The Ultimate Guide to Pain Management
The Ultimate Guide to Pain Management
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Nonopioid analgesics are first-line agents for pain; prescribe them alone for mild to moderate pain and in combination with opioids for severe pain. [14]
Benzodiazepine and opioids – a safety concern. Generally, do not initiate opioid therapy in patients routinely using benzodiazepine therapy. Both drugs are sedating and suppress breathing. Together they can cause a fatal overdose.
Buprenorphine can be prescribed for pain without an XDEA waiver, but the waiver is required to prescribe medication-assisted therapy for opioid use disorder.
It may seem hard to quit “cold turkey,” where you stop smoking suddenly. But Dr. Solanki says studies show that whether you taper your cigarettes or quit cold turkey, the results are the same.
Anticonvulsants are useful adjuncts in the management of neuropathic pain. They typically will not be helpful for acute pain, rather are more commonly used for chronic neuropathic pain.
Principles for managing opioid use disorder in pain patients. The treatment of pain patients who exhibit evidence of opioid use disorder requires heightened monitoring, or discontinuation of opioid therapy and initiation of addiction treatment.
Substance use disorders. Obtain a substance use history in all patients with chronic pain, including the use of alcohol, illicit drugs, tobacco, and caffeine. When the etiology of pain is unclear, this history can help assess the risk for substance use disorder prior to considering treatment with opioids. Obtain a family history of substance use disorders as part of a comprehensive risk assessment. Consider use of a standardized screening tool, such as the drug abuse screening test (DAST-10) or the Michigan opioid risk assessment (MORA).
If you’re feeling short of breath, sleep can be tough — propping yourself up or sleeping on your side may help
Evidence is limited regarding the long-term benefit of any single individual treatment modality. However, they may be used as part of a multimodal treatment program to improve function, quality of life, and alleviate pain.
Cognitive impairment. Patients new to opioids should not drive a vehicle or operate power equipment or heavy machinery until they see how they are impacted by the therapy.
Prescription problems. There is a pattern of prescription problems for a variety of reasons that may include lost, spilled, or stolen medications.
Discontinue all ineffective medications to get more info avoid polypharmacy, minimize toxicity, and limit unrealistic beliefs about the benefit of medications.
Avoid alcohol. Never mix alcohol and sleeping pills. Alcohol increases the sedative effects of the pills. Even a small amount of alcohol combined with sleeping pills can make you feel dizzy, confused or faint.
While multidisciplinary subspecialty pain services are increasingly available, primary care clinicians will continue to manage the majority of patients with chronic pain. This care can be challenging and resource-intensive, and many clinicians are reluctant or ill-equipped to provide it.