Case vignette: A 21 y/o has surgery for a condition expected to improve. He fills a discharge prescription for 5 days of an opioid at a standard dose. At 1-week follow-up with his family doctor for suture removal, he describes ongoing pain. Is a renewal of opioid appropriate, potentially dangerous, or both? Aggressive promotion of opioids for chronic non-cancer pain (CNCP) began in the … [Read more...]
[Jan 14] Evidence for/against Non-opioid Treatment of Chronic Pain
Date And Time: Tuesday, 14 January 2020, 6:15 PM – 8:00 PM PST Location: Craft Beer Market, 85 W 1st Ave., Vancouver, BC [View Map] Speaker: Dr. Tom Perry, Therapeutics Initiative Description: Vancouver Division invites you to attend our next event in CHA 6 (South Vancouver). This is the 4th event of the Doctors Lounge series for 2019-2020, which will provide members with the oppportunity … [Read more...]
[117] Gabapentin and pregabalin: Are high doses justified?
Analgesia once seemed a relatively straightforward aspect of medicine. Recommendations in textbooks and guidelines were definitive, albeit heavily conflicted. Even recent guidelines encourage dose titration, based on an implicit, if unsupported, notion that more is likely to be better.1 Recent experiments and systematic reviews show that drugs seldom outperform placebo significantly in chronic … [Read more...]
[115] Cannabinoids for Chronic Pain
Canada's parliament legalized the recreational use of herbal cannabis (marijuana) in October 2018. The well-publicized limitations of clinical research and well-recognized side effects such as cannabis intoxication have not deterred people from seeking out and using herbal cannabis for chronic pain in increasing numbers. This is occurring with or without a physician’s authorization.1 In fact, half … [Read more...]