Pain Management and the Opioid Epidemic


Book Description

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.




Rethinking Causality, Complexity and Evidence for the Unique Patient


Book Description

This open access book is a unique resource for health professionals who are interested in understanding the philosophical foundations of their daily practice. It provides tools for untangling the motivations and rationality behind the way medicine and healthcare is studied, evaluated and practiced. In particular, it illustrates the impact that thinking about causation, complexity and evidence has on the clinical encounter. The book shows how medicine is grounded in philosophical assumptions that could at least be challenged. By engaging with ideas that have shaped the medical profession, clinicians are empowered to actively take part in setting the premises for their own practice and knowledge development. Written in an engaging and accessible style, with contributions from experienced clinicians, this book presents a new philosophical framework that takes causal complexity, individual variation and medical uniqueness as default expectations for health and illness.




Explain Pain


Book Description

Imagine an orchestra in your brain. It plays all kinds of harmonious melodies, then pain comes along and the different sections of the orchestra are reduced to a few pain tunes. All pain is real. And for many people it is a debilitating part of everyday life. It is now known that understanding more about why things hurt can actually help people to overcome their pain. Recent advances in fields such as neurophysiology, brain imaging, immunology, psychology and cellular biology have provided an explanatory platform from which to explore pain. In everyday language accompanied by quirky illustrations, Explain Pain discusses how pain responses are produced by the brain: how responses to injury from the autonomic motor and immune systems in your body contribute to pain, and why pain can persist after tissues have had plenty of time to heal. Explain Pain aims to give clinicians and people in pain the power to challenge pain and to consider new models for viewing what happens during pain. Once they have learnt about the processes involved they can follow a scientific route to recovery. The Authors: Dr Lorimer Moseley is Professor of Clinical Neurosciences and the Inaugural Chair in Physiotherapy at the University of South Australia, Adelaide, where he leads research groups at Body in Mind as well as with Neuroscience Research Australia in Sydney. Dr David Butler is an international freelance educator, author and director of the Neuro Orthopaedic Institute, based in Adelaide, Australia. Both authors continue to publish and present widely.




Relieving Pain in America


Book Description

Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.




Mechanisms of Vascular Disease


Book Description

New updated edition first published with Cambridge University Press. This new edition includes 29 chapters on topics as diverse as pathophysiology of atherosclerosis, vascular haemodynamics, haemostasis, thrombophilia and post-amputation pain syndromes.




Practical Chronic Pain Management


Book Description

This book focuses on both the management of the pain as well as the pain patient and is formatted as a practical, evidence-based guide to managing chronic pain conditions. It meets the market need for a reference that aides physicians in understanding and improving chronic pain in their patients. Organized across 46 chapters, the book begins with an introduction on chronic pain evaluation, and specifically stresses the importance of complete patient evaluation including social and psychological evaluation. Subsequent chapters then start with an evaluation, medical and interventional options available, how and when to move from one option to another and the level of evidence offered for each intervention. These unique chapter elements provide the reader with a case-based approach to managing their patients. Additionally, a brief discussion of epidemiology and pathophysiology of the disease process is included and the technical aspects of interventional techniques are reviewed. Edited by a leader in the field with international contributing authors across pain medicine, Practical Chronic Pain Management this book is written primarily for anesthesiologists, pain specialists, rheumatologists, and primary care physicians.




Chronic Pain and Addiction


Book Description

The relationship between chronic pain and addiction Patients with chronic pain understandably seek relief from their distress and discomfort, but many medications that alleviate pain are potentially addictive, and most chronic pain conditions only have a temporary response to opiate analgesic drugs. This volume reviews the fundamental topics that underlie the complex relationships of this controversial domain. The authors review behavioral models and practical methods for understanding and treating chronic pain and addiction including methods to formulate patients with complex comorbidity and screen patients with chronic pain for addictive liability. Finally, the authors describe the current findings from clinical and basic science that illuminate the role of opiates, cannabinoids and ketamine in the treatment of chronic pain. Up to date and comprehensive, this book is relevant to all professionals engaged in the care of patients with chronic pain or addiction and all others interested in these contemporary issues, particularly non-clinicians seeking clarity in the controversy over the best approach to patients with chronic pain.




Manage Your Pain


Book Description

Chronic pain is a silent epidemic, with one in five people suffering in their day-to-day life.An indispensible guide to understanding why your pain persists, what is going on inside your body and the symptoms that pain triggers, Manage Your Pain presents possible medical treatments and guides you through practical exercises for daily life. Dr Nicholas and Dr Molloy's strategies make it possible to set short and long term goals that will minimise the impact of pain on both work and leisure. In short, this book offers clarity and control.- Draws on the authors' extensive experience and the latest research - Clearly explains the causes of pain - Offers positive and practical ways to minimise the impact of pain- Revised and updated - Includes a chapter on pain management for older people




Dissolving Pain


Book Description

This guide to harnessing the power of the brain to resolve chronic pain includes a variety of simple attention exercises and a 65-minute guided audio program For four decades, Dr. Les Fehmi has been a leader in brainwave biofeedback (also called neurofeedback), training individuals how to balance and regulate their brainwave patterns to improve mental, emotional, and physical health. Dissolving Pain is based on the premise that although pain is perceived to exist in a particular part of the body, pain in fact resides in the brain. Drawing on existing scientific research and on decades of clinical experience, Dr. Fehmi offers brain-training exercises that quiet the pain signal in the brain. The exercises involve altering the way we pay attention to pain, cultivating what Fehmi calls Open-Focus Attention: a relaxed form of awareness that changes the neural blood flow and increases alpha brainwave activity (associated with reduced stress and beneficial hormonal changes). These exercises are effective in the treatment of many forms of pain including back, shoulder, neck, and joint pain; headaches; muscle pain and tension; and pain from traumatic injury. Included with the book is a link to a 65-minute downloadable audio program in which Dr. Fehmi guides listeners through the fundamental Dissolving Pain exercises. To learn more, visit openfocus.com.




Reversing Chronic Pain


Book Description

Reversing Chronic Pain offers a dynamic framework for joining body and mind to speed the healing of traumatic pain from the body level up. Each chapter presents a body-centered skill set that can be mastered through a broad menu of practice exercises. The resulting interlinked somatic building blocks help readers shift from physical pain to body awareness, and from unstoppable suffering to heartfelt connection and peace. Building on the AIDS cocktail approach that reflects the fact that chronic pain is complex and no one tactic is likely to solve the problem, renowned expert Maggie Phillips presents a 10-1 pain plan comprised of easy strategies based on somatic experience. Even if the reader’s pain is perceived as a “10” at the onset of the program, with 10 being intolerable, the somatic building blocks help shift the pain one point at a time until it gradually diminishes to “1” or even “zero.” Showing how the common professional interventions—medication, physical therapy, acupuncture, biofeedback—may be more harmful than healing, Reversing Chronic Pain stresses self-treatment throughout, involving sufferers in attaining lives not simply endured but actively enjoyed.