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#156 Chronic Pain, Opioids, Tapers: Pain Management Pearls & Updates from Doctors Soraya Azari and Phoebe Cushman

#156 Chronic Pain, Opioids, Tapers: Pain Management Pearls & Updates from Doctors Soraya Azari and Phoebe Cushman

DeThe Curbsiders Internal Medicine Podcast


#156 Chronic Pain, Opioids, Tapers: Pain Management Pearls & Updates from Doctors Soraya Azari and Phoebe Cushman

DeThe Curbsiders Internal Medicine Podcast

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Longueur:
66 minutes
Sortie:
Jun 24, 2019
Format:
Épisode du podcast

Description

Rethink how you’re diagnosing and managing chronic pain with high-yield tips from pain experts and primary care doctors Soraya Azari MD @azarimugs (UCSF), and Phoebe Cushman MD, MS (UMass Memorial). Because let’s face it, managing chronic pain can be very difficult. Expand your toolbox for management-- including the importance of activity, empowering your patient, risk stratification for patients prior to opioid initiation, how to identify opioid use disorder, and how to taper opioids. Plus, updates on recent practice changing articles in chronic pain. Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Nora Taranto MD Hosts: Nora Taranto MD, Paul Williams MD, Matthew Watto MD Edited by: Emi Okamoto MD, Matthew Watto MD Guests: Soraya Azari MD; Phoebe Cushman MD, MS Sponsor This episodes was recorded LIVE at #SGIM19 in Washington DC! Join the Society for General Internal Medicine today! Time Stamps 00:00 Intro, disclaimer, guest bios 04:50 Guest one-liners, book recommendations, picks of the week, career advice 14:50 A case of chronic pain; Group pain into 1 of 3 buckets 18:48 Use of pain scales; and taking a pain history; affirming positive behaviors surrounding pain 23:13 Nonpharmacologic measures for chronic pain 26:30 Cognitive behavior therapy (CBT) for chronic pain; remote CBT vs traditional CBT 30:32 Apps for Meditation, Affirmations 31:53 Back to the case: Should we trial opioids for our patient’s chronic pain? Our guests give their recommendations and how they counsel patients about opioids 34:55 Counseling about risk of opioids 37:42 Risk stratifying patients requesting opioids; Some risk tools (COMM, Opioid Risk Tool, DIRE); Don’t forget to screen for mood disorders 42:10 What to do if pain is not improved on high dose opioids; How to identify an opioid use disorder 45:13  How to taper patients off opioids; Forced tapers and the CDC guidelines; how to taper the right way 50:34 Buprenorphine for opioid use disorder and/or chronic pain 57:38 Gabapentin and risk for misuse and/or unintentional overdose in patients also using opioids 61:42 Plugs: Get your x-waiver, or better yet advocate for getting rid of the waiver
Sortie:
Jun 24, 2019
Format:
Épisode du podcast