Art of Pain Management News & Articles

Helpful hints from Dr Schina Guide to weaning off and reducing opioids

Jerry@stemcellsphiladelphia.com (Jerry Penders at Stem Cells Philadelphia) — Tue, 27 Feb 2024 13:24:34 GMT

Guidelines for Tapering Off Opioids

Guidelines for tapering off opioids recommend gradually reducing 5% to 10% of the morphine-equivalent dose every two to four weeks and switching from immediate-release opioids to extended-release on a fixed schedule.

Research shows 15% of complex surgical patients develop severe postoperative pain leading to extended use of opioids. Implementing a transitional pain program helped nearly half of those who had not used opioids prior to surgery to wean off the drugs. Among those who had already used opioids prior to surgery, 1 in 4 was able to quit.

To help patients manage their pain, the program uses a variety of methods, including nonopioid medications, exercise, acupuncture, and mindfulness training.

Opioids killed 33,000 Americans in 2015 and nearly 42,250 in 2016, and the death toll is still trending upward, as overdose cases admitted into emergency rooms increased by more than 30% across the U.S. between July 2016 and September 2017.

Studies show addiction affects more than 1 in 4 of those using opioids for chronic noncancer pain, and 1 in 550 patients die from opioid-related causes within 2.5 years of their first prescription.
Despite the drugs' high risk of addiction, a 2016 NPR health poll indicated less than one-third of people said they questioned or refused their doctor's prescription for opioids.

Opioid Addiction and Treatment

Prescription opioid overdose deaths commonly involve methadone, oxycodone, and hydrocodone.

There is very little difference between oxycodone, morphine, and heroin, making the transition from prescription opioids to street drugs like heroin relatively easy for many addicts.

Many patients are under or misinformed about the addictive nature of prescription opioids and how to stop using them.

Addiction can occur in a short period of time, especially for long-term or chronic pain patients.

Transitional Pain Services aim to prevent acute post-surgical pain from becoming chronic and to taper opioid use or eliminate it if possible.

These services use nonopioid medications, exercise, acupuncture, and mindfulness training to help patients with pain and successfully reduce opioid use.

Stanford University offers a similar program called the Comprehensive Interdisciplinary Pain Program.

Many state authorities and insurance companies are cracking down on opioid use, leaving long-term users with little guidance or support to quit or find alternative pain relief methods.

There is little research on how to best taper opioids for chronic pain patients, and the value of drugs like buprenorphine in chronic pain treatment is not well understood.

Only a small number of studies on tapering opioids for pain treatment have been of high quality.

Tapering Off Opioids Post-Surgery

Evidence shows that tapering off the dosage improves pain and quality of life

Reckless restriction of opioids can destabilize patients

A Stanford study shows that a slow dose reduction can help patients cut their opioid dosages nearly in half without increased pain

A study at Toronto General Hospital's Transitional Pain Service found that nearly half of patients who had not used opioids prior to surgery successfully weaned themselves off the drugs, and 1 in 4 of those who had used opioids prior to surgery was successful

Identifying high-risk patients who are having difficulty reducing or eliminating their opioid use post-surgery is crucial to prevent long-term opioid use, and the dose upon discharge is a strong predictor of remaining on opioids long-term

Guidance on Opioid Tapering

Emotional distress factors such as anxiety or depression, and pain catastrophizing are important factors in how well patients on opioids before surgery can wean off opioids.

Adult patients with chronic noncancer pain who are on a 90-milligram (mg) morphine equivalent dose daily or greater should consider opioid tapering to the lowest effective dose and discontinue use if possible.

Other reasons to consider tapering include lack of improvement in pain and/or function, nonadherence to the treatment plan, signs of addiction, serious opioid-related adverse effects, or patient request.

Prescribers are urged to collaborate with pharmacists to support and monitor patients during opioid tapering.

A multidisciplinary approach is associated with success in weaning patients off opioids.

Benefits of tapering include relief of withdrawal symptoms, reduction in opioid adverse effects, and improvements in overall function and quality of life.

The Guideline urges physicians to discuss tapering with their patients, prepare them by optimizing nonopioid therapy, and utilize nonpharmacological therapy and psychosocial support.

To taper opioids for chronic noncancer pain, the guideline recommends gradually reducing 5% to 10% of the morphine-equivalent dose every two to four weeks, switching from immediate-release opioids to extended-release on a fixed schedule, and collaborating with the patient's pharmacist to assist with scheduling of the dose reductions.

Alternative methods for tapering include medically supervised rapid dose reduction at a withdrawal center, switching to buprenorphine (naloxone) followed by gradual tapering of these drugs.

Medical cannabis is an effective pain reliever that, unlike narcotic pain killers, cannot lead to fatal overdoses due to the absence of cannabinoid receptors in the brain stem.

Legalization of medical marijuana has been associated with significant decreases in opioid overdose deaths, suggesting its potential as an alternative pain management option.

Clinical studies and reports indicate that cannabis is effective at controlling pain and easing withdrawal symptoms in individuals attempting to wean off opioids.

Research suggests that opioid-free options may be as effective as opioids for relieving severe acute pain, providing valuable alternatives for pain management.

Prescription opioids can lead to addiction, tolerance, increased sensitivity to pain, depression, low testosterone levels, and more

Nonopioid pain relievers have their own issues, including severe liver and kidney problems in susceptible people with long-term Tylenol use

N-acetyl cysteine (glutathione precursor) can alleviate many of these problems
Opioids have a legitimate purpose in acute pain but are being indiscriminately prescribed in many cases

Loss of two years in the average life expectancy of the average American due to opioid addiction

Warning to take caution when using dangerous medications

Disclaimer : Information on the website is not intended to replace a one-on-one relationship with a qualified healthcare professional and is not intended as medical advice.

How To Deal With Chronic Pain

Tue, 14 Feb 2023 16:53:46 GMT

Chronic pain conditions are a challenge for any person who faces them. The pain affects your life every day in many different ways, restricting your ability to perform daily activities. If you are suffering from chronic pain , it is important to know some ways to cope with it.

Learn Deep Breathing or Try Meditation

Both deep breathing exercises and meditation are methods used by people all over the world to help relax. Along with mental relaxation, these activities can help reduce the intensity of your pain. Tension can have a severe physical effect on your body. Take a meditation class or take a few minutes to focus on your breathing any time you are feeling pain.

Eliminate Sources of Stress in Your Life

If you do not want to meditate or do deep breathing exercises, you can go straight to the source and try to cut out the stress in your life. Negative mental states and emotions reduce your body’s ability to deal with pain. Find something that helps you relieve stress and do it anytime you are feeling stressed out.

Drink Less Alcohol

Alcohol consumption is a dangerous choice in general. It is especially bad for people suffering from chronic pain. People who are constantly in pain usually have a hard time sleeping. Alcohol makes sleeping even harder. If you are sleep deprived it is more difficult for your body to cope with the pain.

Exercise

Physical exercise increases the endorphins in your brain. Not only do endorphins improve overall mood, they also block pain signals, which will help dull your chronic pain. Exercise can also help prevent other health problems such as heart disease, diabetes, and high blood sugar.

Join a Support Group

Talking with people who understand your struggle can make you feel less alone and help almost any situation. Join a support group of people who suffer from chronic pain. Not only will you feel connected and cared for, they may be able to give you tips for coping with the pain. If a support group does not help you, consider meeting with a therapist or psychologist. Chronic pain can increase a person’s chance of struggling with mental issues such as depression and anxiety, which a mental professional can help you deal with.

Keep Notes About Your Pain

Try to track the intensity of your pain and what you are doing when it happens. It will help your doctor have a better idea about your chronic pain and your physical functioning, as well as indicate which activities make your pain worse.

Source:
https://www.webmd.com/pain-management/guide/11-tips-for-living-with-chronic-pain#1

Decrease Inflammation In The Body

Tue, 17 Dec 2019 19:55:35 GMT

World Health recently published an article titled: Ultra Processed Food Linked To Lower Heart Health .

Below is Dr. Teller’s notes on the subject.

Not only is processed food associated with a higher risk of heart disease but it is one of the biggest factors of inflammation in the body. Inflammation = Pain !! As pain management doctors we are always trying to decrease inflammation in the body.

Modern Stress & Mobile Devices

Thu, 10 Oct 2019 18:55:35 GMT

6 in 10 Millennials never get to relax because of constant urges to check the cell phone/mobile/smart handheld devices, even when there hasn’t been a notification alert of a new message to read.

In modern day it appears as if most people have had their cell phones/mobile devices attached to their hands, they just don’t go anywhere without them, not even to the bathroom despite hygiene risks. The average person now thinks “keys, wallet, phone” before leaving the house, and some have even become so attached they feel empty if it is not by their sides all the time.

While there is no denying that smartphones and mobile devices have made it easier to stay connected to the interwebs, is there a cost to all of the convenience, instant gratification and communication? According to a growing body of evidence there is more than a financial cost, this new survey adds to the data.

According to a new survey conducted by OnePoll of 2,000 millennials aged 18-34 because of constantly checking their phones, like an addiction, they only get to relax for 7 hours over an entire week; on a daily basis less than one hour was reported to be completely by themselves. 6 in 10 report never being able to fully relax because of compulsively checking emails, texts, tweets, feeds, etc. 1 in 10 report struggling to go even 10 minutes without looking at their device; and nearly half of all adults report wishing that smartphones were never invented.

For older adults that suggest only the young are addicted to these devices, this is not true as even older adults report relaxing for only about 90 minutes a day; 10% of all respondents actually struggle to go 10 minutes without checking their phones, and 9 in 10 check regularly even if they are aware that there has been no alert for a new message.

“Relaxing is hugely important, but it’s something we often relegate to the back burner of our lives. Thanks to mobile phones and everything they allow us to do, it means that often when we are ‘relaxing’, we are still ‘switched-on’,” comments a spokesperson for Treatwell, the hair and beauty booking app that commissioned the survey, in a statement. “Neglecting our relaxation time can have a really detrimental effect on us, but it can happen quite slowly, so you don’t realize it’s happening.”

Excessive time spent on these mobile devices appears to be creating a void in people’s lives as many respondents reported not being able to relax even if they have no work to do, and one-third reported being at a loss of what to do with themselves other than staring blankly at the screens of their mobile devices when they have nothing to do. Have people become so addicted that they have forgotten how to think for themselves and just be?

62% of all respondents report finding modern life stressful, and 46% of all respondents went as far as to report that they wish smartphones/mobile devices had never even been invented altogether.

Activities that respondents report helping them to unwind include: 1 in 5 list walking a dog, 14% report putting their devices out of sight, 59% list watching TV, 54% list reading, 52% list going for a walk, the sound of the ocean helps to relax 52%, the sound of rain helps to relax 30%, and upon hearing the sound of a waterfall 28% instantly relax.

52% of female respondents would like a spa day to relax. Over half of the respondents report their lives as being less stressful before they had children. 3 in 10 respondents report that they don’t believe their romantic partners put in enough effort to give them time to relax, and another 3 in 10 report making more of an effort to relax but are not able to and fall back into feeling constantly stressed.

While weather appears to play roles in stress levels with winter being considered to be twice as stressful as summer, jobs are reported as being one of the biggest obstacles that is impeding the respondents' ability to relax.

One of the largest causes of pain is an increase in inflammation in our bodies . That is why we at the Art of Pain Management, try and teach you to reduce inflammation medically and naturally. Cell phones & computers cause stress and lack of sleep. When we are stressed a hormone called cortisol increases and this causes an increase of inflammation in your body . Before bed it is important to be off all screens and eat anti-inflammatory food like eggs and fish oil to reduce cortisol and inflammation in the body.

- Dr. Jarrad Teller

ORIGINAL ARTICLE: https://www.worldhealth.net/news/modern-stress-mobile-devices

*Note: Content may be edited for style and length.

Materials provided by:

https://www.treatwell.co.uk

https://www.studyfinds.org/modern-stress-6-in-10-millenials-never-relax-constant-urge-to-check-phone

*This article is not intended to provide medical diagnosis, advice, treatment, or endorsement.

10 Ways to Make Your Meal Prep Brain Healthy

Mon, 30 Sep 2019 18:55:35 GMT

These days, with hectic schedules jam-packed with school projects, work presentations, meetings, errands, sporting events, concerts, and other social functions, who has time to think about meals?

Fortunately, there’s a super helpful way to relieve the stress that can come from buying and making food every day. Learning the essentials of meal prepping is a great way to save time and money…and eat healthily.

To streamline your mealtime, here are 10 simple ways to plan out and create a series of savory and healthy meals…

1. Make a Plan

As Benjamin Franklin once said, “If you fail to plan, you are planning to fail!” Before heading out to the store to purchase a week’s worth of groceries, take stock of what you already have on hand. Make an inventory of what’s in your refrigerator, freezer, pantry and spice rack. In the long run, you’ll save time and money if you have a solid plan in place for everything you need to buy for your weekly meal prep. It might surprise you just how much easier it is to make healthy meals when you plan ahead.

2. The Power of Protein

Be sure to include protein with every meal. Protein helps maintain healthy blood sugar levels , decrease cravings, and power your metabolism more than high-carb, sugar-filled foods. Nuts, seeds, legumes, grains, and vegetables all contain some of the 20 essential amino acids you need. Fish, poultry, and most meats contain all of them. Shop for animal protein that is free-range, grass-fed, and free of hormones and antibiotics. For fish, seek out sustainably harvested and mercury-free sources. Though more expensive than industrial, farm-raised animal protein, quality fish and other meats are a good investment in your health.

3. Smart Shopping

Pick one day a week to go food shopping. Fill your cart with vegetables and other nutrient-rich foods to help fuel your body and keep your brain active and healthy. Avoid processed, boxed foods as much as possible. Never shop without a grocery list as this can create the need to make multiple trips to the store if you forget important items. Try to purchase everything you need for meal prep in just one shopping trip each week.

4. Eat from the Rainbow

In addition to leafy green vegetables like spinach, kale, and collard greens, different colored vegetables, such as bell peppers, squash, broccoli, and cauliflower, all have tremendous health benefits. They provide an enormous array of vitamins, essential minerals, free radical-blocking carotenoids, and flavonoids that are excellent antioxidants. Plant foods (phytonutrients) also can help balance healthy inflammatory responses and lessen your chances of brain, heart, blood pressure, blood sugar, joint, or gastrointestinal problems.

5. Prepare Together

If possible, try tackling your “to do” list with others. Spending time with friends and family while you share tasks, like shopping, cooking, and cleaning can be an enjoyable time of bonding. Plus, the more helping hands you have, the quicker the meal prep process should go. You don’t have to do it all by yourself, so don’t be afraid to enlist some help.

6. “Smart” Carbohydrates

So-called “smart” carbohydrate s are essential to life because they’re loaded with nutrients, help keep your blood sugar in a healthy balance, and decrease cravings. Most vegetables, legumes, and low glycemic fruits (apples, pears, and berries) are smart carbs. When shopping for fruits, only purchase those that have the lowest sugar content and the lowest glycemic (unlikely to raise blood sugar) indexes.

7. Schedule a Time

Set aside one day each week to prepare meals that are balanced and healthy. Having a set time hardwired into everyone’s schedule will help make meal prep a priority while giving your handy helpers something to look forward to. If something comes up and you need to change your meal prep day, that’s okay. Try to re-establish a consistent day as soon as your schedule allows.

8. Healthy Fats

The body needs fats to build cell structures. The most healthy fats tend to come from foods that contain omega-3 fatty acids , which are found in chia seeds, ground flaxseeds, walnuts, avocados, and sweet potatoes. Though the body can convert some of these into small amounts of EPA and DHA, cold-water fish (salmon, tuna, mackerel, sardines, anchovies, and cod) are good sources of actual, preformed EPA and DHA. Avoid farmed salmon and try to get cold-water fish from Alaska or close to the Antarctic, where the ocean waters are the least contaminated.

9. Antioxidant-Rich Berries

The brain is vulnerable to attack by free radicals – highly reactive molecules that burn away antioxidants. Berries are one of the most concentrated sources of antioxidants in the plant kingdom. The antioxidants in blueberries help protect the brain against oxidative stress (including from toxic pollutants), support learning capability and motor skills and have shown promise for memory in clinical trials. Other berries, including strawberries, blackberries, and raspberries, as well as goji, mangosteen, and noni, provide differing classes of antioxidants. The greater the variety of berries you eat, the broader the antioxidant protection you’ll have.

10. Quality Storage Containers

After you’ve prepared several delicious and nutritious meals, make sure you have adequate means to preserve the food. Storage containers are one of the most important parts of meal prep. If you don’t already own quality storage containers, now is the time to invest in some. Select containers that are specifically designed to hold healthy portions and make sure they’re dishwasher and microwave safe. Whether glass or plastic, purchase durable containers that will last for several years. If you intend to freeze foods, make sure the containers have tight seals to prevent freezer burn.

Following these 10 meal prep tips can help relieve the stress and tedium of making piecemeal meals and free up more time for you to do the things you love. You can find many delicious, brain-healthy recipes in The Brain Warrior’s Way Cookbook .

At BrainMD, they are dedicated to providing the highest purity nutrients to give you the energy, focus and mental sharpness you need to lead a brain-healthy life. For more information about our full list of brain-directed supplements, visit BrainMD .

Note: Content may be edited for style and length.

Original Article can be found at: https://brainmd.com/blog/meal-prep-tips