5 Pharmacologic Options for Keeping Arthritis Non-Surgical

5 Pharmacologic Options for Keeping Arthritis Non-Surgical[EXTRACT]
Musculoskeletal arthritis affects millions of Americans each year. It represents an annoying source of pain, and finding a cure for arthritis would be the Holy Grail of medicine. Unfortunately, we don’t have a silver bullet right now, but we do have some treatments that can be very effective in allowing patients to live and function without incapacitating pain from the arthritis.One of the common things that patients experience with arthritis is similar to a pebble in one’s shoe. The pain comes on and typically just does not go away. It’s almost like a gnat at a family barbecue, that comes around for a bit and is extremely annoying, then leaves for a little bit, then comes back. All in all it makes for extremely irritating situation.Treatment for patients with arthritis can be very challenging. However, whether the arthritis is in the hip knee, shoulder, ankle, and, etc., most of the pharmacologic treatments can be similarly effective.Let’s discuss 5 of the most effective pharmacologic ways of treating arthritis while avoiding surgery at the same time.

Pharmacological therapy – The 1st method treatment involves acetaminophen (Tylenol), which is a great medication that can help with pain relief. It should not be taken over 4 grams per day, and maybe even less if the patient has a liver problem to begin with. However it is a very cost-effective medication and can alleviate pain on a regular basis for most individuals.
NSAIDS – Another great medication that is typically over-the-counter involves nonsteroidal anti-inflammatory’s. These are available in formulations such as ibuprofen, along with naproxen, among others. There are some NSAIDS that they’re still necessary to obtain a prescription, and actually to get higher doses of ones like ibuprofen you will need to obtain a prescription from your doctor. For instance, most of the ibuprofen that comes over-the-counter is in 200 mg per pill, whereas, a prescription can be upwards of 800 mg per pill. Typically the dough should not exceed over 2400 mg per day broken up into 3 doses.
Neuromodulating medications – There are additional neuromodulating medications that are coming into play now which include Neurontin, Lyrica, and other ones such as duloxetine. These are all prescription medications that can have some modulatory effects on the nerves that are bringing the pain sensation to the area of arthritis. In conjunction with other medications, they may help substantially. They can also be sedating, so patients need to be careful to make sure that they don’t take them for the 1st time and then go operate heavy machinery.
Opioids – Additional medications that can be used for arthritis include narcotic and non-narcotic opioid medications. These should not be taken on a consistently chronic basis. They should be more for acute inflammatory exacerbations and for short-term therapy. Otherwise, narcotic side effects can be substantial including but not limited to depression, constipation, tolerance, and addiction. This in turn will make the problem of arthritis even worse, because now the patient has a problem with being addicted to a controlled substance. So this should only be used in the acute situation.
Glucosamine and Chondroitin Sulfate – The medications including glucosamine and chondroitin sulfate have very little risk, unfortunately they only have minor clinical relevance. They’re available in health food stores or over-the-counter, so easy to obtain. They can help promote the growth of a slight amount of cartilage and also prevent the loss of some existing cartilage, hence some amount of pain relief be achieved. Therefore they can be of some value, although expectations need to be kept very low for these medications.

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Any attempt to avoid surgery for arthritis, pharmacologic options are abundant, patients generally need to be astute to make sure that they are taking them according to the manufacturers recommendations and they’re not being abused.

More On Methadone Treatment for Opioid Addiction

More On Methadone Treatment for Opioid Addiction[EXTRACT]
The suitable methadone dose is a popular subject amongst opioid treatment programs patients. What’s the ideal dose to treat somebody’s opioid addiction? The best answer to this question is:The lowest dose which effectively will eliminate an individual’s withdrawal symptoms to opioids.The objective in utilizing opioid replacement therapy includes removing the uncomfortable day-to-day withdrawal which interferes with an individual’s capability of normally functioning. The level of opiate withdrawal sickness differs from one person to another as does the severity of each individual’s opioid addiction.There will include various factors which influence how an individual will respond to varying dosages of methadone:• Number of years they’ve been opioid addicted• Amount and kind of opioids used• Method of use (injection, inhalation, or oral)

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• Frequency of use• Individual’s general state of health which includes liver functioningAs an individual’s tolerance and dependency to opioids builds up over time, they discover that they require higher quantities of opioids or stronger opioids to eliminate their symptoms of withdrawal.How Will The Center Decide How Much Methadone Is Needed?Induction is a treatment which carefully is followed by the center’s clinical staff to slowly assist a new patient in adjusting to their methadone medicine. Patients typically are started upon a safe methadone dose which introduces a low threat of overdose, and their dose then is increased every couple of days until the individual arrives at a dosage that successfully eliminates their withdrawal symptoms to opioids.Historically within methadone treatment centers, it’s within this period of induction when an individual is at a higher accidental overdose risk. For this reason, reputable centers begin their patients upon a safe dose and gradually raise the medicine level as the individual become adjusted to the medicine.Beginning a patient on a high methadone dose or raising the dosage too rapidly may put the individual in jeopardy of accidental overdose. Well-managed, high quality centers carefully will observe their patients while in induction and cooperate with them to get them to a dosage level that is comfortable as soon as possible, yet without taking unneeded risks.The Clinical Opiate Withdrawal Scale (COWS) includes an evaluation tool which is utilized to measure the extent of an individual’s withdrawal from opioids. The tool assesses the severity and presence of different withdrawal symptoms (such as restlessness, tremor, sweating, chills, nausea, etc.). It helps medical staff in deciding the necessity for a medicine increase and amount of increase which should be offered.

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What is the Average Dose for Most Patients?The average methadone dose is 80 milligrams to 120 milligrams for most individuals. Importantly, there will include a substantial amount of individuals who are very comfortable under 80 milligrams and numerous patients who might require over 120 milligrams. Dosing is extremely individualized. What will work best for one individual might not work well for an additional one.The proper methadone treatment dose will be that which eliminates opioid craving and withdrawal sickness, and that permits a patient to refocus on their goals and life.

Opiate Addiction and Types of Treatment Provided

Opiate Addiction and Types of Treatment Provided[EXTRACT]
Suboxone has produced the least amount of acclaim for drug addiction treatment, yet it is the one drug that is widely dispensed by physicians.If you are taking a prescription drug right now, chances are you are taking it incorrectly. Misuse is a major health problem in the United States. The U.S. Government estimates approximately 11 Million Americans are dependent on drugs, but there are more addicts than drug centers. A large percentage of addicts seeking help face long waiting lists and thus become hesitant to start a program once their name surfaces to the top of the list. Almost 70 percent of people face a waiting list for longer than thirty days.Those dependent on prescription drugs have a mind-set that is different from what addiction-free individuals believe. Addicts are resistant to letting go of their drugs. They typically justify their drug use because for many, they have gotten the drugs legitimately, from their doctor. Some addicts do not realize they are prone to addiction, and they can become hooked on a legal drug. Equally unfortunate is the addict who finally realizes they require help, and then seek help only to be placed on a waiting list. In the end, far too many addicts go untreated. It would seem the odds are against addiction treatment, but Suboxone relieves this problem since the guidelines to prescribe the drug is more relaxed and offer greater flexibility.

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What is Suboxone?Suboxone contains two active substances, buprenorphine and naloxone, both used to treat dependence on opioid drugs. The cost of treatment depends on the dose used and the frequency of services. This cost is higher than that of methadone treatment when the two drugs are served daily; however, there is greater flexibility in prescribing Suboxone.How Does Suboxone Work?Suboxone binds to opioid receptors, and thus produces welcoming effects of euphoria, and a secure comforting feeling, although at much lower levels than those addicts would of total opioid agonists such as methadone. The effects of these agonists are sufficient to allow addicts to stop the misuse of opiates, without encountering withdrawal symptoms.The Benefits of Suboxone· Less risk of respiratory problems
· Lower risk of overdose
· The withdrawal symptoms are less profound than when using methadone to combat addiction
· Euphoric symptoms occur lessAdverse Effects of Suboxone The side effects of Suboxone mainly occur when too much of the drug is taken. The symptoms are similar to the side effects of opiates:

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· Headache
· Sick
· Constipation (delayed bowel function)
· Poor sleep
· Sleepy
· Drowsiness
· Dizzy
· Sweaty
· Breathing difficulties (always contact a doctor)
· Dry mouth (brushing your teeth regularly and extra good care of your teeth)
· Slight pain is felt with less risk of causing more inflammation or untreated injuries
· Psychological problems (hallucinations, nightmares, depression) treatment should be coordinated with psychologist
· Itchy rash (contact your physician in connection with possible allergic reaction)
· Sleep apnea (consult a physician)
· Difficult to urinate (call a physician)Every drug has an adverse effect, yet the result of using Suboxone is positive.

When Treatment Becomes Addiction

When Treatment Becomes Addiction[EXTRACT]
Those addicted to prescription medications may be prescribed another medication to help overcome dependency. Suboxone is one such medication that can be beneficial for those who are attempting to lead a drug free life. Many are not aware that Suboxone is a narcotic and can be habit forming as well. Addiction to this medication is gradual and many do not recognize a problem until it is too late. Addiction to this or any medication is risky due to possible overdose and loss of life. Help comes in many forms, and those who discover a problem should not hesitate to seek help.Suboxone is an FDA approved medication and has been since 2002. It is used to treat addiction by combining the two meds buprenorphine and naloxone. These two medications work by delivering a mild euphoric feeling and deterring abuse by causing extreme withdrawal symptoms if taken improperly. Those who take this medication long term are exposed to the risk of addiction because it is a narcotic. Most who become addicted to Suboxone take it in a fashion that is not prescribed by a doctor.Opioids are pain medications prescribed to control mild to severe pain from injuries and sickness. Hydrocodone and oxycontin are powerful narcotics and dependency is a risk. Pain can be excruciating and disruptive to life, so many take too much pain medication and develop a dependency issue. Suboxone is often prescribed because of its ability to give a mild euphoria while the patient slowly detoxifies. The problem occurs when one addiction replaces another and Suboxone is taken improperly and with other medications like sleep aids or alcohol.

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Symptoms of Suboxone addiction are similar to the symptoms of opioid addiction. Feelings of dizziness and tremors or shakes are apparent when the medication is not present in the system. It is often when this medication is ceased that the problem is discovered. Withdrawal often means sleeping difficulty, nausea and vomiting, pain and cravings for the drug. Overdose is a very real possibility, especially if not taken properly. Overdose symptoms include passing out, body weakness, hypotension, shortness of breath and possible coma. These are life-threatening side effects of an overdose that require immediate medical attention. Treatment is offered for addiction to Suboxone in many forms.Treatment starts with detoxification. This process erases the drugs from the body’s receptors and decreases the need or cravings for the drug in question. Not taking Suboxone of course eliminates the risk for addiction, but this is not a preferred option for most. Since Suboxone has helped many overcome dependency many opt to take it even if aware of a possible dependency issue. Detoxification is a part of the healing process and something every addict must endure, but there are several ways to make this tolerable.Detoxification can be slowly or by complete cessation of medication. Both are effective, but slow detoxification with the aid of medications is preferable because it offers the best chance for success. Quick detox means possibly severe withdrawal symptoms, and this can mean failure for some. For many, withdrawal symptoms are too much to deal with, so they quit before detox is complete. Slow detox affords the opportunity to receive medications that aid in the recovery process. Medications to reduce symptoms of pain, nausea, sleeping difficulties and anxiety can be given if needed. Some will opt for sedation while detoxing as this means skipping the most extreme withdrawal symptoms completely. Sedation is done by anesthesia medications, and the patient is put into a voluntary coma where they can sleep through nausea, pain and anxiety.Follow-up care is important for recovery. This is crucial because it offers counseling and continuing help via medications to manage symptoms. Group therapy means speaking with a professional therapist or others who have an addiction problem. This offers support and the feeling of not being alone. Family therapy is an option, to include family member support and to help them understand and help in the healing process. Learning to avoid tempting situations and environments is a part of counseling. This teaches individuals to refrain from others who are still using drugs or areas where drugs may be purchased.

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Recovery from Suboxone addiction is possible with the right help. While it may be difficult to accept that addiction to another drug has occurred, this should not keep anyone from seeking help. Addiction to this medication is dangerous for health and well-being, and may cause death. Help is available in the form of medication, therapy and the willingness to beat dependency. Suboxone was designed to help beat addiction, and if used the right way, it does just that, but for those who develop a dependency, there is help available. A doctor can help best determine the right treatment option for obtaining a drug free existence and ensuring success.

A Look at Pill Addiction

A Look at Pill Addiction[EXTRACT]
Unfortunately pill addiction is becoming more and more predominate in today’s society. There are many complexities that are contributing to this uprising and concern today and both the why and how can it be prevented. According to the National Survey on Drug Use and Health in 2009, approximately 16 million Americans age 12 and older used a prescription for non-medical purposes at least once in the year prior to being surveyed, that prescription being either an opioid, stimulant, sedative, or analytic. We will review the why’s and how’s but before we go there, let’s get an understanding of what pill addiction is and the full extent of the problem on our hands.When it comes to pill addictions, they are broken down into three categories: 1) Opioids (used to treat pain symptoms); 2) Sedatives / Anxiolytics (used to treat anxiety and sleep disturbances); and 3) Stimulants (often used to treat attention difficulties). Now often times these symptoms may be legitimate thus stimulating a patient to speak to their physician who therefore begins to treat the reported symptoms with appropriate medications. The problem with this is that so many of these medications have a high abuse potential meaning that the medication if not used exactly as prescribed can be easily abused to get a desired effect/mood. Now add into the mix a patient with addictive tendencies and we have a serious problem on our hands. Medications like Vicodin, OxyContin, Ambien, Valium, Xanax, Adderall, and Ritalin are just a few of these abused medications. Changing the way these medications are ingested, using more than prescribed, and mixing with other substances are just three ways to abuse these pills. It should be noted that in no way are physicians to blame for this epidemic – rather they are just a means for an addict to obtain their pills. Physicians are one of many ways we see pill addicts getting these medications. Other ways include buying them on the street, taking someone else’s, stealing, etc. Let’s use opioids for an example.

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Say patient, John Doe, sought out his physician after having a serious skiing accident where he broke his ankle thus requiring a surgery to have screws attached to his broken ankle to assist in the healing process. Naturally, John had immense pain with this injury and his treating physician prescribed him OxyContin to treat the pain symptoms. During John’s recovery he continues to take his medication when experiencing pain, unfortunately John starts noticing that he isn’t getting the relief he used to have and increases his dosage until that stops working and he increases the dosage again (building up his tolerance). This pattern continues for twelve months. By this time, John’s injury has healed for the most part but he is still reporting pain. This is where the problem lies. Opioids can create a sense of euphoria and pleasure due to how the chemicals react to the chemical makeup of the brain – central nervous system. John has learned that and as a result struggles with letting go of those pleasurable moods. At this point, the psychological dependence surfaces and can go as far as deceiving John into thinking he still has pain (phantom pain) due to the OxyContin’s effects on John’s nerves. John then continues to report feeling the pain and now, due to having a high tolerance to the medication and having used it for such an extended period of time, John has a physiological dependence, as well. The problem for John is that now when he doesn’t use the OxyContin, he will begin to experience withdrawal symptoms such as restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, etc. John continues to rationalize his use and states that he is not addicted and he is only taking what his physician prescribed him for pain.This is precisely where the problem lies! John has developed an addiction to OxyContin that naturally he doesn’t acknowledge because he rationalizes his pill use, stating that his physician prescribed them. This is one example of a typical patient. The problem is John has both physiological symptoms and psychological symptoms. It is much easier for him to focus on the physical and struggle with seeing the psychological. John may eventually stop being able to get his pills legally and look to illegal methods such as buying them on the street, stealing/obtaining from friends, etc. This brings us to how do we help John to remove these opioids from his system and treat the addiction?

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There are many approaches currently being used to treat pill addictions and it really comes down to the specific pills being used with the objective being to completely eliminate them all together. As far as pharmaceutical interventions, currently opioids are the main class of prescriptions that use Medication-Assisted Treatment also known as MAT. Studies have shown that MAT in combination with behavioral therapy techniques have high success rates compared to those that don’t use MAT. For instance, Suboxone (a combination of buprenorphine + natrexone) can be used in collaboration with behavioral therapies and 12 Step facilitation to best help opioid patients (both for prescription opioids and street opioids such as heroin and opium). We have seen patients not using any type of MAT tend to lose focus of their desires for sobriety due to their struggles from withdrawing and their rates of using while in treatment are elevated compared to those that do incorporate MAT. Using more behavioral modification approaches and having constant collaboration with external providers are also a necessity.