Steven A. King, MD, MS

Quick . . . name a class of prescription medications that, by most evidence, appears to be overprescribed and abused and the use of which has resulted in an increasing number of emergency department visits. If you said "opioids," you would be right.

In this 2-part video, Steven King, MD discusses the various causes of cancer pain and then focuses on role that psychiatrists can play in helping patients cope.

The report notes that pain is a significant public health problem that affects more than 100 million Americans, costs our society at least $560 to $659 billion annually, and can be severely detrimental to the lives of sufferers.

REMS programs are meant to focus on drugs that are associated with special risks that the FDA does not feel are sufficiently addressed by the standard prescribing information.

When it comes to analgesics, many options and various factors must be weighed to make the best choice for each patient.

The most important question is whether the new diagnostic criteria are an improvement. . . . I am highly skeptical that they are.

Apart from the lack of evidence supporting their use, is there any reason not to use patient opioid agreements and urine drug testings?

There have been multiple criticisms of both the proposed content of DSM-5 and the process by which it is being developed. I have expressed my concerns about its proposals for diagnoses dealing with pain, especially the creation of the new diagnosis of Complex Somatic Symptom Disorder, to readers of Psychiatric Times in my Pain Management columns.

Nothing can replace talking with patients. This can take substantial amounts of time, but it is the only way to obtain as clear a view as possible about whether a patient is benefiting from treatment.

Unless you have been living on a desert island for the past 2 years, you are well aware that the development of DSM-V is well under way.

Two new oral analgesics have recently been approved by the FDA: milnacipran (Savella) for fibromyalgia and tapentadol (Nucynta) for moderate to severe acute pain.

Persistent pain is not an inevitable part of aging, but it is, unfortunately, fairly common among those aged 65 years and older. Between 25% and 50% of the general geriatric population and 45% to 80% of those in nursing homes have this problem.

Over the past decade, NSAIDs have been on a roller-coaster ride almost as wild as that now being experienced by this country’s housing and financial markets. The selective COX-2 inhibitors-first celecoxib (Celebrex) and then rofecoxib (Vioxx) and valdecoxib (Bextra)-promised to revolutionize the treatment of pain.

As a licensed acupuncturist, I am often asked by both medical professionals and laypersons whether acupuncture actually “works” and whether it should really be considered part of a belief system rather than science.

The guideline divides the therapies it reviewed into nonpharmacological, nonsurgical, and pharmacological categories. The nonpharmacological category includes a wide range of modalities from treatments that patients can perform themselves, such as yoga and exercise, to psychotherapy, acupuncture, and a variety of physical therapy techniques, including heat and laser treatments.

Patients with low back pain (LBP) face many decisions, ranging from the nature and extent of the evaluation they should undergo to determining which treatments are likely to be most effective. These choices can be confusing not only to those who are in pain but also to their health care providers.

The use of cannabinoids for medical indications is the subject of ongoing debate. Some medical professionals and patients argue that cannabinoids have marked analgesic properties, while other physicians, who cite the still relatively scant literature supporting their use, are skeptical about their efficacy, especially in comparison with other currently available analgesics.

Although methadone (Dolophine, Methadose) is primarily thought of as treatment for opioid addiction, it is also an excellent and underused analgesic. This column discusses the issues to consider when deciding whether to prescribe methadone for pain relief.

New formulations of several opioids were introduced during the past year. This month's column reviews current recommendations for the use of these medications and how they compare with previously available opioids.

NSAIDs have long been considered first-line treatments for a variety of pain conditions--most notably, musculoskeletal pain. Many NSAIDs are available in over-the-counter preparations, so they are inexpensive and, for better or worse, can be obtained without consulting physicians or health care professionals. For most patients, these drugs were considered safe, except in those who are at risk for GI bleeding or who have renal dysfunction. The most common adverse effect associated with NSAID use is GI distress.

Each year, the CDC's National Center for Health Statistics creates a report on the current health status of the US. In addition to the issues usually addressed in this report, such as information on morbidity and mortality, vaccination rates, and use of health care resources, the recently released report contained a special feature on pain.

Treatment of Low Back Pain

First described more than 500 years ago, phantom limb pain (PLP) is a common disorder today; as many as 50% to 80% of patients who undergo amputation report experiencing pain in the missing appendage.

Diabetes mellitus (DM) has been a significant public health problem for many years. However, the number of cases is continuing to grow at such an alarming rate that some have suggested we are facing or are already experiencing a diabetes epidemic.

A review of the diagnosis and treatment of complex regional pain syndrome (CRPS).

Because complex regional pain syndrome (CRPS) is commonly misunderstood by both physicians and patients, patients may be misdiagnosed and may not receive appropriate treatment.

First described more than 500 years ago, phantom limb pain affects as many as 50% to 80% of patients who undergo amputation. Although it is easy to recognize and diagnose, its cause remains unclear, it can be difficult to manage successfully, and health care professionals often do not address it.