I Won’t Be Shamed for implementing Opioids to handle My Cancer Discomfort

 

Session 1: Living With Pain: America’s Opioid Dilemma

Video taken from the channel: Johns Hopkins University


 

Chapter II: High Dose Opioids for Chronic Non-Cancer Pain

Video taken from the channel: Andrew Kolodny


 

Myths and Hysteria Surrounding the Use of Opioids for Non-cancer Pain

Video taken from the channel: Pharmacy Times TV


 

Cancer Pain Management And Living Meaningfully | Sandra H. Sacks, MD, MEd

Video taken from the channel: UCLA Health


 

More Opioids for Cancer Patients, Part I

Video taken from the channel: Johns Hopkins Medicine


 

Stigmas to access and use opioids for cancer pain management generate useless suffering

Video taken from the channel: European Society for Medical Oncology


 

Pain management in cancer patients

Video taken from the channel: MD Anderson Cancer Center


But when I take my opioids, the pain decreases. I can move again. I can breathe again. I can handle my full-time job. I can go to the park with my 8 year old son.

I can manage my pain. So when I went to the pharmacist in my hometown in California and the pharmacist again refused to fill my opioid prescription, I was frustrated and angry. Not. When I’m having a good day, my pain is a 5 or 6 out of 10 on the pain scale. Some days, my pain escalates to an 8 or 9 and I can’t function.

But when I take my opioids, the pain decreases. I can move again. I can breathe again. I can handle my full-time job.

I can go to the park with my 8 year old son. I can manage my pain. While media coverage surrounding opioid misuse in the cancer patient population is sparse, research does indicate that cancer patients are not immune to addiction. It is also clear that opioid prescribing rates among cancer patients are substantially higher than those of other patients.

But opioid overdoses and substance abuse problems do occur in a small subset of cancer patients, and clinicians at The University of Texas MD Anderson Cancer Center have implemented a system for detecting and managing issues that might arise from opioid abuse in cancer patients with chronic pain. SM: One of the biggest challenges is that we know very little about how patients manage their cancer pain. We know that opioids are widely prescribed, but we also know that there is poor adherence to prescribed opioids.

Other treatments such as acupuncture are not consistently covered by health insurance or lack data on clinical effectiveness. According to a recent clinical practice guideline for chronic pain management in cancer survivors, published by the American Society of Clinical Oncology, careful assessment of the pain and its effect on function, and of the possible risks associated with use of an opioid, are the first step. When opioids are considered, providers should assess every patient for risk factors for addiction. Opioids for Cancer Pain.

Opioids (narcotics) are used with or without non-opioids to treat moderate to severe pain. They are often a necessary part of a pain relief plan for cancer patients. These medicines are much like natural substances (called endorphins) made by the body to control pain. They were once made from the opium poppy, but today many are man-made in a lab.

Guidelines have been developed to support oncologists when prescribing the long-term use of opioids for cancer survivors. The challenges surrounding the use of opioids, and the need for safe and effective alternative analgesics, are leading to intense interest in the potential benefits of cannabis for cancer-related. Cancer patients are a challenge for pain management because both the disease and its treatments — including radiation, chemotherapy and surgery — are usually very painful. Eighty percent of patients with advanced-stage cancer experience pain. For those patients, taking opioids like Vicodin is virtually a necessity, and doctors need to listen carefully when patients ask for more.

The US Centers for Disease Control and Prevention (CDC) wants to make it clear: its guideline on the use of opioids for the treatment of chronic pain is not intended to apply to pain related to cancer treatment, palliative care, or end-of-life care.

List of related literature:

On the other hand, opioids for chronic, severe cancer pain may be titrated upward many times over the course of therapy to maintain adequate pain control.

“Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume” by Sharon L. Lewis, RN, PhD, FAAN, Linda Bucher, Margaret M. Heitkemper, RN, PhD, FAAN, Shannon Ruff Dirksen, RN, PhD
from Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume
by Sharon L. Lewis, RN, PhD, FAAN, Linda Bucher, et. al.
Elsevier Health Sciences, 2013

Opioids should be avoided in chronic pain (except cancer pain).

“Quick Review of Pharmacology” by Dr J G Buch
from Quick Review of Pharmacology
by Dr J G Buch
Quick Review of Pharmacology,

Many patients will fear that the exposure to opioids for cancer pain will make them addicts.

“Textbook of Medical Oncology” by Stan B. Kaye`
from Textbook of Medical Oncology
by Stan B. Kaye`
Taylor & Francis, 1999

Opioids are the cornerstone therapy for cancer pain in most patients; however, these medications may not always provide adequate pain control [1].

“Essentials of Interventional Cancer Pain Management” by Amitabh Gulati, Vinay Puttanniah, Brian M. Bruel, William S. Rosenberg, Joseph C. Hung
from Essentials of Interventional Cancer Pain Management
by Amitabh Gulati, Vinay Puttanniah, et. al.
Springer International Publishing, 2018

Nurses need to educate families about the appropriate use of opioids and assure them that addiction is not a concern when managing cancer pain.

“Lippincott Q&A Review for NCLEX-RN” by Diane Billings, Desiree Hensel
from Lippincott Q&A Review for NCLEX-RN
by Diane Billings, Desiree Hensel
Wolters Kluwer Health, 2016

While this seems justified in cancer pain, opioids are usually not indicated in chronic noncancer pain (see earlier section “Opioids”).

“Miller's Anesthesia, 2-Volume Set E-Book” by Michael A. Gropper, Ronald D. Miller, Lars I. Eriksson, Lee A Fleisher, Jeanine P. Wiener-Kronish, Neal H Cohen, Kate Leslie
from Miller’s Anesthesia, 2-Volume Set E-Book
by Michael A. Gropper, Ronald D. Miller, et. al.
Elsevier Health Sciences, 2019

On the other hand, opioids for chronic, severe cancer pain may be titrated upwards many times over the course of therapy to maintain adequate pain control.

“Lewis's Medical-Surgical Nursing: Assessment and Management of Clinical Problems” by Diane Brown, Helen Edwards, Lesley Seaton, Thomas Buckley
from Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems
by Diane Brown, Helen Edwards, et. al.
Elsevier Health Sciences, 2017

Remind them that pain is an appropriate indication for use of opioids and that under these circumstances patients are not “addicted” to medications.

“Manual of Medical-Surgical Nursing Care E-Book: Nursing Interventions and Collaborative Management” by Frances Donovan Monahan, Marianne Neighbors, Carol Green
from Manual of Medical-Surgical Nursing Care E-Book: Nursing Interventions and Collaborative Management
by Frances Donovan Monahan, Marianne Neighbors, Carol Green
Elsevier Health Sciences, 2010

This virtue is nearly lost when doctors decide that all pain is “cancer pain,” and cancer pain should be treated with opioids.

“Peripheral Nerve Entrapments: Clinical Diagnosis and Management” by Andrea M Trescot, MD, ABIPP, FIPP
from Peripheral Nerve Entrapments: Clinical Diagnosis and Management
by Andrea M Trescot, MD, ABIPP, FIPP
Springer International Publishing, 2016

The trend is to avoid opioids for non–cancer-related chronic pain due to evidence that the risks are significant including increased risk of fractures, hospitalization, and mortality.

“Varcarolis' Foundations of Psychiatric-Mental Health Nursing E-Book: A Clinical Approach” by Margaret Jordan Halter
from Varcarolis’ Foundations of Psychiatric-Mental Health Nursing E-Book: A Clinical Approach
by Margaret Jordan Halter
Elsevier Health Sciences, 2017

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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  • Im a cronic pain patient and have to jump through rings every month so i can fuction. (Broken back, 4 surgeries) every month i see a NPA not a doctor to get my scripts filled. There office os a pill mill making millions a year and could give a bent shit if the treatment is working.
    There more interested in keeping themselves out of trouble in Compliance than practicing medicine.