Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of serotonin and noadrenaline precursors on the training of the animals on emotionally different reinforcement was studied. 5-OTP (10 mg/kg) facilitated the training of rats on the food reinforcement, but aggravated it on the pain reinforcement. D, L-DOPA (20 mg/kg) facilitated the training on the food reinforcement. The influence of precursors on the peculiarity of the serotonin and noradrenaline distribution in the brain structures of trained animals was also determined by the biological significance of the reinforcement used in the training.
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PMID:[Characteristics of rat training on emotionally varied reinforcement under conditions of an oriented change in the level of brain serotonin and noradrenaline]. 30 22

In this issue of the Hastings Center Report, Joshua Rager and Peter Schwartz suggest using opioid treatment agreements as public health monitoring tools to inform patients about "the requirements entailed by undergoing opioid therapy," rather than as contractual agreements to alter patients' individual behavior or to benefit them directly. Because Rager and Schwartz's argument presents suspected OTA violations as a justification to stop providing opioids yet does not highlight the broader epistemic and systemic context within which clinicians prescribe these medications, their proposal may perpetuate a climate of distrust and stigmatization without correcting systemic factors that may have placed patients and others at risk in the first place. Given the context of epistemic uncertainty regarding opioid safety and efficacy, insufficient training for opioid prescribers, and inadequate patient education, I propose replacing OTAs, which have a narrow focus on patient behaviors, with opioid treatment plans, which would promote mutual, collaborative, and shared decision-making on the most appropriate pain management program. An OTP can be ethically justified as a tool to prevent and treat iatrogenic addiction under a specific paradigm-one that adopts a default position of professional epistemic humility and holds all collaborative parties accountable in chronic pain management.
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PMID:Reconciling Patient Safety and Epistemic Humility: An Ethical Use of Opioid Treatment Plans. 2854 18