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Guides Newsletter (2011) 16 (2): 1–7.
Published: 01 March 2011
...Robert J. Barth, PhD The increasingly severe epidemic of overuse, abuse, and death involving prescription narcotics is of specific relevance to workers’ compensation, which is the primary venue for use of the AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ). Because...
Guides Newsletter (2016) 21 (2): 11–13.
Published: 01 March 2016
... (the rationale is unclear from the records). Her pain persisted and treatment has included chronic narcotics; she reported multiple physical and psychological complaints and difficulties, and illness behavior and unreliable self-reports failed to corroborate her reports. Needle EMG must be performed...
Guides Newsletter (2013) 18 (1): 1–18.
Published: 01 January 2013
... as a risk factor for chronic pain, it is noteworthy (and distressing) that workers’ compensation claimants are almost never evaluated for same, even when examined by a mental health specialist (Melhorn). Misuse of narcotics prescribed for chronic benign pain has become an epidemic in the United...
Guides Newsletter (2020) 25 (1): 3–11.
Published: 01 January 2020
... substantiation of the diagnosis and for initiation of treatment would be necessary before the diagnosis of OUD is confirmed and the status “at MMI” is confirmed prior to being deemed “ratable.” Prescription narcotics as an obstacle to MMI was explored in the March/April 2011 issue of the Guides Newsletter. 9...
Guides Newsletter (2021) 26 (5): 3–12.
Published: 01 September 2021
...) Narcotic Opioid Opioid-Use Disorder OUD Independent medical and impairment evaluations often involve a patient who is taking chronic opioids. Therefore, evaluating physicians need to understand the current science pertaining to opioid therapy and how this impacts patients and these assessments...
Christopher R. Brigham, MD, James B. Talmage, MD, Marjorie Eskay-Auerbach, MD, JD, Charles N. Brooks, MD
Guides Newsletter (2013) 18 (5): 11–12.
Published: 01 September 2013
... consideration of probable behavioral, personality, or other psychosocial issues. Prescription narcotics are a major obstacle to maximum medical improvement, 2 and the ongoing opioid use is likely contributing to his chronic pain. In those on daily analgesics, the most common cause of cephalgia is medication...
Guides Newsletter (1999) 4 (6): 12–13.
Published: 01 November 1999
... twenties. In one of those accidents, he sustained a lumbar compression fracture when he fell from a platform; in the other, a mild traumatic brain injury when he was struck by falling pieces of lumber. After all of the injuries, there was a pattern of prolonged disability, chronic pain behavior, narcotics...
Guides Newsletter (2016) 21 (5): 3–8.
Published: 01 September 2016
... that resulted in thoracic fusions at T10-T12). He had been on chronic narcotics for pain for several years prior to 2012. He underwent anterior C5, C6, and C7 corpectomies and posterior spinal instrumentation and fusion at C3-T2. Fusion included lateral mass screws in the cervical spine, pedicle screws...
Guides Newsletter (2016) 21 (6): 12–13.
Published: 01 November 2016
... neuro-surgeon's advice: “Don't even bother looking for another job.” The only thing Pete's doctors offered was opioid (narcotic) pain relievers. His new life was lying in a recliner, still suffering despite his meds. Pete grieved over the loss of his self-respect and his ability to be a good husband...
Guides Newsletter (2013) 18 (3): 1–3.
Published: 01 May 2013
... be particularly concerning for patients with elevated fear-avoidance beliefs, since they may be more predisposed to respond negatively to diagnostic labels, develop chronic LBP, be prescribed narcotics, or remain on disability. 17 Among workers with LBP, early MRI is not associated with better health outcomes...
Guides Newsletter (2017) 22 (4): 3–5.
Published: 01 July 2017
... . May–June 2008 , 14–18 and July–August 2008, 6–14. 8. Feinberg SD , Brigham CR , Ensalada L . Assessing Impairment and Disability in the Pain Patient . Guides Newsletter . January–February 2016 , 2 – 10 . 9. Barth RJ . Prescription Narcotics: An Obstacle...
Robert L. Knobler, MD, PhD, Charles N. Brooks, MD, CIME, Leon H. Ensalada, MPH, FAADEP, CIME, James B. Talmage, MD, Christopher R. Brigham, MD
Guides Newsletter (1998) 3 (5): 8–10.
Published: 01 September 1998
.... Second, there are global effects on cognitive processes. Constant pain leads to impairment of sleep, decreased alertness, and altered attention due to distraction by pain. Memory, particularly short-term memory, suffers as a result. Further, there are drug effects from the use of narcotic analgesics...
Guides Newsletter (2009) 14 (3): 3–6.
Published: 01 May 2009
..., narcotics, ergotamine derivatives, nonsteroidal anti-inflammatory etc) is the necessary and sufficient cause of chronic daily headache complaints, and that treatment will not be successful unless the patient is detoxified from such medications. Scientific findings point toward mental illness as one...
Guides Newsletter (2012) 17 (3): 1–10.
Published: 01 May 2012
... and social issues in the genesis of chronic pain complaints? 11 Have I considered the effects of treatments? For example, in cases of chronic pain, have I considered the effects of prescription narcotics, which scientific findings have indicated as a reliable cause of worsening of chronic pain? 15...
Guides Newsletter (2003) 8 (6): 1–9.
Published: 01 November 2003
...-function and depression), reflective of pain (eg, difficulties with ambulation associated with an antalgic gait), due to other illness (eg, a patient with a low back injury and urinary difficulties who also has benign prostatic hypertrophy), or due to medications (eg, constipation and narcotic analgesics...
Guides Newsletter (2005) 10 (3): 1–3, 10-12.
Published: 01 May 2005
... medical findings Others signs of preoccupation with general medical health A tendency for treatment to produce brief improvements that are not maintained Tranquilizer use Development of narcotic addiction Development of drug-induced confusional states Unsuccessful surgeries A history...
Guides Newsletter (2007) 12 (3): 1–3, 8-15.
Published: 01 May 2007
... their pain 70% lower, were using 85% less narcotic medication, had over 85% fewer ED visits, and had 100% fewer surgical consultations, highlighting the importance of reassurance. 28 Although the negative effects of physical inactivity on the body have been repeatedly reported in the medical...
Joseph A. Hirsch, PhD, PsyD, Steven Mandel, MD, Kurt T. Hegmann, MD, MPH, Alexandra G. Stratyner, PhD, Stuart Gitlow, MD, MPH, MBA, James B. Talmage, MD, Christopher R. Brigham, MD
Guides Newsletter (2023) 28 (2): 1–38.
Published: 01 March 2023
... American Medical Association. All Rights Reserved. 2023 American Medical Association Addiction Disability “Disease of Brain” Model Drug Dependence Fentanyl Narcotic Dependence Opioid Dependence Beginning in early 2020, two large, overlapping epidemics affected the United States (US...
Guides Newsletter (2006) 11 (6): 1–3, 8-11.
Published: 01 November 2006
.... Complex regional pain syndrome serves as an example of this problem, because a CRPS-like presentation can be created by a relatively brief prescription of narcotics. 20 Similarly, the contribution that pain medications make to the chronicity of pain complaints has been documented for occupational...
Guides Newsletter (2007) 12 (5): 1–4, 12-16.
Published: 01 September 2007
... to substance-induced disorders. Research has revealed that a relatively brief prescription of narcotic medication can create a CRPS-like presentation. 46 Such findings are consistent with the warnings from the American College of Occupational and Environmental Medicine that pain medications represent...