Annals of family medicine
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Annals of family medicine · Jan 2021
Association between Opioid Overdose and Health Plan Disenrollment with Mitigating Impact of Buprenorphine Initiation.
Context: Health plan disenrollment has been associated with higher mortality in patients with opioid use disorder. Insurance loss and health plan disenrollment might be downstream social consequences of opioid misuse and overdose that may heighten patient mortality risks during a period of heightened need for professional assistance. Objective: To test hypotheses that: 1) overdose events in patients prescribed long-term opioids are associated with subsequent health plan disenrollment; and 2) buprenorphine initiation after overdose would attenuate this association. ⋯ Among patients with overdose events, subsequent buprenorphine initiation was associated with substantially reduced risk of health plan disenrollment [aIRR 0.36 (0.17-0.74)]. Conclusions: Overdose events in patients prescribed long-term opioids may portend other social consequences, such as health insurance loss, which may exacerbate patient risk at a time of heightened need and vulnerability. Buprenorphine may mitigate the risk of health plan disenrollment in opioid-prescribed patients who overdose.
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Annals of family medicine · Jan 2021
Observational StudyDiagnostic Agreement Between Telemedicine on Social Networks and Teledermatology Centers.
With increasing delays in obtaining a dermatological consultation, general practitioners (GPs) are using social networks for telemedicine to obtain advice on dermatological images. The objective was to analyze diagnostic agreement between telemedicine on social networks (Twitter and MedPics) and standard teledermatology services (TDS). ⋯ Diagnostic agreement using social network images showed that use of this telemedicine tool could be a reliable means to alleviate the difficulties of accessing dermatology consultations although data safety probably needs to be improved.
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We are living in unprecedented times. While the world is grappling with COVID-19, we find the horrors of racism looming equally large as we, yet again, confront lurid deaths in the center of the news cycle of Black and brown people from police bias and brutality. ⋯ In the tone of the Netflix series, "Dear White People," we further emphasize that we are not alone in trying to reach out to you, our White colleagues and leaders. Please hear our story and heed our call to action.
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Annals of family medicine · Jan 2021
When Physical and Social Pain Coexist: Insights Into Opioid Therapy.
The US opioid epidemic challenges us to rethink our understanding of the function of opioids and the nature of chronic pain. We have neatly separated opioid use and abuse as well as physical and social pain in ways that may not be consistent with the most recent neuroscientific and epidemiological research. ⋯ Many of the patients who use opioid medications long term for the treatment of chronic pain have both physical and social pain, but these medications may produce a state of persistent opioid dependence that suppresses the endogenous opioid system that is essential for human socialization and reward processing. Recognition of the social aspects of chronic pain and opioid action can improve our treatment of chronic pain and our use of opioid medications.