Experts say painkiller guidelines 'too permissive'
The American Academy of Neurology (AAN), in an article in the journal Neurology, has proposed stricter guidelines for how doctors prescribe opioid painkillers, noting that for many chronic pain patients, the risk of dependence far outweighs the benefits.
This represents a significant change in the organization’s position–in the late 1990s it had, under pressure from pain advocacy groups and pain specialists, agreed that the medications could be an effective long-term treatment for people with chronic, non-cancer pain, such as fibromyalgia and low back pain. That helped lead to numerous states dropping their bans on opioid painkillers being prescribed for longer than three months.
Those changes have been blamed for what’s been described as a painkiller addiction" epidemic." More than 100,000 people have died from using prescribed opioid painkillers since the late 1990s.
The AAN now acknowledges that the more liberal attitude about the perceived safety of long-term opioid use occurred without clear scientific evidence that that was the case.
Among the new guidelines are recommendations that before prescribing opioid painkillers, doctors should screen patients for depression or any past drug use and use random urine drug testing. The AAN also recommended that doctors consult a pain management specialist if dosage exceeds a morphine-equivalent dose of 80-120 mg per day.
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Sourced from: Medical News Today, Regulations over opioid prescriptions ‘too permissive,’ say experts
Published On: Oct 1, 2014
Study: Acupuncture doesn't help knee pain
Researchers in Australia say that the benefits of acupuncture in healing knee pain may be greatly exaggerated.
In a study published in the Journal of the American Medical Association, scientists from the University of Melbourne say that neither needle acupuncture or laser acupuncture made a big difference in relieivng knee pain.
They studied a group of 282 chronic knee patients ages 50 and older and assigned them to receive either needle acupuncture, laser acupuncture, sham laser acupuncture (where the laser is inactive), or no acupuncture. In the trial with laser acupunctures, neither the patient nor the acupuncturists knew when the laser was sham or active.
After 12 weeks of treatment, the needle acupuncture group and sham acupuncture groups reported some improved physical function compared with the group that received no acupuncture. Participants receiving either needle or laser acupuncture also reported modest improvements in pain control. But after one year, neither pain nor physical function were improved. Overall, the researchers found no significant differences between acupuncture and sham laser acupuncture.
The study authors concluded that “benefits of acupuncture were exclusively attributed to incidental effects." They noted that subjective measures, such as levels of pain and self-reported physical function, can be susceptible to a placebo effect.
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Sourced from: Medical News Today, Acupuncture is ‘not beneficial for knee pain’
Published On: Oct 1, 2014