Buy Opioids Online. For many years, health care providers like me were told that we were undertreating pain and that pain was a vital sign that needed to be measured. As a result, opioid prescriptions in the United States skyrocketed. A common way to compare opioids is to calculate their strength relative to morphine, called morphine milligram equivalents, or MMEs. In 1992, our country dispensed 25 billion MMEs of prescription opioids; by 2011, that number had reached 242 billion. Meanwhile, opioid-related deaths and treatment admissions increased in parallel. high-dose opioids Furthermore, there is increasing evidence that long-term opioid therapy is not very efficacious. Multiple studies culminated in the Centers for Disease Control and Prevention (CDC)’s 2016 Guideline for Prescribing Opioids for Chronic Pain, which states that providers “should avoid increasing dosage to 90 MME or more per day or carefully justify a decision to titrate dosage to 90 MME or more per day.” As a point of reference, a commonly prescribed opioid is oxycodone, the medicine in the brand name Percocet. Should patients on more than 90 MME be abruptly cut off? Should a rapid taper occur to get to the safe upper limit? A recent open letter written by a group called Health Professionals for Patients in Pain and signed by hundreds of experts across the country made some scathing accusations: insurer-imposed barriers, pharmacy limitations, and metrics were then applied that adversely affected patients on high-dose opioids; and some patients had even turned to suicide or illicit substance use as a result of this unnecessary suffering. Buy Opioids Online
Buy pain relief pills online. Cannabidiol, or CBD, is an active compound in the cannabis plant. CBD oil is gaining popularity due partly to early research that shows that it might be helpful for certain health conditions. Some anecdotal evidence suggests that CBD oil can help with the symptoms of attention deficit hyperactivity disorder (ADHD), but there is still very little scientific evidence to back this up. Anyone thinking of using CBD oil should be aware of the regulations in their area and never replace any standard ADHD treatments with CBD oil before speaking to a doctor. In this article, we look at whether CBD oil can help treat ADHD. We also discuss the possible risks and whether it is safe in children. What is CBD oil? CBD oil contains high levels of cannabidiol, which is an active compound in the cannabis plant. CBD oil is an oil that contains high levels of the compound cannabidiol, or CBD. CBD is one of more than 100 active compounds in the cannabis plant. Most people associate cannabis with another active compound called tetrahydrocannabinol (THC). THC is the compound that makes a person feel euphoric or "high" when they smoke or ingest it. CBD does not activate the same regions in the brain as THC, so it does not cause a high. CBD oil may have several potential health benefits because of how it interacts with the body and brain. The human body contains an endocannabinoid system, which includes receptors in the central nervous system. CBD interacts with these receptors, potentially triggering positive effects. Can CBD oil treat ADHD? There is little scientific evidence that CBD can help treat ADHD. Additionally, much of the research surrounding ADHD and CBD focuses on cannabis, which contains more than 100 compounds other than CBD. However, there are anecdotal reports from people saying that CBD oil helps them deal with ADHD symptoms, such as hyperactivity or restlessness. Many people choose to use the substance as part of their ADHD treatment. A small 2017 study looked at a group of adults with ADHD who were self-medicating with cannabis. The researchers noted an insignificant improvement in brain function and symptom reduction. There was a very slight improvement in markers of impulsivity and hyperactivity, but not enough to consider the drug more effective than the placebo. CBD oil and ADHD symptoms Further research will need to explore the effect that CBD oil has on ADHD symptoms. CBD oil might not be a treatment for ADHD, but it may help with managing specific symptoms that many people experience. Some people with ADHD struggle with anxiety, which can make their symptoms worse. There is minor evidence to show that CBD oil may help with symptoms of anxiety. A 2016 case studyTrusted Source backed up earlier claims by researchers that CBD may help with anxiety and sleep problems in children. Further research will need to explore this effect in a large cohort. A 2013 study also explored the relationship between symptoms of ADHD and cannabis use. People with subtypes of ADHD that involve symptoms of hyperactivity and impulsivity were more likely to use cannabis daily to manage their symptoms than people with inattentive subtypes of ADHD. However, it is unclear exactly what causes this subjective symptom relief. Additionally, this study focused on cannabis as a whole rather than just the CBD compound. More research on ADHD and CBD alone may help highlight its potential as a treatment. Potential risks and side effects People may have a range of reactions to CBD. Common side effects include digestive issues, such as an upset stomach or nausea. Some people also experience drowsiness or headaches, especially when taking higher doses. These side effects may go away with time as the person becomes used to the product. People who inhale CBD through vaping or smoking may also experience lung irritation and coughing. Researchers have notedTrusted Source that many of the potential long-term effects of CBD oil are unknown. Additionally, it is still unclear whether CBD affects hormones in the body, which may be especially concerning for developing teenagers. Additional research needs to investigate the potential for side effects in these areas. CBD oil is not subject to the same regulations as medicines, which puts it at risk for contamination. The manufacturers of a product may say that it is pure CBD oil, but it could contain other ingredients, such as THC. A product may also not contain the amount of CBD that it claims to, limiting its potential therapeutic effect. Is it safe for children? Doctors may recommend CBD for children in certain circumstances but will not usually advise it for ADHD. While there is some evidence to support the usefulness of CBD in children with specific medical conditions, such as epilepsy, there are also major concerns. A study in the journal Drug and Alcohol DependenceTrusted Source noted that children who use cannabis before the age of 16 years may have a higher risk of cognitive impairment as their brain is still developing. It is not clear whether this remains true for CBD extracts and CBD oil as well. Children with ADHD are also at a higher risk for substance abuse. Although this may not be an issue for nonpsychoactive CBD oil, other sources of CBD, such as marijuana, may contribute to addiction. Research from 2014 found that children with ADHD are about 1.5 times more likely to meet the criteria for marijuana use disorder. Buy pain relief pills online Although CBD oil is not marijuana, some parents and caregivers have concerns about the association and may prefer not to introduce the product to a child. Anyone who thinks that CBD oil may relieve their child's symptoms should talk to a doctor and explore all of their options. How to use CBD may be available in some pharmacies and online outlets. CBD oil is available in a few different forms. The oil is available on its own in some pharmacies and online. Producers may also create CBD-infused treats and snacks. People who do not like the flavor or texture of the oil may wish to consume it in capsules instead. Those who already smoke or vape may choose to vape CBD oil. Currently, there are no guidelines on the effective dosages for CBD, so a person should always aim to use the lowest possible dosage to treat their symptoms. Some CBD oil producers have their own guidelines for dosing, but anyone who is uncertain should talk to their doctor before using the product. The authors of a 2017 review in Cannabis and Cannabinoid ResearchTrusted Source noted that adults can tolerate doses of up to 1,500 milligrams per day. However, the tolerated dosage will be significantly less in children. Buy pain relief pills online
Buy Pain Medications Online. Robert H. Shmerling, MDFaculty Editor, Harvard Health Publishing All medications come with a dose of risk. From minor side effects to life-threatening allergic reactions, every decision to take a medication should be made only after the expected benefits are weighed against the known risks. You aren’t on your own in this: your doctor, your pharmacist, and a trove of information are available for your review. Recently, I wrote about how newly approved drugs often accumulate new warnings about their safety, including a gout medication that garnered a new warning due to an increased risk of death. Now, according to a new study, the common prescription pain medication tramadol may earn a similar warning. Tramadol is unique When first approved in 1995, tramadol was not considered an opiate (like morphine or oxycodone) even though it acted in similar ways. However, because there were cases of abuse and addiction with its use, the thinking and warnings changed. In 2014, the FDA designated tramadol as a controlled substance. This means that although it may have accepted use in medical care, it also has potential for abuse or addiction and therefore is more tightly regulated. For example, a doctor can only prescribe a maximum of five refills, and a new prescription is required every 6 months. Compared with other controlled substances, tramadol is at the safer end of the spectrum. Heroin, for example, is a Schedule I drug (high abuse potential and no acceptable medical use). OxyContin is a Schedule II drug (it also has high abuse potential, but has an accepted medical use). Classified as a Schedule IV drug, tramadol is considered useful as a pain reliever with a low potential for abuse. Despite these concerns, tramadol is one of many common treatments recommended for osteoarthritis and other painful conditions. Several professional societies, including the American Academy of Orthopaedic Surgeons, include it in their guidelines as a recommended drug for osteoarthritis. Buy Pain Medications Online New research on tramadol Researchers publishing in the medical journal JAMA examined the risk of death among nearly 90,000 people one year after filling a first prescription for tramadol or one of several other commonly recommended pain relievers, such as naproxen (Aleve, Naprosyn), diclofenac (Cataflam, Voltaren), or codeine. All participants were at least 50 years old and had osteoarthritis. Those prescribed tramadol had a higher risk of death than those prescribed anti-inflammatory medications. For example: naproxen: 2.2% of the tramadol group died vs. 1.3% of the naproxen groupdiclofenac: 3.5% of the tramadol group died vs. 1.8% of the diclofenac groupetoricoxib: 2.5% of the tramadol group died vs. 1.2% of the etoricoxib group. Meanwhile, people treated with codeine had a similar risk of death to people treated with tramadol. However, because of the study’s design, the researchers could not determine whether tramadol treatment actually caused the higher rates of death. In fact, the patients for whom tramadol is prescribed could make it look riskier than it truly is. What is confounding? Medical research studies may draw faulty conclusions for a number of reasons. Perhaps there were too few participants to find meaningful differences. Maybe the dose of the treatment was too high or too low. But a major source of error in studies is called confounding. It means an unexpected or external factor — not the one actually being examined — has led to the observed results. For example, let’s say two groups are compared for the risk of heart attack and the group with the higher risk has a less healthy diet. One might conclude that dietary choices led to poorer heart health. But what if those with the unhealthy diet also smoked far more than the healthy eaters? The smoking could be the real culprit. It is a confounder that must be accounted for if the research is to have credibility. How could confounding affect the study results? With this new study of tramadol, confounding is a real concern. For example, for a person who has both kidney disease and arthritis, doctors may prescribe tramadol rather than naproxen because the latter may worsen kidney disease. Yet kidney disease could increase the risk of other health problems, including a higher rate of death, which could then be attributed to the tramadol. In other words, the very reason your doctor chose tramadol could make this medication appear riskier than it really is. The authors of the study acknowledge this possibility and took measures to limit it. In fact, many studies try to avoid these sorts of errors, but they are impossible to avoid completely. Buy Pain Medications Online The bottom line If you take tramadol, talk to your doctor about this study. While the higher rates of death among tramadol users is worrisome, it’s not clear that tramadol is the actual culprit. We’ll need more research to confirm — or refute — the findings. If tramadol does increase the risk of death, we want to understand why and what to do about it (for example, is it an easily avoidable risk, such as an interaction with other medications?). Further research can also help educate doctors and patients about all of the potential risks of tramadol treatment.
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