High doses of powerful narcotic painkillers appear to be linked to a higher risk of depression in patients, new research finds.
64. Say (O Muhammad 
): "O people of the Scripture (Jews and Christians): Come to a word that is just between us and you, that we worship none but Allah, and that we associate no partners with Him, and that none of us shall take others as lords besides Allah. Then, if they turn away, say: "Bear witness that we are Muslims."
): "O people of the Scripture (Jews and Christians): Come to a word that is just between us and you, that we worship none but Allah, and that we associate no partners with Him, and that none of us shall take others as lords besides Allah. Then, if they turn away, say: "Bear witness that we are Muslims."
65. O people of the Scripture (Jews and Christians)! Why do you dispute about Ibrahim (Abraham), while the Taurat (Torah) and the Injeel (Gospel) were not revealed till after him? Have you then no sense?
66. Verily, you are those who have disputed about that of which you have knowledge. Why do you then dispute concerning that which you have no knowledge? It is Allah Who knows, and you know not.
67. Ibrahim (Abraham) was neither a Jew nor a Christian, but he was a true Muslim Hanifa (Islamic Monotheism - to worship none but Allah Alone) and he was not of Al-Mushrikun (See V.2:105).
68. Verily, among mankind who have the best claim to Ibrahim (Abraham) are those who followed him, and this Prophet (Muhammad 
) and those who have believed (Muslims). And Allah is the Wali (Protector and Helper) of the believers.
) and those who have believed (Muslims). And Allah is the Wali (Protector and Helper) of the believers.
69. A party of the people of the Scripture (Jews and Christians) wish to lead you astray. But they shall not lead astray anyone except themselves, and they perceive not.
70. O people of the Scripture! (Jews and Christians): "Why do you disbelieve in the Ayat of Allah, [the Verses about Prophet Muhammad present in the Taurat (Torah) and the Injeel (Gospel)] while you (yourselves) bear witness (to their truth)."
present in the Taurat (Torah) and the Injeel (Gospel)] while you (yourselves) bear witness (to their truth)."
71. O people of the Scripture (Jews and Christians): "Why do you mix truth with falsehood and conceal the truth while you know?"
72. And a party of the people of the Scripture say: "Believe in the morning in that which is revealed to the believers (Muslims), and reject it at the end of the day, so that they may turn back.3. Aal-'Imran
The study focuses on a class of prescription narcotic painkillers called opioids, which include drugs such as Oxycontin and Vicodin. While most people use the medicines to ease pain, widespread abuse of narcotic painkillers is also a growing concern.
The new study involved 355 patients in Texas who reported low back pain at an initial medical visit and still had the pain one and two years later.
Although the study couldn't prove cause-and-effect, people who used higher doses of narcotic painkillers to manage their pain were more likely to have an increase in depression, the researchers found.
Learning more about the link between these painkillers and depression, along with what dosage might put patients at higher risk, "may inform prescribing and pain management" by doctors, wrote a team led by Jeffrey Scherrer, an associate professor for family and community medicine at Saint Louis University, in St. Louis.
The findings are published in the February issue of the journal Pain.
After the study was accepted for publication, the investigators continued their research and found "that most of the risk of depression is driven by the duration of use and not the dose," Scherrer said in a journal news release.
It "could be that the patients who increase dose were the longer-using patients," Scherrer said. "This is logical, as longer use is associated with tolerance and a need to increase opioids to achieve pain relief."
Too many women of childbearing age take narcotic painkillers, putting any unborn babies at risk, U.S. health officials said Thursday.
Thirty-nine percent of females aged 15 to 44 who were enrolled in Medicaid filled a prescription for a narcotic painkiller each year from 2008 to 2012, says a new report from the U.S. Centers for Disease Control and Prevention (CDC). Among privately insured women, that rate was 28 percent.
"We are concerned because we know that 50 percent of all pregnancies in the U.S. are unplanned," said CDC epidemiologist Jennifer Lind.
Using narcotic painkillers in early pregnancy can increase the risk for certain birth defects, including spina bifida (a defect of the spine), gastroschisis (a defect of the abdominal wall) and heart defects, Lind said. These drugs also have been linked with preterm birth, she said.
In addition, infants exposed to narcotics in the womb can be born with a condition called neonatal abstinence syndrome, according to the report. These babies experience symptoms of withdrawal from the drugs taken by the mother during pregnancy.
The study appears in the Jan. 23 issue of the CDC journal Morbidity and Mortality Weekly Report.
Lind said that most of the women in the study were prescribed narcotic painkillers to treat moderate to severe pain, such as after surgery.
"We encourage doctors to make sure that they are discussing pregnancy potential with their patients and understand that they may be treating two patients whenever they are prescribing reproductive-aged women," Lind said.
"We recommend that they use the lowest effective dose for the shortest amount of time possible, and birth control to reduce the risk of becoming pregnant while taking them," Lind said.
Dr. Jose Cordero, a member of the March of Dimes Board of Trustees, agreed. "If you are using an opioid painkiller, you should also be practicing effective birth control," he said in a statement Thursday.
"If you decide to get pregnant or do become pregnant, tell your health care provider about all the medications you are taking right away. You may be able to switch to a safer alternative," Cordero said.
Addiction to painkillers is a serious problem, Lind said. Depending on the pain level and the patient's medical condition, doctors may recommend an over-the-counter pain medication rather than a narcotic, she said.
The narcotic painkillers most commonly prescribed are hydrocodone, oxycodone and codeine, also found in some prescription cough medicines, Lind said. "Some familiar brand names are Vicodin and Percocet," she noted.
Another expert, Dr. Jill Rabin, agreed that women should take the lowest dose for the least amount of time.
"The biggest risk is that the baby can be born addicted and have to go through withdrawal," said Rabin, co-chief of the division of ambulatory care in the Women's Health Programs-PCAP Services at North Shore-LIJ Health System in New Hyde Park, N.Y.
She advises women with chronic pain to see a pain specialist to help find the best way to manage pain. If they feel they are becoming dependent on narcotic painkillers, she added, they should get help from a specialist who treats addiction.
Dr. Scott Krakower, assistant unit chief of psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y., said women shouldn't rush to take painkillers.
"Women should be cautious about what they are being prescribed," he said.
Alternative ways of managing chronic pain, such as acupuncture and yoga, are widely available, Krakower said, adding there also are non-habit-forming drugs.
The higher rates of narcotic painkiller use among Medicaid patients than those of privately insured women might be because of differences in the medications covered under their health insurance plan, differences in health care services, or differences in the prevalence of underlying medical problems, the researchers said.
For the study, CDC researchers analyzed 2008-2012 data from Medicaid, and another database of claims from women with private health insurance.
Data from private insurance indicated that prescriptions for narcotic painkillers were highest among reproductive-aged women in the South and lowest in the Northeast.
From Medicaid, the researchers found that white women of reproductive age had nearly 1.5 times as many prescriptions for narcotic painkillers as black or Hispanic women
The heart drug propranolol (Inderal) appears to be effective in treating "strawberry" birthmarks known as infantile hemangiomas, a new study finds.
About 3 to 10 percent of infants develop an infantile hemangioma, the researchers say. These red, rubbery-looking growths are caused by the abnormal buildup of blood vessels. Although harmless, they can cause physical and psychological harm, depending on their location.
"Propranolol is the first and only medical treatment approved to treat infantile hemangioma," said lead study author Dr. Christine Leaute-Labreze, a pediatric dermatologist at the University of Bordeaux in France.
She said the results of her study were key to U.S. Food and Drug Administration approval of propranolol for the treatment of infantile hemangioma in 2014. The drug -- a so-called beta-blocker used to treathigh blood pressure and angina -- works by starving the hemangioma of blood. This stops its growth, and eventually the cells in the birthmark die, Leaute-Labreze explained.
In the current study, propranolol was taken by mouth for six months.
Dr. Ana Duarte, director of pediatric dermatology at Miami Children's Hospital in Florida, said early treatment of infantile hemangioma is needed to prevent permanent disfigurement and scarring.
"If the tumor occurs near the eyes, nose, mouth or ear, there can be long-term functional problems, so it is important to intervene early," Duarte said.
She welcomed FDA approval of propranolol for the condition.
"In 2008, I was treating them with corticosteroids, which had many side effects," Duarte said. "I really welcomed this new treatment. It completely changed the way I treat my patients."
Without treatment, these birthmarks usually fade or flatten out within nine or 10 years, Leaute-Labreze said.
For the study, published Feb. 19 in the New England Journal of Medicine, the researchers identified 460 infants 1 to 5 months old with infantile hemangioma. They were randomly assigned to take one of four doses of propranolol, or a placebo.
After 24 weeks of treatment, the most effective dose of propranolol was 3 milligrams per kilogram of body weight daily, the researchers found.
Among infants receiving that dose, 60 percent had their birthmark disappear or nearly disappear, compared with 4 percent of babies receiving a placebo, Leaute-Labreze's team found.
In all, 88 percent of infants treated with propranolol showed improvement by the fifth week, compared with 5 percent of the infants given the placebo.
The researchers added that one in 10 babies getting propranolol needed another round of therapy.
Side effects of propranolol -- high blood sugar, high blood pressure, slow heartbeat or breathing difficulty -- were rare, the researchers said. And the rate of side effects did not differ significantly between the propranolol group and the babies receiving a placebo, they noted.
The study was funded by Pierre Fabre Dermatologie, the French drug company that makes propranolol for infants.
People withdepression might be more likely to commit a violent crime than those without depression, a new study suggests.
Researchers analyzed data from more than 47,000 people in Sweden who were diagnosed with depression and followed for an average of three years. They were compared to more than 898,000 gender- and age-matched people without depression.
People with depression were five to six times more likely than those in the general population to harm others or themselves, according to the researchers at Oxford University in England.
"One important finding was that the vast majority of depressed persons were not convicted of violent crimes, and that the rates reported are below those for schizophrenia and bipolar disorder, and considerably lower than for alcohol or drug abuse," study author Seena Fazel, a professor of psychiatry, said in a university news release.
"Quite understandably, there is considerable concern about self-harm andsuicide in depression. We demonstrate that the rates of violent crime are at least as high, but they don't receive the same level of attention in clinical guidelines or mainstream clinical practice," Fazel added.
Specifically, almost 4 percent of depressed men and 0.5 percent of depressed women committed a violent crime after their depression diagnosis, compared with slightly more than 1 percent of men and 0.2 percent of women in the general population.
The researchers defined violent crime as a conviction for any of the following: murder or attempted murder; aggravated or common assault; robbery; arson; sexual offences (including indecent exposure); and illegal threats or intimidation.
The findings are published Feb. 24 in the journal Lancet Psychiatry.
The study authors did not examine what effect treatment for depression had on the risk of violent crime, but they added that they plan to investigate this question in further research.
A growing number of Americans on work disability chronically use powerful prescription painkillers, according to a new study.
Researchers found that between 2007 and 2011, about 44 percent of people receiving Social Security Disability Insurance benefits were prescribed narcotic painkillers each year. And the percentage using the drugs long-term rose from 21 percent in 2007 to 23 percent in 2011.
Experts said the trend is worrying because narcotic painkillers -- which include OxyContin, Percocet and Vicodin -- can be addictive, or abused by people with existing drug problems.
What's more, when it comes to typical workplace injuries, narcotic painkillers are not a good long-term solution, the study authors noted.
"The effectiveness is at best uncertain, and the risks are very real," said researcher Ellen Meara, of the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, N.H.
The findings, reported in the September issue of the journal Medical Care, aren't surprising, Meara noted. Nationwide, prescriptions for narcotic painkillers -- also known as opioids -- surged 300 percent after 1999, according to the U.S. Centers for Disease Control and Prevention (CDC).
On Thursday, the U.S. Drug Enforcement Administration said it was proceeding with tough new controls on painkillers containing hydrocodone, which has been tied to a surge in dangerous addictions across the United States.
The new restrictions would cover prescription narcotic drugs such as Vicodin, Lortab and their generic equivalents, putting them in the same regulatory class as painkillers such as Oxycontin, Percocet and codeine. Patients will now only have access to a three-month supply of the drug and will have to see a doctor to get any refills.
The new Medical Care study focused on Americans younger than 65 who qualified for Medicare benefits because of long-standing work disabilities. Most had a "musculoskeletal" condition, such as chronic back, neck or joint pain, which don't, in the long run, respond well to prescription painkillers.
"In the short term, people get some relief," said Dr. Eric Collins, physician-in-chief at Silver Hill Hospital in New Canaan, Conn., which specializes in psychiatric and addiction treatment.
"But there's no good evidence that long-term use is effective for non-cancer pain," Collins said.
Despite that, Meara's team found an increase in chronic painkiller use -- defined as six or more prescriptions. By 2011, nearly one-quarter of disabled workers were using a prescription painkiller long-term.
On the other hand, prescriptions overall dipped slightly. They peaked in 2010, when just under 45 percent of disabled workers got a painkiller prescription. A year later, that was down one percentage point.
"I do think there will be less prescribing now," Collins said, noting the national concern over what many call an "opioid epidemic."
According to the CDC, about 12 million Americans abused prescription painkillers in 2010 -- meaning they used the drugs for nonmedical reasons. And in recent years, roughly 15,000 Americans have died annually from overdosing on the drugs. That's triple the rate in 1999.
Both federal and state governments have taken steps to control painkiller prescriptions. Some states now require doctors to check state-run prescription databases before prescribing a painkiller to help spot patients who are "doctor-shopping" to get multiple prescriptions of the same drug.
In this study, people who were chronically taking painkillers often had multiple providers. But Meara said it's not clear how many of them might have been doctor-shopping.
Multiple factors contribute to the widespread use of prescription painkillers, Collins said.
At one time, prescription painkillers were rarely used. But starting in the 1980s, there was growing concern that many people in chronic pain weren't adequately treated. Pain came to be considered the "fifth vital sign," Collins noted, and doctors began to increasingly turn to narcotic painkillers.
The drugs do bring quick relief -- at least in the short term. "It takes a lot longer to talk to patients about physical therapy, exercise and diet changes to lose weight, which might help with musculoskeletal pain," Collins said.
Plus, he noted, for people who have long been sedentary, the idea of becoming active when they're in pain could seem daunting.
"I think a lot of providers and patients may be overvaluing the immediate relief, and not taking the long view," Collins said.
Besides the risk of addiction, there are more common side effects of the drugs, such as chronic constipation. Also, research suggests that long-term use of prescription painkillers can ultimately worsen chronic pain, Collins said.
The truth is, Meara said, treating chronic pain is difficult. Common problems such as low back pain have no one-size-fits-all therapy, but a number of non-drug options exist, such as exercise, over-the-counter pain medications, acupuncture and biofeedback.
"We need to be cautious about moving to these drugs too quickly," Meara said. "And I think we need to be concerned about whether we're taking care of these patients adequately. We need to do a better job."
Narcotics (also called opioid pain relievers) are used only for pain that is severe and is not helped by other types of painkillers. When used carefully and under a doctor's direct care, these drugs can be effective at reducing pain.
Narcotics work by binding to receptors in the brain, which blocks the feeling of pain. When used carefully and under a doctor's direct care, they can be effective at reducing pain. Almost always, you should not use a narcotic medicine for more than 3 to 4 months.
NAMES OF NARCOTICS
- Codeine
- Fentanyl (Duragesic) -- available as a patch
- Hydrocodone ( Vicodin)
- Hydromorphone (Dilaudid)
- Meperidine (Demerol)
- Morphine (MS Contin)
- Oxycodone (Oxycontin, Percocet, Percodan)
- Tramadol (Ultram)
TAKING NARCOTICS
These drugs can be abused and addictive, and have been associated with accidental overdose deaths. Always take narcotics as prescribed. Your doctor may suggest that you take your medicine only when you feel pain.
Or, your doctor may suggest taking a narcotic on a regular schedule. Allowing the medicine to wear off before taking more of it can make the pain difficult to control.
Taking narcotics to control the pain of cancer or other medical problems does not itself lead to addiction.
Store narcotics safely and securely in your home.
You may need a pain specialist to help you manage long-term pain.
SIDE EFFECTS OF NARCOTICS
Drowsiness and impaired judgment often occur with these medications. When taking a narcotic, do not drink alcohol, drive, or operate heavy machinery.
You can relieve itching by reducing the dose or talking to your doctor about switching medications.
To help with constipation, drink more fluids, get more exercise, eat foods with extra fiber, and use stool softeners, if needed.
If nausea or vomiting occur, try taking the narcotic with food.
Withdrawal symptoms are common when you stop taking a narcotic. Symptoms include strong desire for the medicine (craving), yawning, insomnia, restlessness, mood swings, diarrhea. To prevent withdrawal symptoms, your doctor may recommend you gradually lower the dosage over time.
Alternative Names
Painkillers; Drugs for pain; Analgesics; Opiods
According to a recent report commissioned by the Office of National Drug Control Policy,1 as many as 1.5 million Americans were chronic heroin users in 2010. Such statistics add further fuel to concerns about rising narcotics abuse and drug-related deaths.Over the past five years alone, heroin deaths have increased by 45 percent2--an increase that officials blame on the rise of addictive prescription drugs such as Vicodin, OxyContin, Percocet, codeine, and Fentora, all of which are opioids (derivatives of opium).According to Gil Kerlikowske, director of the U.S. Office of National Drug Control Policy,3 approximately 100 Americans died from drug overdoses each day in 2010.Prescription painkillers were responsible for 16,600 deaths that year, and heroin was involved in about 3,000 deaths. (Meanwhile, cocaine use decreased by about 50 percent between 2002 and 2010.)The reason for the resurgence of heroin is in large part due to it being less expensive than its prescription counterparts, and US officials now warn that narcotic painkillers are a driving force in the rise of substance abuse and lethal overdoses. According to the US Justice Department, prescription opiates and heroin are two of the most lethal substances available.
Prescription Narcotics—A Driving Force in Rising Substance Abuse
This connection finally received some media attention following the death of Philip Seymour Hoffman,4 a 46-year-old Oscar-winning actor. He died from heroin overdose on February 2. Last year, Hoffman entered rehab when addiction to prescription painkillers led him to switch to heroin.US Attorney General Eric Holder recently announced his office is taking steps to address the problem head-on. This effort includes5 but is not limited to tracking drug overdose trends, educating health care professionals and the public about prescription drug abuse, and promoting programs shown to prevent such abuse.The federal government will also require manufacturers of extended-release and long-acting opioids to provide prescribers with educational programs explaining the risks and benefits of opioid therapy, and how to select appropriate candidates for such therapy. Also, as reported by Reuters:6"As part of that campaign, Holder reiterated the Obama administration's call for more law enforcement agencies to train and equip personnel with an overdose-reversal medication called naloxone... Holder said 17 states and the District of Columbia have amended their laws to increase access to naloxone, a blocking agent that can reverse the effects of an overdose and help restore breathing."
No comments:
Post a Comment