Nearly four years after the United States Congress heralded a "decade of pain control and research", chronic pain remains a mounting public health concern worldwide. The escalating prevalence of chronic pain in recent years has been paralleled by a rise in prescription opioid availability, misuse, and associated human and social costs. However, national monitoring surveys in the U.S. and Canada...

There has been a concerted effort by public health, regulatory, and professional groups to curtail the serious problem of prescription opioid-related misuse that emerged during the last decade. The nature of this problem was fully explicated in a recent Pain Medicine Supplement [1], and the American Academy of Pain Medicine (AAPM) has been engaged with several agencies, including the United Sta...

Persons experiencing pain, whether acute or chronic, seek and deserve relief from their discomfort and loss of function. However, opioid analgesics have the capacity to induce tolerance, physical dependence, and addiction. Furthermore, persons with a history of opioid use disorders or other substance misuse problems are at "high risk" when they acquire painful conditions requiring aggressive tr...

Background Unhealthy drug use (UDU), including both illicit drug use and misuse of prescription medications, is high among Americans 12 or older (9.4% past month; 48% lifetime), and is often 50-100% higher among emergency department (ED) patients (Cherpitel & Ye, 2008). While most screening, brief intervention and referral to treatment (SBIRT) projects focus on questionnaire screening for UDU, ...

Background: Direct thrombin inhibitors and factor Xa inhibitors are gaining popularity as alternatives to warfarin for patients requiring anticoagulation. Toxicity due to these medications is difficult to manage because overdose experience is very limited and there is no clear guidance on when or whether to use antidote in this setting. Case Presentation: A 50-year-old man with normal renal fu...

Abstract In Saudi Arabia, there are concerning rates of non-compliance with pharmaceutical regulations prohibiting the pharmacy dispensing prescription-only medications without a physician prescription. This is first study in Middle East which examines physicians’ perceptions regarding misuse codeine, listed as narcotic, controlled, and drug. The CODEMISUSED survey was adapted to Arabian contex...

PURPOSE The current epidemic of prescription opioid abuse and misuse in the United States is discussed, with an emphasis on the pharmacist's role in ensuring safe and effective opioid use. SUMMARY U.S. sales of prescription opioids increased fourfold from 1999 to 2010, with an alarming rise in deaths and emergency department visits associated with the use of fentanyl, hydrocodone, oxycodone, ...

BACKGROUND In observational studies concerning drug use and misuse, persons misusing drugs may be less likely to respond to surveys. However, little is known about differences in drug use and drug misuse risk factors between survey respondents and nonrespondents. METHODS Using electronic health record (EHR) data, we compared respondents and non-respondents in a telephone survey of middle-aged...

BACKGROUND The primary aim of this work was to present the prevalence data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a representative 3-year longitudinal survey (ages 18+ years) that captured information on patterns of self-reported pain interference and prescription pain reliever misuse. A second aim was to assess the degree to which the risk of various...

The life of every living organism is sustained by the presence of oxygen and the acute deprivation of oxygen will, therefore, result in hypoxia and ultimately death. Although oxygen is normally present in the air, higher concentrations are required to treat many disease processes. Oxygen is therefore considered to be a drug requiring a medical prescription and is subject to any law that covers ...