Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2009
Do international model drug control laws provide for drug availability?
A preliminary review of the United Nations Office on Drugs and Crime (UNODC) model drug control laws was conducted by the Pain & Policy Studies Group (PPSG) to determine whether the models provided governments with language they can use to carry out the obligation to ensure adequate availability of opioid analgesics for the relief of pain and suffering, specified in the Single Convention on Narcotic Drugs, 1961 as amended, and as recommended by the International Narcotics Control Board in 1995. The results showed that current model laws lack the drug availability provisions. Based on initial positive feedback from the International Narcotics Control Board, the UNODC, and the World Health Organization, the PPSG developed preliminary recommendations based on existing provisions in the Single Convention. ⋯ If these models convey the dual obligations of governments, the models would be considered "balanced," and national governments would have model policy language not only for control of licit drugs, but also for their availability. Most governments have already adopted laws to implement the Single Convention; however, it is not known if they followed the Single Convention itself or model laws. The PPSG conducted this preliminary assessment of whether the models published by the United Nations Office on Drugs and Crime are balanced, using as a guide the 1995 recommendations of the International Narcotics Control Board (www.incb.org/pdf/e/ar/1995/suppl1en.pdf) and the 2000 WHO publication Achieving Balance in National Opioids Control Policies: Guidelines for Assessment (www.painpolicy.wisc.edu/publicat/00whoabi/00whoabi.htm).
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J Pain Palliat Care Pharmacother · Jan 2009
Guidelines for the diagnosis and management of neuropathic pain: consensus of a group of Latin American experts.
These consensus guidelines have been developed by a group of Latin American experts in pain management, to point out patterns and make practical recommendations to guide the diagnosis, identify warning signs (yellow and red flags), and establish comprehensive medical management (pharmacologic and nonpharmacologic treatment) and monitoring plans for patients enduring neuropathic pain. From the viewpoint of pharmacologic management, drugs are classified into groups according to efficacy, availability/accessibility, and safety criteria. Drugs are recommended for use depending on the disease and particular circumstances of each patient, with an approach that favors multimodal treatment while taking into consideration the idiosyncrasies of medical practice in Latin America.
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J Pain Palliat Care Pharmacother · Jan 2009
Prevalence, etiology, and management of neuropathic pain in an Indian cancer hospital.
Neuropathic pain is still an under-diagnosed and undertreated problem in third world countries. This retrospective study was undertaken to detect the prevalence, etiology and treatment profile of neuropathic pain in cancer. During January-December 2007, 716 new cancer pain patients were examined in Tata Memorial Hospital Pain Clinic. ⋯ Only 35% patients followed up more than once at the pain clinic. The most common and challenging patients were of orofacial pain. Nerve blocks techniques have a limited role in neuropathic pain.
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This commentary refutes published assertions that opioid use is inherently dangerous and to be discouraged. A reasoned case for risk-to-benefit considerations is presented. Data from federal reporting systems are placed in perspective. The importance of using opioids rationally in pain management is supported.
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J Pain Palliat Care Pharmacother · Jan 2009
Analysis of controlled substance agreements from private practice physicians.
Controlled substance management agreements (contracts) are widely used by pain specialists in the United States, but what do they contain? This survey analysis answers that question by taking a thorough look at 41 controlled substance medication management agreements from physicians in private practice.