Podcasts about prescription opioids

Even with strict guidelines around prescribing opioids, people are becoming addicted to the painkillers. The medical community has made efforts to reduce over-prescribing in recent years. But as Mary Jane Hampton tells us in this week's health hack, there are things we can do as well.

The Justice Department is accusing CVS Pharmacy of filling unlawful prescriptions for opioids. AP correspondent Donna Warder reports.

Broadcast on KSQD Santa Cruz on 7-05-2024: Guest introduction and Background Introduction of Rita Hewitt, regional director for Central Coast overdose prevention, and her professional background. Overview of Rita's notable achievements and roles in various healthcare and harm reduction initiatives. Rita's journey from a licensed pharmacy technician to her current role in overdose prevention. Impact of the prescription opioid epidemic on her career choices and motivation to address addiction and overdose issues. Stories from Rita's early career, including encounters with prescription opioid misuse and its consequences. Challenges in Opioid Prescription and Addiction Discussion on the challenges faced by healthcare providers in managing pain and the consequences of opioid prescriptions. Examples of misuse and the impact of addiction on individuals and the community. Historical Context of Opioid Epidemic Examination of the history of opioid use and misuse, from pharmaceutical origins to current trends. The role of pharmaceutical companies and legislation in shaping the opioid crisis. Pendulum Swing in Opioid Prescribing Practices Analysis of the shifting attitudes towards opioid prescribing over the decades. The impact of educational mandates and legislation on prescribing practices and patient care. Current Strategies for Harm Reduction Overview of harm reduction initiatives and resources available in the community. Discussion on the effectiveness of buprenorphine and other medications in treating opioid addiction. Emerging Drug Threats Introduction of new substances like Xylazine and their impact on the community. Challenges in addressing these new threats and the limitations of existing overdose reversal medications. Testing and Safety Measures Importance of fentanyl test strips and other tools in preventing overdoses. Availability and distribution of test strips and Narcan within the community. Legislation and Policy Initiatives Recent laws and mandates aimed at improving opioid prescription practices and overdose prevention. Discussion on potential future initiatives to enhance harm reduction and public safety. Pendulum Swing in Opioid Prescribing Practices Continued discussion on the history of opioid prescribing and the shifts in attitudes over the decades. Impact of legislation and educational mandates on opioid prescribing practices and patient care. Challenges and Personal Experiences in Addiction Rita shares personal experiences and anecdotes about friends and community members affected by opioid addiction. Dr. Dawn shares a story about a patient with a severe infection due to opioid misuse and the challenges in managing their pain and treatment. Current Strategies for Harm Reduction Overview of harm reduction strategies and resources available in the community. Discussion on the effectiveness and benefits of buprenorphine and other medications in treating opioid addiction. Emerging Drug Threats Introduction of new substances like Xylazine and their impact on the community. Challenges in addressing these new threats and the limitations of existing overdose reversal medications like Narcan. Statistics and Trends in Overdose Fatalities Examination of the current statistics and trends in overdose fatalities in the local community and nationally. Discussion on the increase in fentanyl-related fatalities and the ongoing challenges in addressing the crisis. Testing and Safety Measures Importance of fentanyl test strips and other tools in preventing overdoses. Availability and distribution of test strips and Narcan within the community. Legislation and Policy Initiatives Recent laws and mandates aimed at improving opioid prescription practices and overdose prevention. Discussion on potential future initiatives to enhance harm reduction and public safety. Community Initiatives and Collaboration Overview of local initiatives and collaborations aimed at addressing the opioid crisis and improving public health outcomes. Importance of community engagement and support in harm reduction efforts. Future Directions and Goals Rita's vision and goals for future harm reduction initiatives and policies. Discussion on the potential impact of upcoming legislation and community efforts on the opioid crisis.

Guest Anna Lembke is a psychiatrist and a specialist in the behavioral sciences who studies addiction. While there is tremendous variety in the things people can be addicted to, all forms are tied to dopamine, a biochemical that is key to human senses of pleasure, reward, and motivation. She says that new treatments are combining traditional abstinence with programs that help patients reenergize dopamine centers in the brain through physical exercise, which is a known producer of dopamine. If patients can reach 30 days of abstinence there is a good chance at recovery, Lembke tells host Russ Altman on this episode of Stanford Engineering's The Future of Everything podcast.Episode Reference Links:Anna Lembke's Stanford ProfileAnna Lembke's WebsiteHow do we fight the disease of addiction? (Anna's previous episode on The Future of Everything podcast)Connect With Us:Episode Transcripts >>> The Future of Everything WebsiteConnect with Russ >>> Threads or Twitter/XConnect with School of Engineering >>> Twitter/XChapters:(00:00:00) Introduction Host Russ Altman introduces guest Professor Anna Lembke, a professor of psychiatry and behavioral sciences at Stanford University, and an expert on addiction.(00:02:27) The Personal Nature of AddictionProfessor Lembke shares a personal story of addiction to romance novels, providing insight into how seemingly benign habits can become harmful addictions.(00:06:02) The Brain Chemistry of AddictionWhat happens in the brain during addiction, including dopamine's role in pleasure, reward, and the process of becoming addicted.(00:11:10) Addressing Addiction in HealthcareHow the medical community has evolved in recognizing and treating addiction, partly due to the opioid epidemic.(00:13:23) Strategies for Managing and Treating AddictionTreatment approaches for addiction, including the concept of hormesis, and how engaging in challenging physical activities can help manage addictive behaviors.(00:17:31) Treatment and Recovery from AddictionProfessor Lembke's own experience with overcoming her addiction through self-intervention and “dopamine fasting”.(00:22:05) The Addictive Personality and Genetic VulnerabilitiesThe concept of an "addictive personality," genetic predispositions to addiction, and how these factors play into the challenge of treating and managing addiction.(00:23:29) The Opioid Epidemic: Insights and Challenges An update on the opioid epidemic, the rise of fentanyl, and the ongoing challenges in addressing opioid addiction.(00:29:08) The Future of AddictionThe broader context of addiction in society, emphasizing the importance of addressing addiction to digital media and other non-substance-related addictions(00:29:57) Conclusion Connect With Us:Episode Transcripts >>> The Future of Everything WebsiteConnect with Russ >>> Threads or Twitter/XConnect with School of Engineering >>> Twitter/X

Will Morgan's story is highlighted in Christina Dent's new book, Curious: A Foster Mom's Discovery of an Unexpected Solution to Drugs and Addiction. On this episode, we talk to Will as well as his wife, Sarah, hearing her journey of supporting Will through his years-long journey with chronic pain and prescription opioids. They offer a window into the other side of the war on prescription opioids - the patients who struggle with chronic pain and now have a harder time finding the medications they need. And yet, the very thing that at one point helped Will became part of the problem. Their story illustrates the tremendous complexity of prescription opioids and the lived experiences of the people who need them and the loved ones supporting them. There are no easy answers here, but a story that gives us a view into the real lives and families impacted by opioids and the policies that govern access to them.  Buy Christina's book Curious here: enditforgood.com/curious

Dr. Cheryl Bettigole, Philadelphia Health Commissioner, discusses a measles outbreak that was detected in the city in early December; Grace DeLeon, ASTHO Senior Analyst for Overdose Preparedness and Response, tells us about an ASTHO report to help agencies better understand how to reduce stigma for people who receive opioids for chronic pain; an upcoming ASTHO webinar focuses on insights from a CDC-funded project identifying Medicaid-enrolled tobacco users and exploring their healthcare patterns; and an ASTHO blog explains how ASTHO members have come up with new ways to help people who are losing Medicaid coverage they received during the pandemic. CDC Webpage: Measles Cases and Outbreaks ASTHO Report: How Healthcare Providers Can Reduce Stigma to Improve Care for Patients Taking Long-Term Opioid Therapy ASTHO Webpage: Opioid Preparedness – Disruptions in Access to Prescription Opioids  ASTHO Report: How State Health Departments Can Reduce Stigma to Improve Care for Patients Taking Long-Term Opioid Therapy ASTHO Webinar: Lessons with the State of Washington on Medicaid Data and Tobacco Use ASTHO Blog Article: Ensuring Continuity in Healthcare Coverage While Medicaid Unwinds  

PAIN: Parents & Addicts in Need's Founder Flindt Andersen and Jason LaChance sat down to discuss some of the conversations around Matthew Perry's passing. We also talk about facts when it comes to prescription opioids and the reframing of "boundaries" and thinking about them as accessibility to one's self. We converse about the various facts that have come out concerning Matthew Perry's untimely passing and speculation to any connections with his addiction history Prescription opioid facts are also discussed as well as the reframing of boundaries to limited access to ones self. For more on Parents & Addicts In Need: If you or a loved ones need our services, to follow on social media, the Don't Hide The Scars Podcast, to get involved, or to donate ⁠⁠⁠⁠⁠⁠https://linktr.ee/painnonprofit⁠⁠⁠⁠⁠⁠ For more on Flindt Andersen or to have him speak at your organization visit ⁠⁠⁠⁠https://www.flindtandersen.com/ ⁠⁠⁠ --- Send in a voice message: https://podcasters.spotify.com/pod/show/donthidethescars/message

Dr. Sarah Stoddard, a Member of the Community Preventive Services Task Force with the U.S. Department of Health and Human Services, says the organization reviewed 60 studies to determine what can help prevent substance use among young people; Dr. Mandy Cohen, CDC Director, has already traveled to several states as part of a campaign to build trust; Dr. Heather Krasna, Associate Dean of Career Services and Professional Development at the Columbia University Mailman School of Public Health, explains the importance of publichealthcareers.org as the website turns one-year-old this month; and ASTHO has tools agencies can use to prepare for the closure of pain clinics. The Community Guide Webpage The Community Guide Webpage: Substance Use: Family-based Interventions to Prevent Substance Use Among Youth Public Health Review Morning Edition Episode 525: CDC Director Shares Priorities Public Health Careers Webpage ASTHO Webpage: Opioid Preparedness – Disruptions in Access to Prescription Opioids   

In episode 13 we discuss opioids and cognitive changes in older adults.Warner, NS, Hanson, AC, Schulte, PJ, Habermann, EB, Warner, DO, Mielke, MM. Prescription opioids and longitudinal changes in cognitive function in older adults: A population-based observational study. J Am Geriatr Soc. 2022; 1- 12. doi:10.1111/jgs.18030 https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.18030----------We also discuss the new (and old) CDC opioid prescribing guidelines.---------Episode 13 Credits:Original theme music: composed and performed by Benjamin KennedyAudio production: Angela OhlfestVideo production: Paul Kennedy----------This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice. The best part of any journal club is the conversation. Send us your comments on Twitter, Facebook, YouTube, email, or join our Facebook group. Email: addictionmedicinejournalclub@gmail.com Twitter: @AddictionMedJC Facebook: @AddictionMedJC Facebook Group: Addiction Medicine Journal Club YouTube: addictionmedicinejournalclub Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities.

This episode is also available as a blog post: https://youarewithinthenorms.com/2022/07/23/prescription-opioids-arent-driving-the-overdose-crisis-illicitly-manufactured-synthetic-opioids-are/ --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/norman-j-clement/support

Jeffrey A. Singer is a senior fellow at the Cato Institute and works in the Department of Health Policy Studies. He is President Emeritus and founder of Valley Surgical Clinics Ltd., the largest and oldest group private surgical practice in Arizona, and has been in private practice as a general surgeon for more than 35 years.He is also a visiting fellow at the Goldwater Institute in Phoenix. Singer is a member of the Board of Scientific Advisors of the American Council on Science and Health. From 1994 to 2016, he was a regular contributor to Arizona Medicine, the journal of the Arizona Medical Association. He served on the Advisory Board Council of the Center for Political Thought and Leadership at Arizona State University from 2014 to 2018 and is an adjunct instructor in the Program on Political History and Leadership at ASU. He writes and speaks extensively on regional and national public policy, with a specific focus on the areas of health care policy and the harmful effects of drug prohibition.

Doctors Adriane Fugh-Berman and Jeffrey Singer debate the harms of prescription opioids

This episode is also available as a blog post: http://donnyferguson.com/2021/09/27/cannabis-therapy-associated-with-reduction-in-intake-of-prescription-opioids-by-chronic-pain-patients/ --- Send in a voice message: https://anchor.fm/donny-ferguson/message

It's believed that opioid use is at an all-time high as a side-effect of the pandemic. New research showcases how chiropractic care can decrease opioid utilization by over 50%! It's time to find relief without the dangers of drugs.Episode Notes: Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal PainAutomatically get more leads and conversions from your website with The Smart Chiropractor. Click here to schedule your demo. Our members use research to GROW their practice. Are you interested in increasing your referrals? Discover the best chiropractic marketing you aren't currently using right here!

Addiction to prescription opioids is typically treated with medications, including buprenorphine, methadone, and naltrexone. These drugs can prevent other opioids from affecting the brain (naltrexone) or relieve withdrawal symptoms and cravings (buprenorphine and methadone), which helps patients avoid relapses.https://recoverypartnernetwork.com/drug/opioid/prescription-opioids

Some of the most common prescription opioids are oxymorphone, oxycodone, hydrocodone, morphine, codeine, and fentanyl.https://recoverypartnernetwork.com/drug/opioid/prescription-opioids

People tend to misuse prescription opioids by taking more than the prescribed dosage, using the medication to get high, and using someone else's prescription. Some people misuse prescription opioids by snorting, dissolving, and injecting the liquid into the vein.https://recoverypartnernetwork.com/drug/opioid/prescription-opioids

Opioids can have a very powerful effect on the brain chemistry of an individual, which could lead to addiction if not used under medical supervision.https://recoverypartnernetwork.com/drug/opioid/prescription-opioids

Some of the harmful effects caused by opiates can include confusion, drowsiness, slowed breathing, constipation, and nausea. Misuse of opioids could also lead to hypoxia, which is brought about by slowed breathing. https://recoverypartnernetwork.com/drug/opioid/prescription-opioids

The opioid molecules bind to the opioid receptors on the cells of the brain, spinal cord, and other organs in the system. After attaching to the receptors, opioid molecules succeed in blocking the pain signals going from the brain to the body and trigger the release of large amounts of dopamine throughout the body.https://recoverypartnernetwork.com/drug/opioid/prescription-opioids

It is important to discuss the risks and benefits of taking opioids during pregnancy with your healthcare professional. Taking opioids during pregnancy is safe for you and the fetus only under medical supervision.https://recoverypartnernetwork.com/drug/opioid/prescription-opioids

Episode 26: Eye KnowThe sun rises over the San Joaquin Valley California. Today is September 4, 2020.It should be not surprise to us that evidence shows the use of marijuana during pregnancy affects the development of the nervous system of the fetus. More than 500,000 live births were analyzed retrospectively from the Canadian birth registry and it showed incidence of autism spectrum disorder (ASD) was higher in children born from mothers who used marijuana during pregnancy compared with non-exposed children (4 versus 2.4 diagnoses per 1000 person-years). Incidence of intellectual disability and learning disorders was also higher in marijuana-exposed children. So, remember to counsel your pregnant patients to avoid marijuana[1].Do you think that patients with obesity have a higher prevalence of musculoskeletal pain? You think? And what’s a common prescription for chronic pain? Yes, you guessed it, it’s opioids. So, you think obesity and opioids are linked? Articles published in the American Journal of Preventive Medicine (AJPM) [2] and Journal of American Medical Association (JAMA)[3] showed a clear link between obesity and opioid use. Patients who are overweight have 24% incidence of long term opioid use, while the incidence in patients with severe obesity was 158%. Again, incidence is 24% in overweight vs 158% in severe obesity. That’s crazy, the most common chronic pain associated with obesity and opioid use was back pain and joint pain. Now you know it, two of the most popular epidemics, obesity and opioids, go hand in hand.    This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program, from Bakersfield, California. Sponsored by Clinica Sierra Vista, Providing compassionate and affordable care since 1971.“Success is not final; failure is not fatal: It is the courage to continuethat counts.” –Winston S. ChurchillSuccess is such a complex term! Success for you may be different than success for me. Success is not final, just as failure is not fatal. Our life has ups and downs and that’s what makes it interesting. I’d like to thank all our listeners for their support in our mission to educate, and sometimes to entertain you. It has not been easy to produce this podcast. Thanks to all the brave residents who have overcome their fears to record in front of a microphone. This week we have reached some milestones. We had our download number 1,000, and today the last resident of the 2019-2020 group is participating in the main part of the podcast. I was planning to end this season, but I’m happy to inform that some people offered to record more, so we may have an additional episode, before closing this season. I’m planning to change our format after hearing some suggestions from our residents.I’m pleased to present to you Dr Garmendia today. He is here to share some of his wisdom with us. Dr Garmendia, we are closing this season of the podcast with you. So you are the cherry on the cake, no pressure. So, let’s relax and have fun.  Question number 1: Who are you? My name is Fermin Garmendia, I am a third-year resident of the Rio Bravo Family Medicine Residency Program. I was born and raised in Cuba where I went to medical school. I came to the US in 2010 and, after several years and some sacrifice, my dream came true. For me, being a family medicine doctor is a privilege. It is diverse and challenging. I have some hobbies, I like watch movies, eat in a good restaurant, passing time with friends but what I enjoys the most it is travel by car, so far yet a short family, my wife, our dog and me. We like to explore and be in several places and California is the opportunity, it is beautiful. I still have a big list of places to visit. Question number 2: What did you learn this week? This week I saw a patient with a subconjunctival hemorrhage. I can picture the face of some colleagues... it is nothing weird or maybe not the most interesting topic, but for some patients (and even for many doctors) this could be frightening. Patients get desperate when they realized the problem, and often those who see someone with subconjunctival hemorrhage may think this is caused by physical trauma. It is common, I have seen many patients with subconjunctival hemorrhages and almost always the treatment is reassuring him or her that it will gradually resolve on its own in few weeks, no need for any treatment, except for some artificial tears for symptomatic relief. We should explain our patients why this event could have happened. This is the interesting topic that I would like to talk about.Subconjunctival hemorrhage Patients are generally asymptomatic. Typically, the patient is unaware of the problem until they look in the mirror or someone else lets them know.A red, bloody eye can look scary, but it is usually harmless and often heal on its own.Causes of subconjunctival hemorrhageThe eye’s conjunctiva contains a lot of tiny blood vessels that can break easily. Rupture of capillaries may happen spontaneously or with Valsalva effect caused by coughing, sneezing, straining, or vomiting (this is because they briefly raise blood pressure in veins and can cause capillaries to break) and trauma, even rubbing your eyes too hard can cause capillaries to break. Less common causes include: Diabetes, HTN, COPD that makes patient cough often; medications that can make you bleed easily such as aspirin or blood thinners like coumadin. Diagnosis of subconjunctival hemorrhageThe diagnosis is confirmed by having a normal vision and the absence of discharge, photophobia, or foreign body sensation.The blood is typically reabsorbed over one to two weeks, depending on the amount of blood. Treatment of subconjunctival hemorrhageNo specific therapy is indicated, but If subconjunctival hemorrhage is recurrent or if the patient has a history of bleeding disorder or blood dyscrasia, or if the patient is on anticoagulant therapy, then an underlying hematologic or coagulation abnormality must be considered.I recommend that we should examine the patient always with a slit lamp or magnifying glass, and stain the eye with fluorescein if you suspect trauma to see any associated corneal injury, such as a corneal laceration or abrasion, or other structures of the eye, especially in patients who wear contact lens.Referral to OphthalmologyAn ophthalmologist should be consulted for the following patients: Suspicion of a leaking eye or intraorbital penetrationSigns of traumatic hyphemaConjunctival lacerations >1 cm in length that will require suturingForeign bodies that are deeply embedded, subconjunctival, or associated with a conjunctival laceration____________________________Speaking Medical: Amaurosis fugax by Xeng Xai Xiong, MS3The medical term for the day is amaurosis fugax. I don’t know about you, but for me this word sounds like a mystifying spell that can wake up the dead.  Amaurosis fugax [Suspense sound effect] comes from the Greek "amaurosis," which means dark, and the Latin "fugax," which means transient. Therefore, it refers to a transient loss of vision in one or both eyes.  Aww, I thought this word would have a deeper meaning.  I first encounter this word, during my internal medicine rotation when a patient presented with weakness on one side of the body, facial drooping, and a transient loss of vision, aka amaurosis fugax. One of the causes of amaurosis fugax is a thromboembolism that blocks the ophthalmic artery and retinal arterioles which results in transient loss of vision.  This symptom can be seen in a patient with stroke. Until next time, remember the word amaurosis fugax [Suspense sound effect].  _______________________________________Speaking Medical: Anisocoriaby Li Liang, MS3Hello, I’m Li, a 3rd-year medical student, and I want to introduce another medical word of the week, Anisocoria.  I will give you a brief introduction of anisocoria and soon I will expand on this topic. We have three levels of definition depending on how hungry your brain is. First level, anisocoria is when a patient has unequal pupils. The second level of defining anisocoria is by explaining the etymology of the word. Anisocoria comes from the Greek “An”: Not, “iso”: equal, “cor”: Pupil of the eye, and the Latin: “ia”: Disease, pathology or abnormal condition.  Our last level as well as the medical definition of anisocoria is defined as an impaired pupillary dilation (parasympathetic nervous system) or constriction (sympathetic nervous system). There is more than meets the eye, and finding which pupil is the abnormal one may be challenging. What can give you clues is history of ocular trauma, old photos (ptosis, ocular deviation, chronic anisocoria), topical medications, drug/toxin exposures, associated ocular and neurological signs and symptoms. I will teach you how to tell which eye and pupil is abnormal. There are some physical evaluations to differentiate which eye is considered the bad eye because it’s not always the “small eye”. Stay tuned to learn more about anisocoria on your next episode.____________________________Espanish Por Favor: Matrizby Claudia CarranzaHi this is Dr Carranza on our section Espanish Por Favor. This week’s word is matriz. Matriz comes from the Latin word “matrix” which means mother and is used to describe a cavity inside females in which babies are carried. Yes, matriz means UTERUS! You will most likely use this term when you want to ask if the patient has their uterus vs if they’ve had a hysterectomy. You can say “Señora, ¿todavía tiene su matriz?” which means: “ma’am, do you still have your uterus?”. Another instance in which you may hear the word matriz is when asking about uterine cancer, you can ask “¿Ha tenido cáncer de matriz?” “Have you hade uterine cancer?” Instead of matriz, you can also use the more formal term útero but most people will understand you better when you say matriz.Now you know the Espanish word of the week, matriz.____________________________For your Sanity: What is civilization?by Lisa ManzanaresSomeone once asked anthropologist Margaret Mead what she considered to be the first evidence of civilization. She answered: a human thigh bone with a healed fracture found in an archaeological site 15,000 years old. Why not tools for hunting? or religious artifacts? or primitive forms of communal self-governance? Mead points out that, for a person to survive a broken femur, the individual had to have been cared for long enough for that bone to heal. Others must have provided shelter, protection, food and drink over an extended period of time for this kind of healing to be possible. The great anthropologist Margaret Mead suggests that the first indication of human civilization is care over time for one who is broken and in need, evidenced through a fractured thigh bone that was healed.This story was told by Ira Byock, an authority on palliative medicine, in his book The Best Care Possible: A Physician’s Quest to Transform Care Through the End of Life.________________Jokes: A nurse is on her way home, pulls out a thermometer out of her pocket and says, “Great, now some a**hole got my pen.”How many optometrists does it take to change a light bulb? 1 or 2, 1 or 2, 1 or 2.Conclusion: Now we conclude our episode number 26 “Eye Know.” Dr Garmendia briefly explained the diagnosis and treatment for subconjunctival hemorrhage, you may say “I know”, but you for sure you learned something new today. Xeng surprised us with his clear explanation of amaurosis fugax, or sudden loss of vision, and Li explained how to say unequal pupils in an educated way, anisocoria. And without warning we went from the eye to the uterus and Dr Carranza taught us the Spanish word Matriz. How did you like our reflection about human civilization? And to close, Dr Saito gave us a piece of humor to please our audience.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Fermin Garmendia, Claudia Carranza, and Xeng Xai Xiong, Li Liang, Lisa Manzanares, and Steven Saito. Audio edition: Suraj Amrutia. See you next week! _____________________References:Jansson, Lauren M, MD, Infants of mothers with substance use disorder, UpToDate, https://www.uptodate.com/contents/infants-of-mothers-with-substance-use-disorder?sectionName=Marijuana&topicRef=8350&anchor=H19&source=see_link&mkt_tok=eyJpIjoiWXpFNFpURmhNVEE0WkdFdyIsInQiOiJ3ZDhUcTI5XC9BZFhGSzhtZXdkSnRCcVNXM0lGZXJHM1ZMNzdNSExHZ3BFeFRvdjJ3Ymc5cmtha2xvMVppKzhmRzJOMEluMHhKYUdxUldtVURmdmR3WWcyZXFZcm1ycjNxK2ErdGlIeUl5ZlgrU09adFwvOTJqbDQzUm9uak9tTzFRIn0%3D#H19, last updated: Aug 20, 2020.Stokes, Andrew, PhD, et al, Association of Obesity with Prescription Opioids for Painful Conditions in Patients Seeking Primary Care in the US, JAMA Network Open. 2020;3(4):e202012. doi:10.1001/jamanetworkopen.2020.2012, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2763785, accessed on September, 2, 2020.Stokes, Andrew, PhD, Obesity and Incident Prescription Opioid Use in the U.S., 2000–2015, American Journal of Preventive Medicine, Published: March 27, 2020, DOI: https://doi.org/10.1016/j.amepre.2019.12.018AMA Recognizes Obesity as a Disease, The New York Times, July 18, 2013. https://www.nytimes.com/2013/06/19/business/ama-recognizes-obesity-as-a-disease.htmlA 15,000 year old bone and the Fall 2013 issue of Reflectionshttps://divinity.yale.edu/news/15000-year-old-bone-and-fall-2013-issue-reflectionsBoyd, Kierstan, Subconjunctival Hemorrhage, American Academy of Ophthalmology, April, 23, 2020. https://www.aao.org/eye-health/diseases/subconjunctival-hemorrhage-causeGardiner, Matthew F, MD, Conjunctival Injury, UpToDate, Last updated: Sep 27, 2019. https://www.uptodate.com/contents/conjunctival-injury

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Our podcast is about the state of the opioid epidemic specifically in Georgia. We talk about the specific areas and populations that are affected as well as what is being done to combat it. References Intro clip: Georgia Public Broadcasting. (2020, January 3). Facebook, georgia reps share videos to ‘stop opioid silence’. https://www.gpbnews.org/post/facebook-georgia-reps-share-videos-stop-opioid-silence Georgia Department of Public Health. (2019, November 21). Opioid epidemic. https://dph.georgia.gov/stopopioidaddiction The Council of Alcohol and Drugs. Stop Rx Abuse in GA, (2017), stoprxabuseinga.org/the-triangle-investigation/ (WXIA), Inside The Triangle Team. “What Is ‘The Triangle’?” WXIA, (27 Feb. 2016), www.11alive.com/article/news/investigations/triangle/what-is-the-triangle/68319931 Baggett, L. (2019, December 5). Chronic disease prevention could ease opioid crisis. UGA Today. https://news.uga.edu/chronic-disease-prevention-ease-opioid-crisis/ Abraham, A., Johnson, A., Langford, J., Norton, M., & Wrenn, G. (2017). Prescription Opioids and Heroin Epidemic in Georgia. Retrieved from http://www.senate.ga.gov/sro/Documents/StudyCommRpts/OpioidsAppendix.pdf

Listen to Episode 54 of the ACA Podcast:Impact of Chiropractic Care on Use of Prescription Opiods with Dr Jim Whedon.

Hot off the press! A new study was just released showcasing how chiropractic care can reduce the likelihood of filling an opioid prescription by over 50%!Episode Highlights-Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal PainWe help you automate the marketing of your chiropractic practice- The Smart ChiropractorThis episode brought to you in conjunction with RocktapeOur members use research to GROW their practice. Are you interested in increasing your referrals? Discover the best chiropractic marketing you aren't currently using right here!

DEA Provider Compliance and Safe Guards: Part 2 Evaluation and Credit: https://www.surveymonkey.com/r/MedChat11part2 Target Audience This activity is targeted toward all physician specialties. Statement of Need Providers should be aware of the latest guidelines related to the prescribing of controlled substances as related to the administrative aspect of their practice to avoid any compliance issues. Objectives At the conclusion of this offering, the participant will be able to: Address common concerns for DEA compliance in practice. Identify red flags for a DEA investigation. Moderator Stephen Wright, M.D. Medical Director, Pediatrics Norton Medical Group Speaker Dennis WichernManaging Partner Prescription Drug Consulting LLC Former Special Agent-in-Charge (SAC) Drug Enforcement Administration (DEA) Speaker Disclosure The speaker has no potential or actual conflicts of interest to disclose. Moderator and Planner Disclosures The moderator and planners for this activity have no potential or actual conflicts of interest to disclose.   Commercial Support This activity has received financial support from Cardinal Health. Physician Credits American Medical Association Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians. DesignationNorton Healthcare designates this enduring material for a maximum of .50 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Date of Original Release | February 2020 Course Termination Date | December 2020 Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org Resources for Additional Study How To Avoid Negative Press and Fines During the Opioid Crisis https://www.prescriptiondrugconsulting.com/articles/how-to-avoid-negative-press-and-fines-during-the-opioid-crisis U.S. Department of Justice Drug Enforcement Administration Diversion Control Division https://www.deadiversion.usdoj.gov/index.html Don't Be Scammed By A Drug Abuser https://www.deadiversion.usdoj.gov/pubs/brochures/drugabuser.htm Reframing the Prevention Strategies of the Opioid Crisis: Focusing on Prescription Opioids, Fentanyl, and Heroin Epidemic. https://www.ncbi.nlm.nih.gov/pubmed/30045589 Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines https://www.ncbi.nlm.nih.gov/pubmed/28226332

DEA Provider Compliance and Safe Guards: Part One Evaluation and Credit: https://www.surveymonkey.com/r/MedChat11part1 Target Audience This activity is targeted toward all physician specialties. Statement of Need Providers should be aware of the latest guidelines related to the prescribing of controlled substances as related to the administrative aspect of their practice to avoid any compliance issues. Objectives At the conclusion of this offering, the participant will be able to: Define the role of the Drug Enforcement Agency (DEA). Discuss key aspects of compliance relative to the practice setting in the prescribing of controlled substances. Recognize important and recurring opioid risk areas. List practical strategies and tips to reduce opioid risks. Moderator Stephen Wright, M.D. Medical Director, Pediatrics Norton Medical Group Speaker Dennis WichernManaging Partner Prescription Drug Consulting LLC Former Special Agent-in-Charge (SAC) Drug Enforcement Administration (DEA) Speaker Disclosure The speaker has no potential or actual conflicts of interest to disclose. Moderator and Planner Disclosures The moderator and planners for this activity have no potential or actual conflicts of interest to disclose.   Commercial Support This activity has received financial support from Cardinal Health. Physician Credits American Medical Association Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians. DesignationNorton Healthcare designates this enduring material for a maximum of .50 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. HB1 / Prescribing Controlled SubstancesThe Kentucky Board of Medical Licensure has approved the podcast DEA Provider Compliance and Safe Guards: Part One for .50 HB1 credit hours. ID# 0120-H.50-NHC1d. Date of Original Release | February 2020 Course Termination Date | December 2020 Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org Resources for Additional Study How To Avoid Negative Press and Fines During the Opioid Crisis https://www.prescriptiondrugconsulting.com/articles/how-to-avoid-negative-press-and-fines-during-the-opioid-crisis U.S. Department of Justice Drug Enforcement Administration Diversion Control Division https://www.deadiversion.usdoj.gov/index.html Don't Be Scammed By A Drug Abuser https://www.deadiversion.usdoj.gov/pubs/brochures/drugabuser.htm Reframing the Prevention Strategies of the Opioid Crisis: Focusing on Prescription Opioids, Fentanyl, and Heroin Epidemic. https://www.ncbi.nlm.nih.gov/pubmed/30045589 Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines https://www.ncbi.nlm.nih.gov/pubmed/28226332

Need To No Ep 2: Prescription Opioids by Clear Lake Today

Editor-in-chief Shawn Kennedy and clinical editor Betsy Todd present the highlights of the November issue of AJN, including articles such as “Implementing Guidelines for Treating Chronic Pain with Prescription Opioids,” “Gestational Hypertension, Preeclampsia, and Peripartum Cardiomyopathy: A Clinical Review,” “Supporting Family Caregivers: No Longer Home Alone: Eating for Healthy Aging,” “Preventing Self-Harm in the Nonpsychiatric Health Care Setting,” and more!

Editor-in-chief Shawn Kennedy and clinical editor Betsy Todd present the highlights of the November issue of AJN, including articles such as “Implementing Guidelines for Treating Chronic Pain with Prescription Opioids,” “Gestational Hypertension, Preeclampsia, and Peripartum Cardiomyopathy: A Clinical Review,” “Supporting Family Caregivers: No Longer Home Alone: Eating for Healthy Aging,” “Preventing Self-Harm in the Nonpsychiatric Health Care Setting,” and more!

Jane Bell and Simon Paget discuss trends in prescription opioid dispensing in Australian children and adolescents, and Scott Hadland comments on lessons learnt from the US experience.

Jane Bell and Simon Paget discuss trends in prescription opioid dispensing in Australian children and adolescents, and Scott Hadland comments on lessons learnt from the US experience.

A podcast for Pharmacy 3420.

A flurry of lawsuits are exposing new information about the Sackler family's role in the country's epidemic.

Editor in Chief Fred Rivara and Deputy Editor Steve Fihn discuss research published in JAMA Network Open in February 2019.

MedShadow is a consumer advocacy resource focused on medications and their side-effects. Founder Sue Robotti talks about the effects of opioids on seniors and the value of "slow medicine." Medshadow.org

MedShadow is a consumer advocacy resource focused on medications and their side-effects. Founder Sue Robotti talks about the effects of opioids on seniors and the value of "slow medicine." Medshadow.org

MedShadow is a consumer advocacy resource focused on medications and their side-effects. Founder Sue Robotti talks about the effects of opioids on seniors and the value of "slow medicine." Medshadow.org

For the first time in our history, more adults are dying from overdoses than from car accidents or gun violence. New statistics shine a light on the reasons behind the tragic trend. Learn more about your ad-choices at https://news.iheart.com/podcast-advertisers

Elizabeth G. Dost is a registered nurse and senior health care executive with more than 20 years’ experience in the Boston area health care market. She is currently serving as a Senior Executive Health Care Consultant to Emerging Service Industries, most noticeably in Medical Cannabis.  Ms. Dost is a Cannabis Nurse and Nominating Committee member of the American Cannabis Nurse Association, Treasurer of the Society for Cannabis Clinicians’ newly formed east location, Clinical Director of the Massachusetts Patients Advocacy Alliance, and is the Chief Operating Officer of MJ&CO, a global cannabis company, while she also consults to private entities seeking to improve lives via the medical application of and safe access to Medical Cannabis. She is a registered participant of My Compassion and the Medical Cannabis Institute.  Beth has been a featured guest on radio, and nationally, as a presenter at Patients Out of Time, United Patients Group, Women Grow Boston and Phoenix, New England Cannabis Convention, annually for the Massachusetts Federation of Hospice and Palliative Care.  Ms. Dost lends her time for interviews to numerous media outlets including but not limited to DOPE Magazine, THC Tucson, and Hemp News for Patients Out of Time to name a few.  Ms. Dost was the Vice President and Executive Director of a non-profit, multi-site hospice company promoting a culture of compassion to all persons and their loved ones seeking end of life health care and support. Sound Health Options

Beth Darnall PhD is a pain psychologist and Associate Professor of Pain Medicine at Stanford University. We'll discuss her book: Less Pain, Fewer Pills: Avoid the Dangers of Prescription Opioids and Gain Control over Chronic Pain. These stories hit the news daily. Dr. Darnall has had her own battle with chronic pain, so has empathy working with those in similar struggles. She helps us with understanding the issues, and being able to make informed choices and decisions. www.bethdarnall.com

"Houston, We Have a Problem!" The Epidemic of Non-medical Use of Prescription Opioids

"Houston, We Have a Problem!" The Epidemic of Non-medical Use of Prescription Opioids

Dr Suzi Gage and Scroobius Pip discuss prescription opioid pain medication, its potential for abuse, and why this might differ between countries. See acast.com/privacy for privacy and opt-out information.

On this week’s episode of the Healthy Wealthy and Smart podcast, Dr. Beth Darnall joins us to talk about the opioid epidemic and alternative treatments for patients experiencing chronic pain. Dr. Darnall is a Clinical Associate Professor in the Division of Pain Medicine at Stanford University and treats individuals and groups at the Stanford Pain Management Center. She is an NIH-funded principal investigator for pain psychology research that is examining the mechanisms of pain catastrophizing treatment, including a novel single-session pain catastrophizing class she developed (funded by the NIH National Center for Complementary and Integrative Health). She is dedicated to empowering life beyond pain. In this episode, we discuss: -The opioid epidemic and cost effective treatment solutions that you can incorporate into your care -Tapering off opioid use, associated effects, and protocol -How opioid use and chronic pain effect brain chemistry -Pain catastrophizing defined and what patients can do if they have chronic pain -And so much more! Treatment for chronic pain with opioids alone is not sustainable and alternative treatment approaches are needed to retrain the brain. The research has shown that, “When we take opioids, it really changes brain chemistry. It actually changes the structure of the brain but so does chronic pain itself…[With alternative treatment,] you're rewiring and recovering and exercise and enjoyment and going out and getting back to doing the things you love, these are going to help facilitate your brain as it is rewiring, as you’re managing pain differently, as you’re becoming more and more active and functional.”   Evidence based healthcare providers must monitor patients who begin opioid treatment for chronic pain and how their condition evolves. “We want to ask ourselves a critical question—are people getting better? And this is where we've really fallen short, opioids will be prescribed and nobody is tracking long term to see if they are getting better or if there are new risk factors or addictive behaviors. It’s a constant process of monitoring… We need to do better at stopping what isn't working. If people aren't getting better, if their pain is only worsening, let's not add more of what isn't working. Let’s stop it and emphasize the alternatives.”   Dr. Darnall supports the biopsychosocial model for treating chronic pain because it effectively and comprehensively targets the nervous system. She states, “The nervous system leads us into this area where we’re really talking about the modulation of pain, the facilitation of pain and the exacerbation of pain… No matter where you feel pain in your body, no matter how it got started or why, the processing of it will occur in the brain and spinal cord. That's what we can target with some of these treatments and therapies, we’re able to dampen the experience of pain… The nervous system is a critically important part in helping decrease not only pain and intensity but more importantly how much a person suffers from pain. “   Dr. Darnall advocates a pain management approach that allows the patient to take more control in achieving a desirable outcome. She stresses, “The most important person on the healthcare team isn't the doctor or the psychologist or the physical therapist—it’s the patient. If you have chronic pain, you are the most important person on your healthcare team. My hope and my wish is that every person on your healthcare team will have a similar philosophy that is focused on empowering you to acquire the right information and the right skills so you can best self manage your pain and your symptoms so that you’re able to become more functional, to enjoy more of the life you have even with the health conditions you have so you’re able to live your best life possible.” For more about Dr. Darnall: Beth is a Clinical Associate Professor in the Division of Pain Medicine at Stanford University and treats individuals and groups at the Stanford Pain Management Center. She is an NIH-funded principal investigator for pain psychology research that is examining the mechanisms of pain catastrophizing treatment, including a novel single-session pain catastrophizing class she developed (funded by the NIH National Center for Complementary and Integrative Health).   She is Co-Chair of the Pain Psychology Task Force at the American Academy of Pain Medicine (AAPM), and in 2015 received a Presidential Commendation from AAPM.   Beth is author of Less Pain, Fewer Pills ©2014 and The Opioid-Free Pain Relief Kit ©2016. Her upcoming book, The Surprising Psychology of Pain: Evidence-Based Relief from Catastrophizing and Pain is due out in 2017. As a pain psychologist, she has 15 years experience treating adults with chronic pain, and she lived through her own chronic pain experience. She enjoys helping individuals with chronic pain gain control over mind and body and live their best life possible.   Beth is a licensed clinical psychologist (CA License #25495).   Beth received her doctoral training at the University of Colorado at Boulder and her clinical residency at the Southern Arizona Veterans Affairs Health Care System (Tucson VA Hospital). She received post-doctoral training at The Johns Hopkins University School of Medicine Department of Rehabilitation Medicine and the Bloomberg School of Public Health (T32 Fellowship). Clinically, she provided psychological services to patients with catastrophic burn, spinal cord injury or amputation. She was an Associate Professor at Oregon Health and Science University (2005-2012) prior to joining the faculty at Stanford University in late 2012. Her desire to specialize in the management of chronic pain was inspired by her clinical experiences and by her own personal experience with chronic pain.   Make sure to grab copies of Dr. Darnall’s books The Opioid-Free Pain Relief Kit: 10 Simple Steps to Ease Your Pain and Less Pain, Fewer Pills: Avoid the Dangers of Prescription Opioids and Gain Control over Chronic Pain and follow her on twitter!   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!   Have a great week and as always stay Healthy Wealthy and Smart!   Xo Karen   P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult

Opioid withdrawal is highly unpleasant, and for some people it feels intolerable.If you take prescription opioids, you may have experienced withdrawal symptoms at some point; perhaps when you forgot to take a scheduled dose of medication. Opioid withdrawal is highly unpleasant, and for some people it feels intolerable. Symptoms can include anxiety, pain, shakiness, nausea, achiness. If you experience withdrawal symptoms, this does not meant that you cannot get off opioids. Withdrawal symptoms mean that your opioid level was dropped too quickly and your body was surprised by the lack of medication. The key is to work with your body to successfully taper your opioids by making small changes slowly over time.Beth Darnall, PhD, author of Less Pain Fewer Pills; Avoid the Dangers of Prescription Opioids and Gain Control Over Chronic Pain, joins Andrea and Lisa to share her seven steps for successfully weaning yourself off prescription opioids.1. Talk with your doctor. Always talk to your prescribing doctor before making medication changes. This is the first step in any opioid tapering program. Most doctors are happy to help their patients reduce their medications.2. Timing is everything. Plan to start your taper when life is relatively calm. Avoid the holidays or times when work or family stress are particularly high. Remember that you want to set yourself up for success. Since stress creates challenges and worsens pain, you want to start your taper when you are least likely to be challenged with pain.3. Opioids should be your only medication change during the taper. Many people fall into the trap of trying to change more than one medication at a time. They decide they will taper opioids, start an antidepressant, and go off their sleeping med all in the same month. This is a setup for failure. Think of your taper as an experiment. Then, when things are calm and you are clear about the result from that change, you can consider making changes to the next medication.4. Go S-L-O-W: The turtle wins this race. Some doctors will suggest a quick taper of 1–2 weeks. Just because you can doesn’t mean you should. By tapering slowly, you can prevent symptoms of withdrawal, stress, and anxiety. Going slow is especially important if you have anxiety, such as panic attacks, post-traumatic stress disorder, or generalized anxiety. Ask your doctor to make small reductions (decrements) in your opioid dose about every two weeks. Even if you feel good, stay on a slow taper schedule and make it easy for your body. 5. Use your mind-body skills. Optimize success with opioid tapering by focusing on calming your mind and body regularly throughout each day. Calming your mind and body needs to be your main priority during the taper period. 6. Watch your choices. Resist the temptation to make many life changes during your opioid taper. If you decide to taper opioids, keep the rest of your life at a constant. If you are already walking twice weekly for 30 minutes, stay with that if it is working for you. You can ramp up your activity level or make other changes once you are through with your taper. 7. Get extra support. Your medical or psychological circumstances may require more structure and support. If your doctor recommends additional support, or if you are running into problems, consider working with a medical professional who can closely supervise your taper.

Kathryn interviews Stanford University Clinical Associate Professor Beth Darnall PhD, author of “Less Pain Fewer Pills: Avoid the Dangers of Prescription Opioids and Gain Control Over Chronic Pain”. In 2014 over 28,000 Americans died of opioid overdoses. Using her 15 years of experience treating adults with chronic pain Dr. Darnall provides concrete, evidence-based psychological and behavioral alternatives for pain control. Dr. Darnall is featured on NPR, ABC News and in Women's Health Magazine. br Kathryn also interviews Fox News' Outnumbered cohost Andrea Tantaros, author of “Tied Up in Knots: How Getting What We Wanted Made Women Miserable”. 50 years after The Feminine Mystique, relations between men and women in America have never been more dysfunctional. If women are more liberated than ever before, why aren't they happier? Tantaros exposes how the feminist pursuit of equality went too far, and how the unintended pitfalls of that power trade have made women (and men!) miserable.

Kathryn interviews Stanford University Clinical Associate Professor Beth Darnall PhD, author of “Less Pain Fewer Pills: Avoid the Dangers of Prescription Opioids and Gain Control Over Chronic Pain”. In 2014 over 28,000 Americans died of opioid overdoses. Using her 15 years of experience treating adults with chronic pain Dr. Darnall provides concrete, evidence-based psychological and behavioral alternatives for pain control. Dr. Darnall is featured on NPR, ABC News and in Women's Health Magazine. br Kathryn also interviews Fox News' Outnumbered cohost Andrea Tantaros, author of “Tied Up in Knots: How Getting What We Wanted Made Women Miserable”. 50 years after The Feminine Mystique, relations between men and women in America have never been more dysfunctional. If women are more liberated than ever before, why aren't they happier? Tantaros exposes how the feminist pursuit of equality went too far, and how the unintended pitfalls of that power trade have made women (and men!) miserable.

Pediatric Grand Rounds with Brendan Gilligan, MD

Interview with Karen H. Seal, MD, MPH, author of Association of Mental Health Disorders With Prescription Opioids and High-Risk Opioid Use in US Veterans of Iraq and Afghanistan

Kenny Goldberg interviews Jeff Coben, MD regarding his article "Hospitalizations for Poisoning by Prescription Opioids, Sedatives, and Tranquilizers" appearing in the May 2010 Issue