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| | Hospital Practice: Chronic Pain: 2. The Case for Opioids |
 | | Opioid analgesia is one of the most prolife therapies that we have to offer patients with cancer pain, and there is no reason to think that patients with other diseases are any less deserving of relief or that their pain is any less amenable to treatment. | | | For patients on chronic opioid therapy, it may soon be reasonable to periodically assess serum levels of the drugs and their metabolites to guide therapy, much as we do with antiarrhythmics and other medications. | | | Opioid medications allow us to treat chronic pain as aggressively as we would any pathogen, but we must first overcome ingrained misconceptions about patients' motivations for seeking treatment and about the addictive properties of the drugs. |
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http://www.hosppract.com/issues/2000/09/brook.htm
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| | Johns Hopkins Arthritis Presents the Benefits and Risks of Opioids for Chronic Pain Management |
| | The use of opioids as a treatment for non-malignant chronic pain remains a subject of considerable debate. | | | Opioids offer an appropriate and safe treatment for some but not all patients with non-malignant chronic pain. | | | Non-malignant chronic pain was considered to be unresponsive to opioids, or the use of opioids was associated with too many risks. |
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http://www.hopkins-arthritis.som.jhmi.edu/mngmnt/opioids.html
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| | Management of Chronic Non-Cancer Pain |
| | Supervening acute pain problems: Patients on chronic opioids who experience trauma, surgery, etc. still need pain medication for their acute pain problem, and usually need larger amounts of opioids for the acute problem. | | | Before a patient is begun on opioid treatment for chronic pain, a comprehensive assessment is indicated. | | | Opioid therapy for chronic nonmalignant pain: Current status. |
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http://www.jenniferschneider.com/articles/opiods.html
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| | Opioids in pain management |
| | In 1999, opioids are used for cancer pain, but we still argue over the use of opioids in non-cancer pain. | | | Medical proponents of opioid use in non-cancer pain argue that when there is no other effective remedy and opioids are effective then they should be used. | | | Fast onset of effect is not a critical factor if the patient is receiving continual analgesics for chronic pain, but may be relevant in patients taking the drug on an as-needed basis for acute or chronic pain. |
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http://www.jr2.ox.ac.uk/bandolier/booth/painpag/wisdom/lancop.html
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| | Opioids for Chronic Cancer and Non-Cancer Pain: A Survey of State Medical Board Members |
| | Guidelines for the use of opioids in the management of chronic non-malignant pain are not as well-developed as in cancer pain. | | | Broadly, the medical decision to use opioids for a particular patient with chronic pain is based on an assessment of the relative benefits and risks to the patient. | | | However, the mainstay of chronic cancer pain management is opioid therapy. |
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http://www.medsch.wisc.edu/painpolicy/publicat/92jmldo.htm
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| | Using Opioids to Control Pain |
| | Therefore, withholding the appropriate use of opioids from a patient who is experiencing pain on the basis of respiratory concerns is unwarranted." | | | Opioids are not the answer to every pain problem or even every severe pain problem. | | | In contrast, pain patients often take very large amounts of opioids and other medications to improve their function, but do not seek out the drug for its own sake or "crave" the medication. |
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http://www.painlaw.org/opioids.html
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| | Cancer Pain Relief: A guide to opioid availability |
| | The INCB has recognized that opioids are underused in the treatment of pain, especially cancer pain, and has called on governments to re-evaluate their needs. | | | In general, studies on the use of opioids to treat pain in cancer patients indicate that public and professional expectations about relief from cancer pain should be much higher than they are at present. | | | Health care workers may be reluctant to prescribe, stock or dispense opioids if they feel that there is a possibility of their professional licences being suspended or revoked by the governing authority in cases where large quantities of opioids are provided to an individual, even though the medical need for such drugs can be proved. |
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http://www.medsch.wisc.edu/painpolicy/publicat/cprguid.htm
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| | Opioids |
| | This position was based on three opinions: first, that patients maintained on opioids commonly developed addiction; second, that tolerance rapidly developed so that opioids were then useless even for acute pain in emergencies; and third, that opioids had medically dangerous side effects such as respiratory depression and liver damage. | | | Most cases of apparent tolerance to opioid analgesia have actually represented progression of the pain condition for which they were prescribed. | | | Opioids for Noncancer pain: from Controversy to Consensus |
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http://www.headachedrugs.com/archives/opioids.html
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| | APS - Definitions Related to the Use of Opioids for the Treatment of Pain |
| | These disparities contribute to a misunderstanding of the nature of addiction and the risk of addiction, especially in situations in which opioids are used, or are being considered for use, to manage pain. | | | Opioids, however, often have their utilization limited by concerns regarding misuse, addiction, and possible diversion for non-medical uses. | | | Addiction in the course of opioid therapy of pain can best be assessed after the pain has been brought under adequate control, though this is not always possible. |
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http://www.ampainsoc.org/advocacy/opioids2.htm
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| | Urinary profiles from people with autism |
| | Opioids are well known intermediaries in neuroendocrinimmunological processes but a detailed discussion of their precise role is beyond the scope of this paper. | | | This model is based upon acceptance of the opioid excess theory of autism as expounded initially by Panksepp (1979) and extended by Reichelt (1981) and ourselves (eg Shattock 1991). | | | Given the compromised state of the immune system of the child with autism, there are risks inherent to this procedure. |
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http://osiris.sunderland.ac.uk/autism/pshdur96.htm
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| | Miller: Endogenous Opioids |
| | The latter pathway is vital to the understanding of the actions of endogenous opioids because the areas along the pathway are rich in opioid peptides and opioid receptors, and serotonin induces the release of opioid peptides. | | | The endogenous opioid system has been used to treat pain through a technique called neuroaugmentation. | | | Partial or complete pain relief has been noted in 27% to 76% of the patients treated with neuroaugmentation; lower levels of efficacy were observed in severely ill cancer patients (15). |
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http://www.uoregon.edu/~iishp/MillerS.html
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| | Drugs Used to Treat Pain: Opioids - Narcotics |
| | Although the terminology is not precisely correct, pain-relieving opioids are often called narcotics, and they may be prescribed to treat acute pain (severe, short-lived pain), post-operative pain and certain types of chronic pain. | | | Opioids have been used for centuries to relieve pain. | | | Opioids work to relieve pain in two ways. |
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http://www.spineuniverse.com/displayarticle.php/article1345.html
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| | Long-Acting Opioids for Severe Chronic Daily Headache |
| | A retrospective study of 302 patients who had been prescribed long-acting opioids for CDH found that after at least 9 months of therapy, only 13% of patients had chosen to continue use of the opioids. | | | The daily use of opioids for nonmalignant pain such as CDH remains controversial. | | | Such techniques as biofeedback, psychotherapy, exercise, physical therapy, relaxation, or yoga also need to be utilized. |
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http://www.headachedrugs.com/archives/opiods_long_severe_CDH.html
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| | Prescription Drug Rehab Prescription Drug Addiction Treatment |
| | Although a behavioral or pharmacological approach alone may be effective for treating drug addiction, research shows that a combination of both, when available, is most effective. | | | Opioids, which are most often prescribed to treat pain; | | | When delivered effectively, behavioral treatments - such as individual counseling, group or family counseling, contingency management, and cognitive-behavioral therapies - also can help patients improve their personal relationships and ability to function at work and in the community. |
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http://www.drug-rehabilitation.com/prescription_drugs.htm
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| | Opioids in Chronic Nonmalignant Pain |
| | Many clinicians think that opioids are inappropriate therapy for chronic nonmalignant pain. | | | Opioids possess the potential for producing addiction; however, pain specialists find very few cancer patients becoming addicted to opioids. | | | However, additional controlled studies are needed to define the subpopulation of nonmalignant pain patients more likely to benefit from opioid analgesics. |
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http://www.meds.com/conrad/pmcd/port3.html
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| | Jennifer P. Schneider, M.D. - Resume |
| | Legal issues in prescribing opioids for chronic pain. | | | Legal Aspects of Prescribing Opioids for Chronic Pain. | | | Tucson, AZ: "Chronic pain, opioids, and your license." Presentation to physicians. |
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http://www.jenniferschneider.com/resume_pain.html
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| | VEGAN-STRAIGHT-EDGE - Opioids In Common Food Products |
| | Gluten, and also casein, and perhaps hemoglobin are all sources of peptides of the opioid family(2,3) and demonstrate psychoactive properties in humans and in animal experiments(6). | | | Endogenous opioid systems regulate mcell proliferation in the developing rat brain. | | | None the less all opioids may form dependancy habits. |
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http://www.vegan-straight-edge.org.uk/opioids.htm
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| | Autism: An Overview and Theories on its Causes |
| | Opioids also seem to play a role in the regulation of vasopressin under some conditions of water balance. | | | This auto-immine response could also affect DPP-IV, reducing its levels, thereby connecting vaccines to the opioid theory of autism. | | | When this happens, tryptophan is not converted into serotonin, but is shunted down alternate pathways, eventually leading to urinary IAG and 3-indoleacetate. |
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http://www.healing-arts.org/children/autism-overview.htm
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| | Frequently Asked Questions about heroin, morphine, and opioids |
| | Hydromorphone is one of the most used opioids in the relief of pain for the terminally ill. | | | Hydrocodone is a weaker opioid than morphine but still a effective opioid with similar potency to oxycodone. | | | It must be noted that physical symptoms may be similar to flu, psychological symptoms can be quite painful. |
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http://www.druglibrary.org/schaffer/heroin/opifaq.htm
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| | Nebulized Opioids |
| | Systematic review of the use of opioid drugs in the palliative treatment of dypnoea. | | | Rare adverse outcomes associated with nebulized opioids include bronchospasm and respiratory depression. | | | Multiple studies have examined the use of morphine and other narcotics in the treatment of breathlessness in seriously or terminally ill patients. |
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http://www.jasonprogram.org/nebulized_opioids.htm
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| | Syllabus on Geriatric Anesthesiology |
| | Transdermal fentanyl has been used for postoperative analgesia; however, because of the increased sensitivity to the depressant effects of opioids in the elderly, the occurrence of respiratory depression with the usual 50-75 mcg/hr dose makes the transdermal patch method of pain control unsuitable in opioid-naïve elderly patients. | | | Lower doses of fentanyl (1 to 3ug/kg), alfentanil (10 to 20ug/kg) or sufentanil (0.125 to 0.25 mcg/kg) are effective adjuvants to thiopental (2 to 3 mg/kg) for induction of anesthesia because they decrease the need for barbiturates and diminish the cardiovascular response to laryngoscopy and intubation. | | | High doses of these analgesics not only produce loss of consciousness, they effectively blunt the blood pressure and heart rate responses to laryngoscopy and intubation. |
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http://www.asahq.org/clinical/geriatrics/opioids.htm
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