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All Pharmacological Articles

Why Some Patients Require High Dose Opioid Therapy
Article explains why some patients require high dose opioid therapy. Chronic pain syndrome represents the end stage of maladaption of having pain as the stressor and, as a result, homeostasis is severely disturbed in all aspects—with abnormal default settings for emotions, immunity, hormone balance, thought, and memory.
FDA’s Proposed Risk Evaluation and Mitigation Strategy (REMS) for Opioids
A brief overview and critique.
Doctors May Now Electronically Prescribe Schedule II Drugs
An in-depth look into the past, present and future of the electronic prescribing of controlled substances. Especially important for doctors prescribing opioids.
Non-responsive Pain Patients with CYP-2D6 Defect
Pain patients who do not respond to the analgesic properties of opioids have a chance of being genetically incapable of generating the clinically active metabolite of these medications. Get tips on when to suspect a patient has CYP-2D6 deficiency.
Urine Drug Testing as an Evaluation of Risk
Implementation of multiple risk assessment and monitoring strategies appears to lower the rate of inappropriate urine drug testing results in a clinical setting as in the experience of this private pain specialty practice.
Compliance Monitoring and Effective Risk Mitigation Strategy
Compliance monitoring using laboratory screening and confirmation, together with physician education, can support an effective risk mitigation strategy. Important article for pain physicians prescribing opioids.
Electronic Prescription of Controlled Substances
A major milestone in healthcare IT history has been reached with DEA lifting restrictions on e-prescribing. Especially important for those who prescribe opioids.
Making Practical Sense of Cytochrome P450
Guidelines for the likely 20 to 30% of pain patients who have a genetic defect involving one of three major CYP450 enzymes and so cannot effectively metabolize certain opioids that must be converted to a metabolite to be effective.
Taking Advantage of the Peripheral Opioid Receptor
Opioids applied in a topical cream that directly target the peripheral opioid receptors (which grow in inflammatory pain sites to attract natural endorphin compounds for pain relief and immune enhancement) may have advantages relative to oral opioids.
FDA’s Risk Evaluation and Mitigation Strategies Program
Proceed with Extreme Caution
Opioid Treatment 10-year Longevity Survey Final Report
Patients in this long-term study were found to be functioning quite well after 10 or more years on generally stable opioid dosages, with the vast majority able to care for themselves and even drive. Read what chronic pain patients taking opioids say about themselves.
A Practical Guide for the Use of Opioids in Chronic Pain
Despite the availability of mono-graphs, papers, lectures, and web sites to teach about o
Simultaneous Use of Opioid and Electromagnetic Treatments
Concurrent therapeutic electromagnetic applications complement opioid treatment and promote enhanced pain control in chronic pain patients.
Keeping Prescribers on Board if Certification Becomes Part of REMS
Consequences need to be acknowledged and serious thought given to the full impact that the FDA's proposed Risk Evaluation and Mitigation Strategies (REMS) plan might have.
Patients Who Require Ultra-high Opioid Doses
The goal of ultra-high opioid dosage therapy is to relieve pain and improve function in those chronic pain patients that are profoundly ill, impaired, and/or bed- or house-bound. However, ultra-high opioid dosage should not sedate them. Read which patients require ultra-high opioid dosage.