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MLSCI 466 > Pain Management > Flashcards

Pain Management Flashcards

1
Q

defin pain

A

unpleasant sensory and/or emotional experience typically associated with physical damage to the body

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2
Q

define chronic pain

A

lasts longer than three months
can occur w/out known cause, after injry has healed, or a condition has been treated

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3
Q

chronic primary pain

A

pain persists after body has healed or no identifiable causes

fibromyalgia, pelvic pain, musculoskeletal pain, lower back pain

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4
Q

chronic secondary pain

A

occurs together with underlying diseases or issues

cancer pain, post-surgical pain, and rheumatoid arthritis

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5
Q

__ in __ Canadians live with chronic pain

A

1 n 5

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6
Q

__% of Canadians living with chronic pain have lived with it for over 10 years

A

50%

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7
Q

how many Canadians over age 65 live with chronic pain?

A

1 in 3

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8
Q

__ to __% of people with substance abuse disorder report chronic pain

A

31-55%

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9
Q

highest prevalence of chronic pain in Canada

A

Indigenous people

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10
Q

chronic pain conditions in Indigenous peoples

A

diabetes 16%

arthritis 18%

chronic back pain 12%

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11
Q

direct healthcare cost for Canada regarding chronic pain

A

$7.2 billion/yr

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12
Q

combined direct and indirect cost of chronic pain in Canada =

A

$ 56-60 billion/ yr

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13
Q

the most common and most expensive cause of work-related disability in the population younger than 45 y/o

A

chronic back pain

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14
Q

the leading cause of long-term disability in adults, esp. in the 45-65 age range

A

arthritis

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15
Q

60% of ppl with chronic pain will…

A
  • loss their jobs
  • will have reduction in responsibilities
  • suffer income loss
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16
Q

people with chronic pain who are employed will lose ____ days of work per year

A

28.5

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17
Q

how many ppl in Alberta are estimated to have chronic pain

A

940 000

18
Q

total health expenditure spent on chronic pain in Alberta

A

6-8%

19
Q

how many people in AB take opioids for pain relief?

A

596 000

20
Q

how many ppl who use opioids in AB ar considered problematic users?

A

58 000

21
Q

how many deaths in 2023 (Jan-April) are from opioids?

A

613

22
Q

define non-specific low back pain

A

pain, muscle tension, or stiffness that occurs between the rib cage and inferior gluteal folds, with or without leg pain and has no identifiable cause

23
Q

specific low back pain

A

associated with an identified cause =
infection, fracture, arthritis, tumor

24
Q

what is the percentage of non-specific back pain in the total cases of back pain?

A

90%

25
Q

in the majority of pople with chronic back pain, the pain will resolve in __ weeks

A

2
- 20% to 40% will xperience another episode within the year
- 2 to 7% = chronic lower back
- 10% of cases cause more than 80% of the cos for low back pain

26
Q

what percentage of people return to work from sick leave from lower back pain within 1 week?

A

66%
- 90% within 2 months
- less than 50% = after 6 months
- virtually no one will return to work after 2 years

27
Q

patients with disabling pain or functional limitation should be referred to a specialist within…

A

2-6 weeks

28
Q

approach to pain treatment

A
  • indivs with chronic pain benefit from a multidisciplinary treatment approach
  • combined exercise and patient education significantly reduce pain
  • efficacy for chronic opioid therapy for chronic noncancer pain is limited
  • nonetheless, COT for chronic noncancer pain increased between 1980 and 2000
29
Q

T or F. Chronic pain and SUDs overlap

A

T
- 3-48% of chronic pain patients have SUDs
- 24-67% of patients with SUDs have chronic pain
- substance use may be a maladaptive coping response to pain

30
Q

broad spectrum analgesics used for treatment of

A

nociceptive and neuropathic pain

31
Q

published rates of abuse and/or addiction in chronic pain populations are __ to __%

A

3 to 19%

32
Q

known risk factors for addition to any substances are good predictors for ..

A

problematic prescription opioid use
- past cocaine use, h/o alcohol or cannabis use
- lifetime history of substance use disorder
- family history of substance abuse, a history of legal problems and drug and alcohol abuse
- tobacco dependence
- history of severe depression or anxiety

33
Q

risk of not Rx

A

continue addiction
unsuccessful detoxification
increase distress and anxiety may trigger relapse

34
Q

risk of Rx

A

may trigger relapse
pressured to supply opioids to addicted friends
maybe tempted to sell opioids to supplement income

35
Q

COT guidelines for high risk patients monitoring tools:

A
  • opioid treatment agreements
  • urine drug testing
  • opioid risk assessments helpful for long term use
  • pill counts

also:
- consultation with mental health/addiction spcialist
- constant need for re-eval
- discontinuation of COT for diverting opioids or serious aberrant behaviours

36
Q

______ drug testing is another tool in the tool box for appropriate care of patients with SUD and/or chronic pain

A

urine

37
Q

predictors of UDS ordering

A

younger age
positive cage questionnaire results
early stage of cancer or no disease status
high pain intensity
lower fatigue scores

38
Q

a primary care, managed approach to opioid therapy in chronic pain patients at risk for substance use

A

opioid renewal clinic

39
Q

45% of pts with previously demonstrated aberrant drug related behaviours were able to adhere to their medication regimes after:

A
  • management with urine drug monitoring
  • signed agreements
  • multispecialty care
40
Q

R03 recommendation statement

A

when using UDS t establish a baseline measure of risk or to measure compliance, be aware of benefits and limitations, appropriate test ordering and interpretation and have a plan to use results

MLSCI 466 (19 decks)

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