those using opioids.
Researchers developed a statistical model to predict hospitalized patients at risk of progressing to chronic opioid therapy. The model correctly identified high-risk patients in 79% of cases and was found to be highly associated with variables such as substance use disorder, benzodiazepine receipt, and surgical procedures during hospit...
Using multiple methods to manage pain during and after joint replacement surgery was associated with a decrease in opioid use, opioid prescriptions, and common complications. Multimodal therapy reduced opioid prescriptions by up to 18.5%, respiratory complications by 19% and gastrointestinal complications by 26%.
A review in Journal of Pediatric Orthopaedics outlines the severity of opioid use among children and teenagers undergoing surgery, with nearly one-fourth of US high school seniors having exposure to prescription opioids. Strategies for reducing opioid prescribing include education, standardized practices, and legislation to shift presc...
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Recent studies on medical marijuana laws find no significant link to increased adolescent recreational use, contradicting previous claims. The evidence also suggests that legalizing medical marijuana does not necessarily reduce opioid overdose deaths, as other factors contribute more significantly to the decline in deaths.
Researchers found that gabapentin is being mixed with other substances to produce euphoria, and some users are turning to it after crackdowns made it difficult to obtain opioid prescriptions. The medication's low cost and increasing popularity have contributed to its misuse, highlighting the need for further study on its abuse potential.
Researchers found medical cannabis significantly relieves pain and improves quality of life for seniors with minimal side effects. The study surveyed 2,736 patients aged 65+ who received medical cannabis through Israel's largest supplier, Tikun Olam.
An imaging study found altered signaling in the brain and spinal cord after short-term infusion of remifentanil, leading to increased sensitivity to heat pain stimuli. The results indicate that opioid application can alter pain processing in the central nervous system.
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A Vanderbilt University Medical Center study found that opioid users have a 1.62 times higher risk of invasive pneumococcal diseases, which can cause meningitis and other severe infections. The study suggests that high-dose opioids, particularly those with long-acting properties, carry the greatest infection risk.
Researchers found a significant association between opioid use and the risk of laboratory-confirmed invasive pneumococcal diseases. High-dose opioids, especially those classified as high potency and long-acting formulations, were most strongly associated with invasive pneumococcal diseases in humans.
A study found that few dermatologists prescribe opioids, but those who do concentrate in Southern states and surgical practices. Higher rates of opioid prescribing were also observed among dermatologists in these areas.
A Saint Louis University study found that treating depression can increase the likelihood of successful opioid cessation in non-cancer pain patients. Patients who adhered to antidepressant medications were more likely to stop opioids and experience a rapid decline in depression symptoms.
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A new study published in the Journal of General Internal Medicine found that long-term opioid prescribing among US military veterans decreased by 30% between 2010 and 2016. The decline was largely due to a reduction in long-term opioid use, rather than a decrease in short-term use.