pain | CARLAT PUBLISHING

Expert Q&A

Management of Chronic Pain

April 1, 2023

Lewei (Allison) Lin, MD, MS. Associate professor, Department of Psychiatry, University of Michigan Medical School; research scientist, Center for Clinical Management Research, VA Ann Arbor Healthcare System. Ann Arbor, MA.

Dr. Lin has served as a consultant for the National Committee for Quality Assurance via a grant from Alkermes. Relevant financial relationships listed for the author have been mitigated.

Patients with psychiatric conditions are more likely than other patients to experience chronic pain and to receive opioid prescriptions. Dr. Lin shares her holistic approaches to pain management that incorporate psychosocial, psychotherapeutic, and psychopharmacologic treatments.

Clinical Update

Confused About Acute Confusional States? A Primer on Delirium

April 1, 2023

Michael Strong, MD and Alexander Thompson, MD, MBA, MPH

Michael Strong, MD. Assistant professor of clinical psychiatry, Perelman School of Medicine at the University of Pennsylvania. Philadelphia, PA.
Alexander Thompson, MD, MBA, MPH. Clinical professor of psychiatry and emergency medicine; director, C-L Psychiatry, University of Iowa. Iowa City, IA.
Dr. Strong and Dr. Thompson have no financial relationships with companies related to this material.

Delirium is widespread among patients in ICUs and surgery units. We review the workup and management of this common condition and give you tips to help prevent it in high-risk patients.

A Psychosocial Intervention for Chronic Pain and SUD

May 21, 2021

David A. Moltz, MD.

David A. Moltz, MD. Dr. Moltz has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Does marijuana use reduce pain and improve quality of life over time? This observational, uncontrolled trial suggests it might, but also identifies the need for more rigorous future studies.

CLINICAL UPDATE

Perioperative Pain Management in Opioid Use Disorder

March 19, 2021

Rehan Aziz, MD.

Rehan Aziz, MD. Associate Professor of Psychiatry and Neurology, Rutgers Robert Wood Johnson Medical School. Dr. Aziz has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Previously, clinicians commonly stopped opioid agonists (methadone and buprenorphine) to simplify pain control during and after surgery. New guidance from the American Society of Addiction Medicine now suggests otherwise.

Kratom: A Primer

February 3, 2021

Alison Knopf

Alison Knopf Editor, Alcoholism & Drug Abuse Weekly Ms. Knopf has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

With opioid-like properties, kratom’s recreational use is increasingly reported among those seeking pain relief or a high. This primer reviews what’s known about this unregulated substance, how to talk about it in the clinic, and early evidence on how to treat its withdrawal syndrome.

Supporting Patients With Pain and Addiction

February 3, 2021

Ajay Manhapra, MD

Ajay Manhapra, MD

Section Chief, Pain Medicine, Department of Physical Medicine & Rehabilitation Services, Hampton VA Medical Center. Assistant Professor, Departments of Physical Medicine & Rehabilitation and Psychiatry, Eastern Virginia Medical School, Norfolk, VA; Lecturer in Psychiatry, Yale School of Medicine, New Haven, CT. Dr. Manhapra has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Dr. Manhapra works with patients with disabling chronic pain, many of whom meet criteria for substance use disorders. He describes his approach to these intersecting phenomena, the biology of pain and its relationship to the reward system, and outlines an approach to improving function among patients with addiction and severe pain.

Medical Marijuana for Chronic Pain: The Cart Before the Horse?

February 3, 2021

Alison Knopf

Alison Knopf Editor, Alcoholism & Drug Abuse Weekly. Ms. Knopf has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

As more states legalize cannabis for medical or recreational use, it’s becoming more common for our patients to add medical marijuana to their medication regimen for various purported indications. In this primer, we will synthesize the debate surrounding the use of medical marijuana for a variety of syndromes, with a focus on pain.

Medical Cannabis for Chronic Pain and Quality of Life

February 3, 2021

Pavan Madan, MD.

Pavan Madan, MD. Dr. Madan has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Does marijuana use reduce pain and improve quality of life over time? This observational, uncontrolled trial suggests it might, but also identifies the need for more rigorous future studies.

Updated Guidelines for Treating Opioid Use Disorder

August 6, 2020

Rehan Aziz, MD.

Rehan Aziz, MD. Associate Professor of Psychiatry and Neurology, Rutgers Robert Wood Johnson Medical School. Dr. Aziz has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity

The American Society of Addiction Medicine released updated guidelines for the management of opioid use disorder (OUD) in March, 2020. They focus on expanding access to methadone and buprenorphine. Additionally, detailed guidance is given for perioperative management of OUD and pain management in patients with OUD.

EXPERT Q&A

Gabapentin Misuse and Diversion

June 10, 2020

Rachel Vickers-Smith, PhD, MPH

Rachel Vickers-Smith, PhD, MPH
Assistant Professor at University of Louisville, KY. Dr. Vickers-Smith has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Clinicians are increasingly turning to gabapentinoids as non-opioid alternatives for pain treatment. Yet we may be inadvertently introducing new risks in so doing. Dr. Vickers-Smith reviews current epidemiology of gabapentinoid use and offers some clues regarding how to turn the tide on gabapentin misuse.