youarewithinthenorms.com
NORMAN J CLEMENT RPH., DDS, NORMAN L. CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., INC.T. SPIRIT OF REV. IN THE SPIRIT OF WALTER R. CLEMENT BS., MS, MBA. HARVEY JENKINS MD, PH.D., IN THE SPIRIT OF C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., EVELYN J. CLEMENT, WALTER F. WRENN III., MD., JULIE KILLINGSWORTH, RENEE BLARE, RPH, DR. TERENCE SASAKI, MD LESLY POMPY MD., CHRISTOPHER RUSSO, MD., NANCY SEEFELDT, WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., NEIL ARNAND, MD., RICHARD KAUL, MD., IN THE SPIRIT OF LEROY BAYLOR, JAY K. JOSHI MD., MBA, AISHA GARDNER, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NJOKU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
Dr. Christopher R. Russo, M.D.
@Ledhedd2
Ketamine can be very useful in anesthesiology too. It is the sole anesthetic for bad hypovolemic shock for instance gunshot wounds bleeding out. Along with a paralytic and a little fentanyl. Can’t give anything that causes vasodilation until resuscitated or they die on induction.
EXCERPTS FROM:
Neat, Plausible, and Generally Wrong:
A Response to the CDC Recommendations for Chronic Opioid USE
Stephen A. Martin, MD, EdM;
Ruth A. Potee, MD, DABAM; and
Andrew Lazris, MD
Sep 7, 2016
A DIFFERENT NARRATIVE OF BALANCING SECURITY AND PRIVACY
“Our concern for individual patients is that recommendations and regulatory changes [62] concerning prescribed opioids are increasingly being developed not through evidence, but by a flawed narrative of how addiction develops and overdose occurs. [63,64]
The CDC was provided with descriptions of these flaws in the period of public comment, but chose to make only minor revisions.
Our concern for public health is that these recommendations do nothing explicitly to address the major source of prescription opioids used in substance use disorders in the United States: diversion. [65]
If the actual goal is to reduce the overall reservoir of prescription opioids in order to reduce diversion, that would be a worthy one.
The continued use of graphs that track kilograms of prescription opioids and overdose deaths, however, misleads when many of those “prescriptions” are taking place outside of a skilled, longitudinal, patient-clinician relationship.” [66,67]
________________________________________________/
63.Scholten W, Henningfield JE. Negative outcomes of unbalanced opioid policy supported by clinicians, politicians, and the media. J Pain Palliat Care Pharmacother. February 2016:1–9. doi:10.3109/15360288.2015.1136368.
64. Fields HL. The Doctor’s Dilemma: Opiate Analgesics and Chronic Pain. Neuron. 2011;69(4):591– 594. doi:10.1016/j.neuron.2011.02.001.
65.Policy Impact: Prescription Painkiller Overdoses. http://www.cdc.gov/drugoverdose/pubs/index.html. Published 2011.
66.Florida Office of the Attorney General. Florida’s Prescription Drug Diversion and Abuse Roadmap 2012–2015.; 2015.
67.MGH to Pay $2.3 Million to Resolve Drug Diversion Allegations | USAO-MA | Department of Justice. https://www.justice.gov/usao-ma/pr/mgh-pay-23-million-resolve-drug-diversion-allegations.
The data we provide here describe a more accurate narrative: Should other treatments not succeed, people suffering from intractable chronic pain may find that carefully monitored long-term opioids, in combination with other modalities, can help reduce their suffering and improve their function. The evidence indicates they can do so with a low risk of developing opiate use disorder and an exceedingly low risk of overdose death.
As with all treatments, the decision to use and continue long-term opioids should be one of ongoing shared decision-making.”
In an era where the need for national security often collides with individual privacy, it is essential to strike a balance. AI and advanced technology have undoubtedly revolutionized how information is collected and analyzed.
Still, it should be done within the boundaries of the law and with respect for individual rights. As technology advances, legal frameworks must adapt to ensure privacy rights are not eroded.
many people struggling with chronic pain
“Overall, the new recommendations sacrifice accuracy for a fabricated sense of clarity. We support efforts to reduce the scourge of opioid addiction and harm. Indeed, this is much of our own clinical work in primary care.
But this goal is better addressed by recommendations that consider both individual patient choice and the impact of prescribed opioids on public health through diversion, two very distinct issues.
The outcome might be less neat — yet still plausible — and have the added advantage of being beneficial to the
OR SEND
TO CASH APP:$docnorm
ZELLE 3135103378
ALL WATCHED OVER BY MACHINES OF LOVING GRACE
BE SURE TO DONATE TO THE MARK IBSEN GOFUNDME DEFENSE FUND, WHERE THE SON ALWAYS RISES!!!
PROCEED TO SERIES 5
FOR NOW, YOU ARE WITHIN
THE NORMS
REFERENCE:
THE TREE OF KNOWLEDGE CAN NOT BE SUPPRESS
Authors
Stephen Martin is a family physician and Associate Professor at the University of Massachusetts Medical School with a special interest in addiction and chronic pain; he is an education/research consultant to CleanSlate Addiction Treatment Centers. Ruth Potee is a family physician and addiction specialist. Andrew Lazris is an internist specializing in geriatric care and in evidence-based medicine. The authors declare no conflict of interest.
Corresponding author:
Stephen A. Martin, MD, EdM
University of Massachusetts Medical School
Barre Family Health Center
151 Worcester Road Barre, MA 01005
stmartin@gmail.com
The authors thank Bonny P. McClain MSc, of Data and Donuts for her graphical contributions.
THANK YOU FOR THE EXCERPTS
