Best Case Ever 41 Opiate Misuse and Physician Compassion

Best Case Ever 41 Opiate Misuse and Physician Compassion

Opiate misuse is everywhere. Approximately 15-20% of ED patients in the US are prescribed outpatient opiates upon discharge. In Ontario, about 10 people die accidentally from prescription opiates every week. Between 1990 and 2010, drug overdose deaths in the US increased by almost four fold, eclipsing the rate of death from motor vehicle collisions in 2009. This was driven by deaths related to prescription opiates, which now kill more people than heroin and cocaine combined. Opiates are the most prescribed class of medication in the US. In 2010, one out of every eight deaths among persons aged 25 to 34 years was opiate-related. Four out of 5 new heroin users report that their initial drug was a prescription opiate. In Ontario, three times the people died from opiate overdose than from HIV in 2011. Yet, we are expected to treat pain aggressively in the ED. Dr. Reuben Strayer, the brains behind the fantastic blog EM Updates tells his Best Case Ever, in which he realizes the importance of physician compassion in approaching the challenging drug seekers and malingerers that we manage in the ED on a regular basis. This Best Case Ever is in anticipation of an upcoming main episode in which Dr. Strayer and toxicologist Dr. David Juurlink discuss how to strike a balance between managing pain effectively and providing the seed for perpetuating a drug addiction or feeding a pre-existing drug addiction, and how we best take care of our patients who we suspect might have a drug misuse problem.

Episoder(392)

Ep 209 Nondisabling Stroke Recognition and Management

Ep 209 Nondisabling Stroke Recognition and Management

In this Part 2 or our 2-part podcast update on ED stroke management with Dr. Katie Lin and Dr. Walter Himmel we explore non-disabling strokes, where symptoms are mild enough that patients can continue...

11 Nov 20251h 19min

Ep 208 Paradigm Shift in Ischemic Stroke Management Part 1: Disabling Strokes

Ep 208 Paradigm Shift in Ischemic Stroke Management Part 1: Disabling Strokes

We are amidst a paradigm shift in the emergency management of acute ischemic stroke. The traditional way of categorizing ischemic strokes as 'minor' vs 'major' is no longer relevant to what we do in t...

28 Okt 20251h 36min

EM Quick Hits 68 Osteomyelitis, Tourniquet Technique, Pediatric Distal Radius Buckle Fractures, DSI RCT, AMS in ESRD & Dialysis, EM Leadership Spotlight #3

EM Quick Hits 68 Osteomyelitis, Tourniquet Technique, Pediatric Distal Radius Buckle Fractures, DSI RCT, AMS in ESRD & Dialysis, EM Leadership Spotlight #3

On this month's EM Quick Hits podcast: Dr. Isaac Bogoch on recognition and management of osteomyelitis in the ED, Dr. Anand Swaminathan on tourniquet tips and tricks. Dr. Andrew Tagg on managing pedia...

7 Okt 20251h 25min

Ep 207 Sleep Strategies for Shift Work

Ep 207 Sleep Strategies for Shift Work

Discover evidence-based sleep strategies for shift workers. Optimize performance, recovery, and health with tips from sleep expert Dr. Michael Mak... If you find this beneficial please consider a dona...

16 Sep 20251h 21min

EM Quick Hits 67 Tick Borne Illness Update, Pediatric ECG Interpretation, Nailbed Repair, Closed Loop Communication, ESRD, Leaders in EM Dr. Catherine Varner

EM Quick Hits 67 Tick Borne Illness Update, Pediatric ECG Interpretation, Nailbed Repair, Closed Loop Communication, ESRD, Leaders in EM Dr. Catherine Varner

On this EM Quick Hits podcast: Tick Borne Illness Update with Dr. Issac Bogoch, Pediatric ECG Interpretation with Dr. Kathleen Stephanos, Nailbed Repair with Dr. Matthew McArther, Closed Loop Communic...

26 Aug 20251h

Ep 206 Massive Hemorrhage Protocols 2.0 – Update on the 7 Ts

Ep 206 Massive Hemorrhage Protocols 2.0 – Update on the 7 Ts

In this update to the 7 T’s of Massive Hemorrhage Protocols with Dr. Jeannie Callum and Dr. Andrew Petrosoniak, we explore the most current, evidence-informed strategies for bleeding patients, from po...

4 Aug 20251h 27min

EM Quick Hits 66 Pediatric Torticollis, Stable Wide Complex Tachydysrhythmias, Post-intubation Neurocritical Care, Hyponatremia Correction Rates, Paronychia Management, Women in EM Leader Series with Judith Tintinalli

EM Quick Hits 66 Pediatric Torticollis, Stable Wide Complex Tachydysrhythmias, Post-intubation Neurocritical Care, Hyponatremia Correction Rates, Paronychia Management, Women in EM Leader Series with Judith Tintinalli

On this EM Quick Hits podcast: Pediatric Torticollis with Dr. Deb Shconfeld, Approach to Stable Wide Complex Tachydysrhythmias with Dr. Anand Swaminathan, Post-intubation Neurocritical Care 5 best pra...

15 Jul 20251h 31min

Ep 205  Leading from the Inside Out: Building Teams, Trust and Purpose in Emergency Medicine

Ep 205 Leading from the Inside Out: Building Teams, Trust and Purpose in Emergency Medicine

In this podcast, with Dr. Thom Mayer, Dr. Carolyn Snider and Dr. Howard Ovens, on leading from the inside out, we cover foundational principles, practical habits, and transformative insights that can ...

24 Jun 20251h 38min

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