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Travel Study: Doctors 'under-prepared' to treat patients struggling with opioid use

00:05  17 october  2019
00:05  17 october  2019 Source:   msn.com

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How many such people will seek treatment under Medicaid expansion is unclear, but there are some rough Not all of those people would be using opioids , as substance use disorders also include other illicit If each of those treated 30 patients with opioid use disorder, the state’s capacity would be

I once found myself entrapped by a patient as much as she felt trapped by me. It was the summer of 2001, and I was running a small internal-medicine clinic, supervised by a preceptor, on the fourth floor of a perpetually chilly Boston building.

A survey of more than 500 physicians indicates that doctors are "well-intentioned but under-prepared" to treat patients struggling with opioid misuse.

a person lying on the ground: A man sleeps on the sidewalk in the Kensington section of Philadelphia which has become a hub for heroin addicts on July 21, 2017 in Philadelphia, Pennsylvania. Over 900 people died last year in Philadelphia from opioid overdoses, a small part of an epidemic that began in the 1990s, when doctors began prescribing higher doses of powerful painkillers.© Spencer Platt/Getty Images A man sleeps on the sidewalk in the Kensington section of Philadelphia which has become a hub for heroin addicts on July 21, 2017 in Philadelphia, Pennsylvania. Over 900 people died last year in Philadelphia from opioid overdoses, a small part of an epidemic that began in the 1990s, when doctors began prescribing higher doses of powerful painkillers.

More than four out of five doctors are reluctant to take on patients using prescribed opioids, and they said that because of the opioid crisis, it's considerably harder today to treat patients in pain than it was before the epidemic. That's according to the new study, which was conducted by Quest Diagnostics and the Center on Addiction.

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+ TORONTO – A small proportion of Ontario doctors who treat people battling opioid addictions prescribe the majority of the medications used to treat the disorder, a study has found, raising concerns about the quality of patient care and access to therapy.

Many doctors around the country are now asking patients with chronic pain to sign a document agreeing to certain conditions before they’ll prescribe an opioid As part of these “ opioid contracts” or “pain contracts,” patients agree to random urine drug screens, opioid pill counts, and other conditions.

Federal guidelines and cuts to opioid production have likely limited doctors' willingness to give out opioid prescriptions over the past few years, according to widespread reports. There's also a chilling effect at the state level, where doctors sometimes have to testify before a review board to justify their opioid prescribing.

On top of physicians' tendency to turn away pain patients, 70 percent of those surveyed said they could use more training on how to taper current patients off the medication. Even more, 75 percent, said they could do with more education on what to do when a patient shows signs of addiction.

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And doctors who specialize in treating addiction say more people are becoming dependent on a class of A 2018 study found about 30 million Americans used benzodiazepines in the past year -- and It tells doctors not to prescribe benzodiazepines for patients who are already taking opioids and to

Some doctors tell him it's an opportunity to have a tough conversation with patients they believe to be at risk for "It's really meant to prevent a future generation from developing opioid use disorder, while not One of her family members struggles with heroin addiction and she's helping raise his daughter.

More training may indeed be in order, since the study also found that doctors are overconfident in their ability to recognize prescription drug misuse. Another component of the survey looked at more than 4 million drug tests and found that more than half showed signs of misuse, even though nearly three out of four physicians said their patients take medication strictly as prescribed.

As a result, report co-author Harvey Kaufman said doctors could be missing some of the drug misuse risks affecting their patients.

"We found that primary care physicians, who are on the front lines of the drug epidemic, are well-intentioned but under-prepared," Kaufman wrote.

Alternate methods for treating pain showed up in the survey. About 78 percent of physicians said that they're prescribing gabapentin, an anti-epileptic drug with euphoric effects, to their patients with chronic pain, instead of opioids. Laboratory data confirmed that finding, noting the drug became the most commonly detected nonprescribed controlled medication in 2018, according to the report.

While 58 percent of physicians surveyed expect more of their physician peers to recommend marijuana to patients with chronic pain, it's not clear that cannabis is an appropriate substitute. Last month, many patients wrote the Drug Enforcement Administration complaining they had turned to medical marijuana when their opioid prescriptions were taken away but said it doesn't help their pain nearly as much.

Chronic pain can do further damage to the body when left untreated, according to the Cleveland Clinic. In addition to increasing the risk for heart disease and high blood pressure, it limits the body's ability to fight off illnesses and disease.

Study: Limits on opioid prescriptions seem to send users to more dangerous drugs .
Less than 2 percent of overdose victims had active opioid prescriptions, study finds.Toxicology reports revealed that 61.4 percent of victims used heroin on or near the date of their overdoses, followed by fentanyl at 45.3 percent, according to the study, published in Public Health Reports. Of the 491 decedents who had at least one active opioid prescription, commonly prescribed painkillers like buprenorphine, oxycodone and methadone were frequently undetected in screenings, according to the study's authors.

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This is interesting!