The Clinical journal of pain
-
Prescription opioid analgesics play an important role in managing moderate to severe pain. An unintended consequence of the availability of these drugs is nonmedical use. We report rates and methods of nonmedical use of the analgesic tapentadol immediate release (IR) and other commonly prescribed opioid analgesics among US college students following the launch of tapentadol IR in June 2009. ⋯ Since its launch, rates of nonmedical tapentadol IR use by college students have been low and have decreased over time. The initial levels of reported nonmedical use may represent a brief period of experimentation after introduction.
-
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.
-
Randomized Controlled Trial
Cathodal and Anodal Left Prefrontal tDCS and the Perception of Control Over Pain.
The prefrontal cortex may be a promising target for the use of transcranial direct current stimulation (tDCS) in the management of pain symptoms. The present study explored the effects of anodal and cathodal tDCS over the left dorsolateral prefrontal cortex on the effects of perceived pain controllability. ⋯ Left dorsolateral prefrontal cortex tDCS may play a role in modulating the neurocircuitry involved with the perception of control over pain.
-
The volume of opioid medications being prescribed in the United States is increasing rapidly. Problems associated with the misuse of opioid medications are also increasing, in part because of medication diversion from legitimate prescriptions. However, little is known about what patients do with any unused opioid medications. This paper uses a qualitative analysis of patients' self-report of medication storage and retention habits to begin to address this gap. ⋯ A majority of patients retain unused opioids, and medication sharing is common. Interventions to improve monitoring of patient experience with opioid medication, educate patients about the dangers of opioid use by nonprescribed others, and increase information about medication disposal options could decrease the supply of opioid medications available for misuse.