This week’s blog is dedicated to pain sufferers in all states, but particularly Florida that are expert at a new dance craze known as the “pharmacy crawl”. Surprisingly in all my years as an experienced pain clinician, I had never known of this dance until a few weeks ago. Unlike those of us that can […]
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Often times when seeing patients I hear similar concerns regarding initiation of “pain medication”. Some of these concerns are appropriate, some legitimate, some are not legitimate, and some are simply a quest to box the prescriber into a prescribing what the patient thinks is best. Here are the concerns, statements, or questions most often heard. […]
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“Why do you call yourself a doctor on your website?” “You won’t give me my oxycodone…you’re not even a real doctor? I want to speak to a real doctor!” “Telephone Call: Dr. Fudin, This is Mr. A. Torney. I need an expert witness to testify in a case where a patient overdosed on fentanyl. I […]
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Certain antidepressants can be extremely efficacious for certain pain disorders, most are good for depression, but none of them are “happy pills”. All of the antidepressants affect at least one of three neuro-amines, namely norepinephrine (NE, sometimes referred to as noradrenergic), serotonin (5-HT, 5-hydroxy-tryptamine), and/or dopamine (DA). The very first antidepressants developed were mono-amine oxidase […]
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The role of nurse practitioner (NP) was first established within the United States by the mid-1960s in an effort to alleviate a shortage of primary care physicians in both urban and rural under-served populations. NP’s are advanced-practice registered nurses who generally work collaboratively with a physician to provide direct patient care, taking on many […]
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WARNING: Methadone should only be prescribed for pain by experienced clinicians! Indubitably, the most difficult opioid conversion challenge to prescribers and pharmacists is methadone. Methadone to Morphine (or equivalent) ≠ Morphine (or equivalent) to Methadone Methadone conversion calculations cannot be bidirectional because the half-life of methadone is long, approximately 15-60 hours. Methadone therefore stays in […]
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