The Clinical journal of pain
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Cognitive and emotional factors are known to influence peoples' pain experiences in many conditions, including low back pain. However, in complex regional pain syndrome (CRPS), their role is unclear. This study aimed to assess the relationships between psychological factors, pain, and disability in CRPS, compared with low back pain. This could help to identify target variables for psychological treatment. ⋯ In CRPS, disability and pain severity were more strongly associated with psychological factors than they were in low back pain. Cause and effect relationships could not be established by this cross-sectional study.
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As long-term opioid analgesic therapy has gained increasing clinical and societal acceptance over the past 2 decades, morbidity and mortality related to the misuse of these drugs have increased in lockstep. Hence, monitoring for opioid-related problems, largely through urine drug testing, has become a central component of risk mitigation in long-term opioid therapy. Despite the increasing use of urine drug testing, little has been written about the ethical aspects of its application. In this paper, we analyze multiple aspects of drug testing-rationale for testing, specimen collection, ordering and interpretation, and response to inappropriate test results-through the principlist lens, using the ethical principles of beneficence, nonmaleficence, justice, and autonomy.