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 […]
The Centers for Disease Control recently issued new recommendations for prescribing opioids for chronic pain, in order to address the opioid epidemic that our country is now facing. At Spine & Nerve, our approach is consistent with the CDC’s guidelines for opioids. The opiate epidemic is a very serious problem, and the care providers at Spine & Nerve Diagnostic Center continue to follow an ever-evolving “best practices” approach that incorporates an integrated, multi-disciplinary pain management plan. Our approach to the treatment of chronic pain includes cognitive behavioral therapy, physical therapy, biofeedback, exercise and other alternative, non-opioid methods of pain relief. […]
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, […]
An estimated 116 million adults experience chronic pain, according to a report published by the Institute of Medicine of the National Academies, and treatment is all too often “delayed, inaccessible, or inadequate…” according to committee chair Dr. Philip Pizzo of the Stanford University School of Medicine, who co-authored the report. The Academies’ report, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research acknowledges that pain is more than just a physical symptom, and is not always resolved by curing the underlying disease. Chronic pain –defined as pain lasting longer than 12 weeks—is individual and “a disease […]
If you’re having prolonged sleep troubles, you may be 150% more likely to experience back pain. Among women, the correlation between insomnia and back pain is even higher. We’ve long known that insomnia increases a person’s sensitivity to pain in general, but a new study from the University of Haifa in Israel was the first to discover such a strong correlation between insomnia and back pain specifically. The study was well designed. Over 2,000 healthy, working adults came in for routine physical exams at the Sourasky Medical Center in Tel Aviv at three intervals over the course of eight years. […]
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