Balancing Pain Control with the Opioid Epidemic 0 Aubuchon JD1, Yee A2 March 8, 2018Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.Balancing pain control has a critical role for confronting the opioid epidemic and the Centers for Disease Control and Prevention (CDC) has issued guidelines for prescribing opioids. In this video lecture, Jacob Aubuchon provides an anesthesiologist's perspective in pain management to providers and surgeons for addressing the epidemic. This lecture documents the history of opioid use, relevant definitions in pain, opioid pharmacology, epidemic statistics, and provider recommendations for controlling pain. More importantly, this lecture provides important considerations for providers when counseling patients in their use of opioids for pain relief.Keywords: pain managementchronic painacute painopioidsopioid epidemic Presentation Table of Contents00:00:00 - Introduction00:00:14 - OVERVIEW00:00:40 - HISTORY OF OPIOIDS00:03:32 - DEFINITIONS00:03:40 - Pain Definition00:04:37 - Tolerance Definition00:04:58 - Dependence Definition00:05:21 - Pseudoaddiction Definition00:05:32 - Opioid Use Disorder Definition00:06:10 - THE BASICS00:06:20 - Narcotics, Opioids, and Opiates00:07:13 - Opioid Pharmacology00:07:47 - Opioid Receptors00:08:46 - Indications00:09:23 - Side Effects00:11:05 - Equianalgesic Dosing00:11:58 - THE EPIDEMIC00:12:11 - World and United States00:13:23 - Pediatric Relevance00:14:28 - CDC Overdose Deaths Involving Opioids00:15:03 - THE PLAN00:15:14 - CDC Guideline for Prescribing Opioids for Chronic Pain00:15:54 - Determining When to Initiate or Continue Opioids for Chronic Pain00:17:08 - Opioid Selection, Dosage, Duration, Follow-up, and Discontinuation00:18:29 - Assessing Risk and Addressing Harms of Opioid Use00:19:25 - Risk Assessment00:20:20 - Prescription Monitoring Programs00:21:03 - Provider Considerations00:21:10 - What to Counsel the Patient On00:22:19 - How to Dispose of Unused Opioids00:24:44 - What If They Are On Chronic Opioids00:26:40 - How Many Pills Do I Give00:27:31 - Multimodal Analgesia00:29:51 - Other Considerations00:30:47 - Summary00:32:10 - Credits PreziREFERENCES Bicket MC, Long JJ, Pronovost PJ, Alexander GC, Wu CL. Prescription Opioid Analgesics Commonly Unused After Surgery: A Systematic Review. JAMA Surg. 2017 Nov 1;152(11):1066-1071. PMID: 28768328. Edlund MJ, Forman-Hoffman VL, Winder CR, Heller DC, Kroutil LA, Lipari RN, Colpe LJ. Opioid abuse and depression in adolescents: Results from the National Survey on Drug Use and Health. Drug Alcohol Depend. Drug Alcohol Depend. 2015 Jul 1;152:131-8. PMID: 25981310. Leave a Comment Cancel replyYou must be logged in to post a comment.