Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2002
The polarized debate over complementary and alternative medicine.
Debate about the place and scientific of complementary and alternative medicine (CAM) has increased markedly in 2002 following the release of the report of the White House Commission on Alternative and Complementary Medicine Policy. Arguments for and against the integration of CAM into mainstream medicine that have been made are discussed. Positions taken by organizations opposed to CAM are described as are arguments to study the place of CAM further.
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J Pain Palliat Care Pharmacother · Jan 2002
Analgesic issues in palliative care, furthering our understanding of pain, the stability and cost of opioid infusion therapy, and opioid effectiveness doses in nociceptive and neuropathic pain.
Literature relating to analgesic issues, pain mechanisms and management, costs of opioid infusions, and the opioids dosing for nociceptive and neuropathic pain are reviewed in the context of palliative care.
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J Pain Palliat Care Pharmacother · Jan 2002
ReviewAnalgesic issues in palliative care gastroesophageal reflux pain and chronic non-cancer pain management.
Brief literature reviews and commentary on gastroesophageal reflux disease associated pain management with rectal dosage forms and beliefs about use of opioids in non-cancer pain are presented. Relevant references including the model guidelines of the Federation of State Medical Boards of the United States on the use of opioids in non-cancer pain are cited.
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J Pain Palliat Care Pharmacother · Jan 2002
ReviewCan patients taking opioids drive safely? A structured evidence-based review.
A structured evidence-based literature review was completed to determine if there was epidemiological evidence of an association of opioid use and intoxicated driving, motor vehicle accidents (MVA) and MVA fatalities; to rate the quality of this research evidence according to Agency for Health Care Policy and Research (AHCPR) type of evidence and strength and consistency of the evidence rating scales; and according to this evidence determine whether patients taking opioids can drive safely. Relevant references were located from Medline, Psychological Abstracts, Science Citation Index and the National Library of Medicine Data Query databases by appropriate subject headings. A manual search was also performed utilizing the reference lists of the retrieved articles. ⋯ The evidence in this review indicates that opioids do not appear to be associated with intoxicated driving, MVA and MVA fatalities, and consistently indicated that opioids are not associated with MVA. Although the comparison of point prevalence rates to the point prevalence may be problematic, the results of this systematic review support the contention that patients taking opioids may be allowed to drive. As in all clinical decisions, this determination should be individualized according to clinical factors.