Abstract from paper
Long-term opioid therapy has the potential for serious adverse outcomes and is often used in a vulnerable population. Because adverse effects or failure to maintain benefits is common with long-term use, opioid taper or discontinuation may be indicated in certain patients. Concerns about the adverse individual and population effects of opioids have led to numerous strategies aimed at reductions in prescribing. Although opioid reduction efforts have had generally beneficial effects, there have been unintended consequences. Abrupt reduction or discontinuation has been associated with harms that include serious withdrawal symptoms, psychological distress, self-medicating with illicit substances, uncontrolled pain, and suicide. Key questions remain about when and how to safely reduce or discontinue opioids in different patient populations. Thus, health care professionals who reduce or discontinue long-term opioid therapy require a clear understanding of the associated benefits and risks as well as guidance on the best practices for safe and effective opioid reduction. An interdisciplinary panel of pain clinicians and one patient advocate formulated recommendations on tapering methods and ongoing pain management in primary care with emphasis on patient-centered, integrated, comprehensive treatment models employing a biopsychosocial perspective.
Read the whole paper.
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Read my thoughts on opioid therapy as a patient who tapered off them.
I watched last night on “Torn From the Headlines: New York Post Reports,” a story about a 68 year-old kidnap victim who survived 12 days buried alive in 1993.
The victim was Harvey Weinstein, the CEO of a tuxedo manufacturing company. His kidnappers held him for ransom for $3 million in dark tomb – with him surviving on just some pieces of fruit and little water.
What an amazing story of strength, I thought to myself as I watched the show. We can learn a lot from this man.
So, I did some reading this morning to learn more.
There is a quote from Weinstein from a 1993 Los Angeles Times article that hit home for me. He said, “I can’t permit fear to govern my life.”
We can do the same when it comes to chronic pain. Sometimes, it’s the fear of pain that holds us back.
Read the story.
We've reached 1,000 members in my Chronic Pain Champions - No Whining Allowed Facebook support group.
Thanks to everyone who has shared my group with their patients and friends!
While I’m glad to see the growth of the group, I look forward to the day when there isn't any chronic pain. In the meantime, keep sharing.
Chronic pain appointments can be difficult for both patients and doctors.
For patients, doctor visits can be intimidating and create anxiety. We want validation of our pain, empathy, answers, and support.
For doctors, chronic pain patients can be more challenging to treat than other patients. We can be demanding of their time, attention, and patience.
While they truly want to help, doctors often have limited training (typically 11 hours of pain education in medical school), limited time (18.5 minutes per appointment), as well as limitations due to government and insurance guidelines.
So, how do you make the most of your appointment time and get the best treatment when you visit with the doctor?
Below are 23 suggestions to help maximize the patient-doctor experience (thanks to the many ideas provided by members of the Chronic Pain Champions – No Whining Allowed Facebook support group):
Before the appointment
At the appointment
To get the best treatment from your doctor, be prepared, calm, engaged, insightful, and open to taking more self-responsibility for your own care. It’s harder for doctors to treat patients who are negative or who expects the doctor to fix all of their problems.
I hope you find these tips helpful.
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•Diffuses fears of chronic pain
•Provides tools to help self-manage pain
HCPs and pain advocates, please share.
Chronic Pain Champions is an information resource/blog/support group to help chronic pain patients, their families, and friends, as well as healthcare professionals. Learn more about this site and the author.
Chronic Pain Champions