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- Geller, Aaron S2
- Hooten, W Michael2
- Becker, Philip M1
- Bennett, Robert M1
- Bertholf, Roger L1
- Buchfuhrer, Mark J1
- Burton, M Caroline1
- Carey, Elise C1
- Chandok, Natasha1
- Coyne, Patrick J1
- Dawson, Nancy1
- Earley, Christopher J1
- Earley, Paul H1
- Eldrige, Jason S1
- Fiscella, Kevin1
- Geller, Alan K1
- Gettman, Matthew T1
- Gold, Mark S1
- Habermann, Elizabeth B1
- Hamid, Hytham KS1
- Hirsch, Ronald Lauren1
- Huntoon, Marc A1
- Kaur, Judith S1
- Lamer, Tim J1
- Lucas, Alexander R1
Opioids
23 Results
- Letter to the Editor
In Reply—The Importance of Educational Interventions and Regional Analgesia in Tackling the Opioid Crisis in the United States
Mayo Clinic ProceedingsVol. 94Issue 5p921–922Published in issue: May, 2019- Matthew J. Ziegelmann
- Elizabeth B. Habermann
- Matthew T. Gettman
Cited in Scopus: 0Overprescribing opioids has true risks for our patients. A study by Sanger et al1 found that more than half of patients in a methadone maintenance treatment program were introduced to opioids through a prescription. This carries particular relevance for surgeons, who prescribe a significant portion of all opioids, including many for patients without a history of exposure.2,3 Optimal prescribing practices therefore toe the delicate line between providing adequate pain control and minimizing the risk of medication misuse and abuse. - Letter to the Editor
The Importance of Educational Interventions and Regional Analgesia in Tackling the Opioid Crisis in the United States
Mayo Clinic ProceedingsVol. 94Issue 5p920–921Published in issue: May, 2019- Hytham K.S. Hamid
Cited in Scopus: 0Ziegelmann et al1 recently published an interesting report titled “Wide variation in opioid prescribing after urological surgery in tertiary care centers” that strives to shed light on the mounting opioid crisis in the United States. In accordance with previous studies, the analysis revealed a considerable variation in postoperative opioid prescribing patterns both for a given procedure and among procedures. This was ascribed to patient-related factors such as younger age, male sex, cancer diagnosis, and prolonged hospital stay and more importantly to lack of standardization and physician and patient expectations. - Letter to the Editor
In Reply II—Root Causes of Opioid Crisis
Mayo Clinic ProceedingsVol. 93Issue 9p1330–1331Published in issue: September, 2018- Teresa A. Rummans
- M. Caroline Burton
- Nancy Dawson
Cited in Scopus: 1Dr Pendyal highlights an important point that the opioid crisis is much bigger than just the “supply side” of the problem. It is truly a biological-psychological-social-spiritual problem that impacts both the “supply side” and the “demand side.”1 However, in his description of the social factors, of which there are many, he too fails to acknowledge many of the drivers of the opioid crisis. Many of the drivers go beyond “unemployment, poverty, and wealth inequality,” with an increasing number of those dying from opioids being employed, middle- and upper-class individuals. - Letter to the Editor
The Root Causes of the Current Opioid Crisis
Mayo Clinic ProceedingsVol. 93Issue 9p1329Published in issue: September, 2018- Akshay Pendyal
Cited in Scopus: 2I read with a great deal of interest the article by Rummans et al1 and the accompanying editorial by Srivastava and Gold2 in the March 2018 issue of the Mayo Clinic Proceedings. - Letter to the Editor
In Reply I—Root Causes of the Opioid Crisis
Mayo Clinic ProceedingsVol. 93Issue 9p1329–1330Published in issue: September, 2018- A. Benjamin Srivastava
- Mark S. Gold
Cited in Scopus: 0We thank Dr. Pendyal for the thoughtful and articulate response to our article.1 We agree that a thorough examination of opioid use disorders and overdoses includes evaluation of structural- and societal-level factors. Indeed, income inequality, social disparities, and other structural inequities are important considerations in chronic illnesses, disease management, premature deaths, infant mortality, maternal illness, and all epidemics past and present, not just the current opioid epidemic. Similarly, depression, despair, hopelessness, and suicide are not exclusively linked to the current opioid crisis but are reflective of the state of health and wellness in our society. - Letter to the Editor
CAREFUL: A Practical Guide for Improving the Clinical Surveillance of Long-Term Opioid Therapy
Mayo Clinic ProceedingsVol. 93Issue 8p1149Published in issue: August, 2018- W. Michael Hooten
Cited in Scopus: 1To the Editor: National prescribing guidelines for opioid use provide recommendations for clinical surveillance aimed at enhancing the safe use of these medications in patients with chronic pain.1 However, despite the widespread availability of these guidelines, most clinicians do not follow recommendations for clinical surveillance.2 The purpose of this letter was to describe an acronym that provides a summary of many key components of clinical surveillance that have been recommended for patients receiving long-term opioid therapy. - Letter to the Editor
In Reply—Additional Safety Considerations Before Prescribing Opioids to Manage Restless Legs Syndrome
Mayo Clinic ProceedingsVol. 93Issue 7p955–956Published in issue: July, 2018- Michael H. Silber
- Philip M. Becker
- Mark J. Buchfuhrer
- Christopher J. Earley
- William G. Ondo
- Arthur S. Walters
- John W. Winkelman
Cited in Scopus: 0We thank Dr Geller for his interest in our article on the appropriate use of opioids in refractory restless legs syndrome (RLS). - Letter to the Editor
Additional Safety Considerations Before Prescribing Opioids to Manage Restless Legs Syndrome
Mayo Clinic ProceedingsVol. 93Issue 7p955Published in issue: July, 2018- Aaron S. Geller
Cited in Scopus: 0Silber et al1 are commended for espousing the merit of low and stable dose opioid treatment of refractory restless legs syndrome (RLS) given the risks of suicide and severely compromised quality of life if untreated. Opioid agreements reduce risks of RLS treatment with opioids as agreements mandate drug testing as well as frequent query of prescription drug monitoring programs. - Letter to the Editor
Interpreting Urine Drug Screen Results in the Context of Poppy Seed Use
Mayo Clinic ProceedingsVol. 90Issue 12p1734–1735Published in issue: December, 2015- Amy C.S. Pearson
- Jason S. Eldrige
- W. Michael Hooten
Cited in Scopus: 1The abuse of home opiate preparations derived from poppy seeds (PSs) is gaining popularity in the United States,1 and clinicians may increasingly encounter these patients in their practice. At least 5 American men have died after consuming poppy-based tea, most often in the context of urine drug screens (UDSs) positive for other illicit substances.1 Clinicians may find that their patients using PS tea are also using other opioids, which may present a challenge when interpreting UDSs. - Letter to the Editor
The Contribution of Patient Satisfaction to the Opiate Abuse Epidemic
Mayo Clinic ProceedingsVol. 89Issue 8p1168Published in issue: August, 2014- Ronald Lauren Hirsch
Cited in Scopus: 3In their editorial on opiate overdose, Berge and Burkle1 list the release of new opioid drugs, the aggressive marketing to physicians, the declaration of pain as “the fifth vital sign,” and the increased willingness of physicians to treat noncancer pain with opioids as the measures that led to the explosion of sales of prescription opioid pain relievers. It is imperative that 3 others be added to this list: the patient satisfaction survey industry, the Centers for Medicare and Medicaid Services (CMS), and hospital administrators. - Letter to the Editor
Benzodiazepine Oncogenesis as Mediated via Diminished Restorative Sleep Effected Sympathoadrenal Activation
Mayo Clinic ProceedingsVol. 87Issue 10p1034–1035Published in issue: October, 2012- Aaron S. Geller
Cited in Scopus: 1The valuable cohort contribution by Kao et al1 associating narcotic zolpidem consumption with heightened iatrogenic malignancy risks would be considerably more compelling if accompanied by proposition of a distinct plausible pathophysiologic mechanism. The most favorably received mechanism would define associations between the physiologic effects of zolpidem that are common to other pharmacologic agents and diagnoses that effect similar intermediary stepwise events epidemiologically linked to oncogenesis. - Letter to the Editor
Buprenorphine Maintenance Therapy in Opioid-Addicted Health Care Professionals Returning to Clinical Practice
Mayo Clinic ProceedingsVol. 87Issue 8p806Published in issue: August, 2012- Kevin Fiscella
Cited in Scopus: 0Hamza and Bryson1 argue against health care professionals returning to clinical practice while taking buprenorphine, based on purported neurocognitive effects. Their argument is based on weak science and flawed assumptions. Studies examining neurocognitive effects associated with buprenorphine are mostly based on small, selected samples and frequently fail to account for preexisting neurocognitive function or to distinguish between short- and long-term effects (after development of full tolerance) of the drug. - Letter to the Editor
Opioid Substitution Therapy for Dependent Health Care Practitioners: Approach With Caution
Mayo Clinic ProceedingsVol. 87Issue 8p803–804Published in issue: August, 2012- Paul H. Earley
Cited in Scopus: 1In a recent article in Mayo Clinic Proceedings, Hamza and Bryson visit the difficult decisions involved in returning addicted health care practitioners (HCPs) back to work; their article focuses on maintenance therapy of addiction disorders with opioid maintenance therapy. Specifically, they propose that “abstinence-based recovery should be recommended until studies demonstrate that it is safe to allow this population to practice while undergoing opioid substitution therapy.”1 They review the current (and limited) research on the cognitive effects of opioid medications, including buprenorphine. - Letter to the Editor
Buprenorphine Maintenance Therapy in Opioid-Addicted Health Care Professionals
Mayo Clinic ProceedingsVol. 87Issue 8p804–805Published in issue: August, 2012- Robert G. Newman
Cited in Scopus: 2In their article entitled “Buprenorphine Maintenance Therapy in Opioid-Addicted Health Care Professionals,”1 Hamza and Bryson draw a distinction between a “harm reduction and damage control model” of opioid-addiction management and treatment for which abstinence (including, very specifically, abstinence from prescribed agonists) defines both the treatment process and its therapeutic objective. The authors' notion that there is an inherent contradiction between continued prescribing of medication and a patient's “recovery” and the suggestion that reducing harm and controlling damage are not part and parcel of any practice of medicine are extraordinary. - Letter to the Editor
Buprenorphine Maintenance Therapy in Opioid-Addicted Health Care Professionals Returning to Clinical Practice: A Hidden Controversy
Mayo Clinic ProceedingsVol. 87Issue 8p805–806Published in issue: August, 2012- Jeffrey Selzer
- Sharon Stancliff
Cited in Scopus: 1The article by Hamza and Bryson1 cites several studies to support their opinion that health care professionals should not be returned to practice if their treatment includes opioid agonist therapy. The quality of the evidence cited is poor. Three of the studies2-4 evaluate the effects of buprenorphine in “healthy volunteers” rather than in patients after careful dose titration. Other studies are small and poorly controlled for the duration of therapy and other drug use. The most relevant study5 compares patients taking buprenorphine with those taking naltrexone. - LETTERS TO THE EDITOR
Safe Use of Opioids to Manage Pain in Patients With Cirrhosis
Mayo Clinic ProceedingsVol. 85Issue 10p959Published in issue: October, 2010- Keith M. Swetz
- Elise C. Carey
- Richard H. Rho
- William D. Mauck
- Kevin J. Whitford
- Timothy J. Moynihan
- and others
- Patrick J. Coyne
- Thomas J. Smith
Cited in Scopus: 6To the Editor: The duty to relieve symptoms, safely, is a preeminent one of health care professionals. We appreciate the concerns of Chandok and Watt1 about the need for cautious use of opioids, particularly in patients with advanced liver disease. Indeed, we concur that caution should be exercised by all health care experts in use of therapeutics. However, we have concerns with the recommendations by Chandok and Watt1 regarding opioid use. Although the fear of precipitating encephalopathy or causing excessive sedation is real, an equally cogent concern is that this fear may result in less-experienced practitioners thinking that pain must be experienced regardless, or that opioids are not safe to be used in patients with cirrhosis. - LETTERS TO THE EDITOR
Safe Use of Opioids to Manage Pain in Patients With Cirrhosis–Reply–I
Mayo Clinic ProceedingsVol. 85Issue 10p960Published in issue: October, 2010- Kymberly D.S. Watt
- Natasha Chandok
Cited in Scopus: 0We thank Swetz et al for their insightful comments. They bring forth valuable contributions to pain management in a subset of patients with liver disease who require palliative care, which we did not differentiate adequately. Because our article was intended to be an overview of outpatient (and/or transient inpatient) pain management, admittedly we did not address the extremes of pain management discussed in the letter by Swetz et al. Our goal was to provide clinicians with a broad approach to cirrhotic patients with pain (patients with abdominal pain, headaches, and joint pain, as well as those with more severe chronic pain). - LETTERS TO THE EDITOR
“Practical Guide” to Urine Drug Screening Clarified
Mayo Clinic ProceedingsVol. 83Issue 7p848–849Published in issue: July, 2008- Gary M. Reisfield
- Roger L. Bertholf
Cited in Scopus: 3To the Editor: Moeller et al1 recently provided a timely and important review of urine drug screening. Drug abuse is a serious medical and social problem in the United States. Urine drug testing (UDT) to detect abuse and diversion of prescription controlled medications, as well as abuse of illicit substances, is increasingly important in clinical medicine. Physicians' ability to accurately interpret UDT results, however, is poor.2–4 Education is critical; equally critical is the dissemination of accurate information. - COMMENTARY
The Sickle Cell Crisis: A Dilemma in Pain Relief
Mayo Clinic ProceedingsVol. 83Issue 3p320–323Published in issue: March, 2008- Alan K. Geller
- M. Kevin O'Connor
Cited in Scopus: 30Sickle cell anemia is a progressive hemoglobinopathy producing chronic hemolytic anemia, microvascular thrombosis, ischemic pain, tissue infarction, decreased quality of life, and ultimately shortened life expectancy.1,2 In sickle cell anemia, valine is substituted for glutamic acid in the sixth amino acid of the β-globin chain. In a person who is homozygous, all hemoglobin is of the abnormal HbS type, and repeated episodes of sickling result in a less malleable molecule even at sites of normal atmospheric pressures of oxygen. - Book Review
Current Pain Management
Mayo Clinic ProceedingsVol. 82Issue 8p1023Published in issue: August, 2007- Marc A. Huntoon
Cited in Scopus: 0Type and Scope of Book: A multiauthored compilation of topics that are relevant to contemporary management of cancer pain, with a multidisciplinary approach to appeal to a broad readership. - Letters to the Editor
Fibromyalgia and Pain Management: In reply
Mayo Clinic ProceedingsVol. 75Issue 3p316–317Published in issue: March, 2000- Robert M. Bennett
Cited in Scopus: 0In reply: I am sure Dr Sartin's letter embodies many of the concerns and prejudices of other physicians involved in treating patients with chronic pain problems. My article does not conclude that all fibromyalgia patients should be treated with narcotics. To quote: “Opiates are seldom the first choice of analgesics in chronic pain states, but they should not be withheld if less powerful analgesics have failed.”1 - Letters
Approaches for Management of Postoperative Pain: The authors reply
Mayo Clinic ProceedingsVol. 65Issue 7p1031–1032Published in issue: July, 1990- Lon J. Lutz
- Tim J. Lamer
Cited in Scopus: 0We appreciate the opportunity to reply to Dr. Wang's letter. He asserts that, in our recent review, we failed to mention the common practice of administering analgesic medication to the patient with postoperative pain. In the opening paragraph of our article, we mentioned conventional parenterally administered opioid analgesia by describing a study in which 75% of patients were inadequately controlled with this treatment.1 We also pointed out other studies that had similar results.2,3 A discussion of patient-controlled analgesia was included, and, as mentioned, many studies have proved the superiority of this method over conventional intermittent intramuscular administration of analgesia. - Book Reviews
The Role of Drug Treatments for Eating Disorders
Mayo Clinic ProceedingsVol. 62Issue 8p754–755Published in issue: August, 1987- Alexander R. Lucas
Cited in Scopus: 0In this concise multiauthored book, the theory and practice of drug treatments for patients with anorexia nervosa and bulimia nervosa are reviewed. The following substances are discussed: monoamine oxidase inhibitors, tricyclic antidepressants, antianxiety drugs, neuroleptics, lithium, anticonvulsants, drugs that affect serotonin, opioid antagonists, and drugs that facilitate gastric emptying. In this evolving area of practice, whether to use medications in the treatment of patients with eating disorders is a hotly debated issue.
