The Clinical journal of pain
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Prescription opioid diversion and abuse are becoming increasingly prevalent in many regions of the world, particularly the United States. One method advocated to assess compliance with opioid prescriptions is occasional "pill counts." Shortly before a scheduled appointment, a patient is notified that they must bring in the unused portion of their opioid prescription. It has been assumed that if a patient has the correct number and strength of pills that should be present for that point in a prescription interval that they are unlikely to be selling or abusing their opioids. ⋯ Pill counts do not assure non-diversion of opioids and provide additional cash flow to illicit opioid dealers.
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Case Reports
Transcranial direct current stimulation (tDCS) relieved itching in a patient with chronic neuropathic pain.
Itching is often called the second modality of nociception besides pain, and affects many chronic pain patients. ⋯ This case provides a rationale for future studies of neuromodulatory treatments for itch, and indicates a potential clinical use of neuromodulation in patients with unrelieved itching.