This cold weather that we’re experiencing here in the Sacramento Valley (which we know doesn’t compare to the cold around the country ) is bringing in more patients complaining of aching joints. It’s well documented that as winter goes on, joint aches and pain rise. The exact science behind cold-related joint aches is still up for debate — but it appears that the cause is the rise in barometric pressure versus the actual cold that makes symptoms worse. Other aspects that contribute are decreasing physical activity and seasonal mood changes that interact with our body’s pain perception. Lower temperatures can cause […]

California Assembly Bill 2760 went into effect on January 1, 2019. That bill requires providers to offer a prescription for the overdose reversing drug, naloxone, when the following conditions are present:  The prescription dosage for the patient is 90 or more ME per day; and/or  Opioid medication is prescribed concurrently with benzodiazepine; and/or The patient presents with an increased risk for overdose, including a patient with a history of overdose, a patient with a history of substance use disorder, or a patient at risk for returning to a high dose of opioid medication to which the patient is no longer […]

The Sacramento Opioid Awareness Summit took place at Sacramento State University on September 12, 2018.  The speakers at the conference included city, county, state and national law enforcement and health officials. The clear message was that opioid prescriptions in Sacramento County and California had decreased by about 12% but there was still more work to be done.   The presenters reminded us that while the United States represents only about 5% of the world’s population, it consumes more than 80% of all opioids.  The conclusion was that opioids are dangerous, and they usually cause more problems than they solve. The following […]

I recently reviewed a report on acupuncture for chronic pain. It reviewed 13 clinical randomized trials that occurred up until December 2015 and included over 20,000 patients. It compared the use of acupuncture to no acupuncture in patients or sham acupuncture, which was fake acupuncture and it found a significant difference in both pain relief and improved function in the patients using real acupuncture. It also found that the results can persist over many months. Our clinic does feel that acupuncture can be a significant beneficial modality for treatment of many types of pain. Patients can sometimes lower their pain […]

Please click on this link for this article by Pauline Bartolone. Drug Overdose Deaths Plateau In California, Soar Nationally This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

For years we have known that opioids (drugs such as Norco, percocet, oxycontin, morphine, fentanyl, etc.) are dangerous. They can lead to dependence and addiction. They can often also lead to overdose and death. A new study suggests that the risk is higher than previously thought. A Centers for Disease Control and Prevention (CDC) study, released on March 17, 2017, (https://www.cdc.gov/mmwr/volumes/66/wr/mm6610a1.htm) evaluated the likelihood of long term opioid use by studying opioid use patterns in the U.S. between 2006-2015. The study demonstrated that patients who had one day of opioid therapy had a 6% chance of long term dependence (still […]

Morphine Equivalent Dose (MED), also known as Morphine Milligram Equivalents (MME) is a numerical way to compare different opioids (narcotics).   For example, if person A is on 4 tablets of Norco (hydrocodone/acetaminophen) 10/325 and person B is on 4 tablets of Percocet (oxycodone/acetaminophen) 10/325, how do we know who is on a higher dose?  We can calculate the MEDs.  1mg of Hydrocodone has an MED of 1, whereas 1 mg of Oxycodone has an MED of 1.5.   Therefore, person A is on 40 MEDs per day and person B is on 60 MEDs per day. If person C is on 20 mg of oxycontin […]

Most people in the Western world will suffer from disruptive lower back pain at some point in their lives.  And studies show that about 75% of people who’ve had one bout of debilitating back pain will have another within a year, which often leads to a downward spiral of pain and a weakening in the muscles of the lower back.  But there’s good news:  even if you have back pain now, a commitment to the right kind of exercise will help keep future back pain at bay, according to a broad new review published in the Journal of American Medicine Association, […]

DEA Reclassifies Hydrocodone Combination Products to Schedule II On August 22, 2014, the U. S. Drug Enforcement Administration (DEA) published the Final Rule moving hydrocodone combination products (HCPs) from Schedule III to the more-restrictive Schedule II classification.   The Final Rule in effective October 6, 2014. The Controlled Substances Act (CSA) places substances with accepted medical uses into one of four schedules, with the substances with the highest potential for harm and abuse being placed in Schedule II, and substances with progressively less potential for harm and abuse being placed in Schedules III through V.   Schedule I is reserved for those […]