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When I Control the Pain, I Control My Life: Opioids and Opioid-Containing Analgesic Medication in the Management of Chronic Intractable Pain
Published in Michael S. Margoles, Richard Weiner, Chronic PAIN, 2019
Dosage increases should be stopped if tiredness sets in, thinking becomes clouded, or nausea and vomiting develop. As you gradually increase your dose of MS Contin® (or similar drugs), begin to taper down on your consumption of Anexia®, Percocet®, Vicodin®, etc. Do not stop the MS Contin®, etc. medication abruptly. First, call your physician for directions. In the worst-case scenario, if you need to taper the medication but have no professional to help reverse the order of the MS Contin®, start at day 13 and begin to taper yourself down, right down to day 1 dosing, and then stop use of the medication.
Opioid Medications and Correct Medical Usage—An Update
Published in Gary W. Jay, Practical Guide to Chronic Pain Syndromes, 2016
There are three types of breakthrough pain: incident or episodic—patients know what can cause the pain and take a pre-emptive, fast-acting pain medication. Next is idiopathic or spontaneous breakthrough pain, which comes on suddenly and not infrequently for no obvious reason. Lastly is end-of-dose failure, which is not as unusual as one would expect. Some patients will need to take MS-Contin or even OxyContin two or three times a day (q8h). Some patients use transdermal fentanyl patches, which are labeled to last 72 hours, but in some patients they may last only 48 hours. The physician can see the end-of-dose failure by the marked increase in breakthrough pain that occurs when the time-release medication has been metabolized and the blood level is dropping.
Development of palliative medicine in the United Kingdom and Ireland
Published in Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita, Textbook of Palliative Medicine and Supportive Care, 2015
15 Kaiko RF, Healy N, Pav J et al. The comparative bioavailability of MS Contin tablets (controlled-release oral morphine) following rectal and oral administration. The Edinburgh Symposium on Pain Control and Medical Education, D. Doyle (ed.). 1989. Royal Soc of Med Serv Int'I Congresses and Symposium N Â ∘149. Royal Soc of Med Services Ltd. Edinburgh, October 1988
Treatment of painful polyneuropathies of diabetic and other origins with 10 kHz SCS: a case series
Published in Postgraduate Medicine, 2020
A 70-year-old female diagnosed with chronic inflammatory demyelinating polyneuritis (CIDP) presented with severe pain in bilateral lower extremities. She was also left with pain in her buttocks and right thigh after her laminectomy. She was using 60 mg TID of MS Contin (morphine sulfate) and 10/325 QID Norco (hydrocodone + acetaminophen) for the management of pain. She was offered 10 kHz SCS treatment for the management of lower extremity pain. At baseline assessment, her pain intensity score was 7, which reduced to 3 at EoT, a 57.1% pain relief (Figure 2A). After receiving a permanent implant of the PG for her lower extremity pain in December 2015, she reported significant improvement at the time of her first follow-up visit. At this visit (11.9 months post-implant), she rated her pain intensity as 2.5 (64.3% pain relief) and described improvement in her daily activities that included being able to cook on her own and able to stay on her feet for longer periods of time. In her second follow-up visit (12.9 months post-implant), she reported a slight increase in her leg strength and function in addition to pain relief. In her last follow-up visit (26 months post-implant), she rated her pain score as 3 (57.1% pain relief) and reported that she had to increase her pain medication for her neck and upper extremity pain (Table 2). Her latest outcomes were not available as she moved out of the area.
Kava (Piper methysticum) in the United States: the quiet rise of a substance with often subtle effects
Published in The American Journal of Drug and Alcohol Abuse, 2023
Salma Pont-Fernandez, Marina Kheyfets, Jeffrey M. Rogers, Kirsten E. Smith, David H. Epstein
While approximately 8% of posts mentioned undesirable effects from kava, the effects were typically characterized as mild. Further, 23% of posts mentioning undesirable effects also mentioned polydrug use, indicating that the effects might not have been caused by kava alone. For instance, one person described a presyncopal event after using kava pills alongside the opioid MS Contin, writing that kava intensified MS Contin’s effects and expedited their onset. Some posts mentioned undesirable effects documented in prior research, such as motor impairment, dermopathy, and dysphoria (2,7,20,37), but these mentions were sparse, and other documented undesirable effects (e.g., tremors) were not mentioned.
The Association between COVID-19 and Changes in Opioid Prescribing Patterns and Opioid-Related Overdoses: A Retrospective Cohort Study
Published in Canadian Journal of Pain, 2023
Alexandra Robins, Alan Dimitriev, Cameron MacKay, Hayden Wang, Abigail Kearney, Daniel P. Borschneck, Amber Simpson
We defined two types of prescription opioid users in our study: new and continuing users. New users were defined as individuals who did not have any opioid prescriptions in the 365 days prior to their index prescription date. Continuing users were defined as individuals who had more than 90 days of ongoing prescription opioid therapy with a date of service before March 17, 2020, and who were not recorded as having a discontinuation of opioid therapy by ICES. Discontinuation is based on the absence of opioid prescriptions in the 180 days beyond the amount supplied in the previous prescription where the “previous prescription” is their most recent prescription relative to 180 days before the lockdown (September 19, 2019). Individuals who had less than 180 days between the amount supplied in their last prescription before the lockdown and the lockdown date itself were classified as continuing users. To ensure exclusivity between the defined user groups, we excluded new users who, over the time frame of the study, could also be classified as continuing users from the analysis. We investigated opioid prescriptions for codeine (both codeine and codeine combination formulations), hydromorphone, morphine, oxycodone (both oxycodone and oxycodone combination formulations), and tramadol; prescriptions for fentanyl and meperidine were excluded from the study due to the sparsity of the data and the associated risk of re-identification. It should be noted that ICES defined the opioid classes previously listed based on a resource referred to as The Ontario Drug Policy Research Network for the NMS. These identified drug classes capture several different formulations and brands. For example, the generalized drug class “morphine” is representative of morphine sulfate, morphine, and morphine HCl formulations, thus encapsulating commonly prescribed brands, such as (but not limited to) Kadian, Statex, and MS Contin. The drug classes of buprenorphine and methadone were excluded given that they are used for opioid dependency and this study focuses on prescription for treating pain. Furthermore, we identified individuals within our study who had an opioid toxicity event using the International Statistical Classification of Diseases and Related Health Problems 10th Revision codes T40.0 to T40.4 and T40.6 in NACRS. Only toxicity events that occurred during our study time frame were included in the analysis.