Wednesday, October 25, 2006

Access to pain relief

There have been important recent developments in the Drug Enforcement Administration regarding their policies on opium-based prescription drugs such as OxyContin. Before September, strict regulation by the Drug Enforcement Administration required physicians to limit prescriptions to a 30-day supply. Physicians who exceeded the required amount have faced investigation, arrest, and persecution as "drug dealers". A new proposal, subject to 60 days of public comment starting in early September, would allow doctors to prescribe up to a 90-day supply without fear of prosecution. Doctors that exceed this new limit will be subject to prosecution. Their cases will be identified on the DEA's new webpage, "Cases Against Doctors".

Marc Kaufman of the Washington Post has been following this, along with many others. Useful links to his articles (available on the PRN website) and more below:

1 comment:

Anonymous said...

I wouldn't have thought that blocking a nerve would be a good thing, but I guess it really does make sense.

Peripheral Nerve Block
are a common treatment for pain relief. They can be used for diagnostic, prognostic or therapeutic purposes.

Nerve block techniques include local infiltration of painful areas, peripheral nerve blocks, and central blocks (spinal, epidural and caudal blocks).

Nerve blocks can be used for diagnostic, prognostic or therapeutic purposes in the management of pain. Nerve blocks can be administered using various techniques, the different methods of using nerve blocks depend on their location, the reason for the nerve block, as well as the medical guidelines for their use.

Indications for diagnostic nerve blocks

To define the precise source of pain.

To distinguish local from referred pain (pain that originates in an area away from the site of the pain), visceral (pain from the internal organs) from somatic pain (pain originating from the walls of the body), and peripheral (pain originating from the nerves that extend from the spinal cord) from central pain (pain the originates from the brain or spinal cord).

To determine if pain is maintained by the sympathetic nervous system (a division of the part of the nervous system where we have no voluntary control, responsible for out "fight" or "flight" response)

To allow assessment of the contribution of pain to immobility or muscle spasm.

Indications for prognostic blocks

To allow assessment of the benefits and risks of neurolytic and neurodestructive blocks. A prognostic local anaesthetic block can be a guide as to whether pharmacological treatment, definitive neurolytic blocks or surgical management should be considered.

Indications for therapeutic blocks

To provide prompt and effective analgesia, either prophylactically (eg local anaesthetic prior to suturing) or following injury (eg femoral nerve block for a broken leg).

To allow adequate examination, intervention or mobilisation of an injured area without the requirement for sedation or general analgesia.