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Opioid

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Newsletter Articles
Guides Newsletter (2020) 25 (1): 3–11.
Published: 01 January 2020
...James B. Talmage, MD The duration of opioid therapy after surgery is the strongest known predictor of ultimate misuse, and researchers have reported that the number of days for which medication was prescribed and the total number of postoperative prescriptions each predicts long-term use...
Newsletter Articles
Guides Newsletter (2021) 26 (5): 3–12.
Published: 01 September 2021
...James B. Talmage, MD; Robert B. Snyder, MD Evidence shows that chronic opioid therapy is usually not beneficial; weaning patients off opioids many times results in less pain and better function, and opioid-induced hyperalgesia is real and frequent. Further evidence suggests that surgical outcomes...
Newsletter Articles
Guides Newsletter (2016) 21 (6): 12–13.
Published: 01 November 2016
...Jennifer Christian, MD, MPH The author considers the hypothetical case of a worker disabled by an accident and spine fusion surgery that did not relieve the pain; he is offered opioids and spends his time in a recliner grieving the loss of his self-respect as a good husband, provider, and father...
Newsletter Articles
Guides Newsletter (2000) 5 (5): 4–5.
Published: 01 September 2000
... Spinal cord (dorsal column) stimulation (SCS) and intraspinal opioids (ISO) are treatments for patients in whom abnormal illness behavior is absent but who have an objective basis for severe, persistent pain that has not been adequately relieved by other interventions. Usually, physicians...
Newsletter Articles
Guides Newsletter (2000) 5 (5): 4–5.
Published: 01 September 2000
... to IMEs, identify strengths and weaknesses, and consider what can be done to improve efficiency and quality. © 2000 American Medical Association. All Rights Reserved. 2000 American Medical Association Spinal cord (dorsal column) stimulation (SCS) and intraspinal opioids (ISO) are treatments...
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One- and 3-year probabilities of continued <b>opioid</b> use among <b>opioid</b>-naive pa...
Published: 01 January 2020
FIGURE 1. One- and 3-year probabilities of continued opioid use among opioid-naive patients, by number of days’ supply * of the first opioid prescription—United States, 2006–2015 4 More
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One- and 3-year probabilities of continued <b>opioid</b> use among <b>opioid</b>-naive pa...
Published: 01 January 2020
FIGURE 2. One- and 3-year probabilities of continued opioid use among opioid-naive patients, by number of prescriptions * in the first episode of opioid use—United States, 2006–2015 4 More
Newsletter Articles
Guides Newsletter (2011) 16 (2): 1–7.
Published: 01 March 2011
... in the evaluation report that the rating is being provided despite reasons to be concerned that the impairment is artificially inflated in a nonpermanent way by the unjustifiable narcotic prescription. Evaluators should not state that the impairment from side effects of the opioids is permanent...
Newsletter Articles
Guides Newsletter (2013) 18 (1): 1–18.
Published: 01 January 2013
Newsletter Articles
Guides Newsletter (2019) 24 (4): 3–14.
Published: 01 July 2019
...); back injury; pain (acute and/or chronic); opioid use (current); delay between injury and first medical treatment (greater) ▪ Compensation factors: prior WC or disability claims (worker or significant other); prior sick leave ▪ Self-rated functional status (poor) ▪ The worker's self-reported...
Newsletter Articles
Guides Newsletter (2017) 22 (6): 3–11.
Published: 01 November 2017
...+ drinks (beer, wine, mixed drink) have significant elevation of relative risk for cirrhosis, injuries, and ear–nose–throat/esophageal/liver cancer. 54 , 55 Substance abuse has been declared a national emergency because of the recent opioid epidemic and increasing number of deaths by overdose...
Newsletter Articles
Guides Newsletter (2013) 18 (1): 18–19.
Published: 01 January 2013
.... He has had significant problems with chronic foot pain and is on chronic opioids. He does not use a gait aid. His Pain Disability Questionnaire is 75. An amputation of the second toe or a transmetatarsal amputation has been suggested; however, the patient prefers not to have surgery. Examination...
Newsletter Articles
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...
Newsletter Articles
Guides Newsletter (2021) 26 (3): 8–13.
Published: 01 May 2021
...-blockers), may be used. Opioids should be avoided. There is no curative therapy, and there is a lack of high-quality evidence for an effective drug regimen. Interventional procedures may be provided independently but are best used to facilitate engagement in functional therapies and to improve quality...
Newsletter Articles
Guides Newsletter (2017) 22 (4): 3–5.
Published: 01 July 2017
..., table, or methodology contained within the entire AMA Guides, Fifth Edition.” 4 Assuming chronic pain is best assessed on a physical basis (typically orthopedic) without considering psychosocial factors, 7 , 8 Considering opioid use as acceptable treatment for chronic pain, 9...
Newsletter Articles
Guides Newsletter (2014) 19 (4): 3–5.
Published: 01 July 2014
... the inclusion and exclusion criteria and baseline characteristics. While RCTs are important tools to help guide practitioners in treatment, such as whether ibuprofen is just as effective as an opioid for acute pain management, RCTs have practical limitations. Three main concerns are ethics, feasibility...
Newsletter Articles
Guides Newsletter (2006) 11 (6): 1–3, 8-11.
Published: 01 November 2006
... Med. 2002 ; 44 ( 5 ): 459 – 468 . 20. Mao , J . Opioid-induced abnormal pain sensitivity: implications in clinical opioid therapy . Pain. 2002 ; 100 : 213 – 217 . 21. Glass LS . Occupational Medicine Practice Guidelines, 2nd Ed. Beverly Farms, Mass : American College...
Newsletter Articles
Guides Newsletter (2006) 11 (3): 6–8.
Published: 01 May 2006
... loss (excision of the entire disc), a higher rate of complications, 5 and on average inferior results. Because discectomy warrants a Category III rating, it seems logical to rate a one level ADR as Category IV. Blumenthal et al reported 72% of all patients were still using opioid analgesics...
Newsletter Articles
Guides Newsletter (2007) 12 (5): 1–4, 12-16.
Published: 01 September 2007
... J : Opioid-induced abnormal pain sensitivity: implications in clinical opioid therapy . Pain . 2002 ; 100 : 213 – 217 . 47. American College of Occupational and Environmental Medicine : Pain, suffering, and the restoration of function , in Glass LS (ed): Occupational Medicine...
Newsletter Articles
Guides Newsletter (2014) 19 (5): 3–12.
Published: 01 September 2014
... in the context of abrupt withdrawal, particularly in a person who had a tendency to have seizures. Another medication that can potentially increase the risk of a seizure in this patient's case was tramadol, which is a synthetic opioid similar in potency to codeine. Tramadol has serotonergic and noradrenergic...