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OAG’s pain physicians have provided comprehensive and interventional pain treatment in the Portland community for more than 15 years.
Our clinic, OAG Interventional Pain Consultants, is a referral-based practice that prides itself on collaborative relationships with primary care physicians, pain psychologists, physical therapists and other medical specialists, assuring excellent continuity of care. Six physicians, all board-certified in pain management, practice at our pain clinic.   Combined, they bring more than 80 years of experience and a shared specialty in the treatment of chronic and acute pain.
Physicians at OAG  Interventional Pain Consultants are adept at performing traditional interventional pain procedures such as facets and nerve blocks as well as proven and effective state-of-the-art modalities. We provide the latest in diagnostic and therapeutic interventional pain procedures for acute, chronic, cancer, and pediatric pain management. Lips are the most delicate and soft organ in our body and they have very soft surface layers of skin.
Lips are exposed to hot rays of the sun as well as cold wind and dry air and hence subject to dehydration. Exposure to sunlight, cold weather and dry air are the main cause for the formation of chapped lips. Cheilitis is a condition in which there is painful inflammation on the lips which is more common in diabetic patients and autoimmune disorder patients. Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website.
We have mapped many of our learning resources to the RPS Faculty's Advanced Practice Framework and Foundation programme.
Hub-and-spoke dispensing has the potential to change community pharmacy for the better but questions remain. The UKCPA has become the first Royal Pharmaceutical Society (RPS) affiliated partner group to be granted a double accreditation by the RPS. Brian OwensCorresponding AuthorBrian Owens is a freelance science writer based in New Brunswick, Canada.
Several different classes of prescription drugs are commonly abused, says Doug Throckmorton, deputy director of regulatory programs at the US Food and Drug Administration (FDA).
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Frank graduated from the University of Oregon and worked in medical laboratories as a phlebotomist and technician before his desire to work with people led him to become a physician assistant. Neurology and Pain Consultants is a professional medical practice dedicated to providing healthcare services (link to services page) to Advance, NC and surrounding area residents that emphasize wellness, prevention, and treatment.
For a caring and compassionate medical practice that thinks of you as family, contact Neurology and Pain Consultants today! We care for all types of pain-related cases ranging from neck and back pain, herniated discs, nerve pain, failed back surgeries, complex pain syndrome, arthritis, neuromuscular disease, and other common afflictions affecting more than 65 million Americans. If they lose moisture from their cells, lips become fragile and develop tiny cracks and splits.
Actinic cheilitis also known as “farmer’s lip” causes chapped lips when the skin is exposed to severe sun damage.
The euphoric effects of prescription painkillers, as well as stimulants and drugs designed to treat anxiety and trouble sleeping, can encourage some people to use them recreationally, with potentially fatal results. These include depressants a€” for example, benzodiazepines such as diazepam (Valium) and alprazolam (Xanax), used to treat anxiety a€” and stimulants a€” for example, the combination of amphetamine and dextroamphetamine (Adderall), and methylphenidate (Ritalin or Concerta), prescribed for attention deficit hyperactivity disorder.But by far the most widely abused, and dangerous, drugs are opioid painkillers, such as hydrocodone (Vicodin) and oxycodone (Roxicodone).

Non-medical use of prescription opioids and prescription opioid-related harms: why so markedly higher in North America compared to the rest of the world? With family in the industry and an interest in science, practicing medicine was a natural fit. He received his Master of Physician Assistant Studies from Pacific University in Forest Grove, Oregon, where he first became interested in pain management. John Porter had over 40 years of neurology experience when he opened Neurology and Pain Consultants in October 2014.
It can be precancerous condition and hence you need to check with your doctor if lips do not heal by self care remedies.
Others who start using these drugs therapeutically can go on to become addicted.The problem is a huge one. Slow-release oxycodone tablets, such as OxyContin, contain a huge amount of the drug, and so account for a disproportionate number of overdoses and deaths, says Throckmorton. Frank joined Pain Consultants of Oregon in 2006 and enjoys helping his patients safely and effectively manage their pain. In the United States, drug overdoses are the leading cause of accidental deaths, eclipsing even car accidents. Our competent staff work diligently to provide the highest quality of services to every patient in a warm and welcoming environment. And the UK joins the United States in the grim statistic that overdose deaths from prescription opioids outnumber those from heroin and cocaine combined.
A variety of approaches are being used to tackle the problem, including educating prescribers, monitoring prescriptions, introducing drug formulations that are tough to abuse and, ultimately, treating addicted individuals. The annual prevalence of abuse of opioid painkillers in the population is greater than 5% in the United States and more than 3% in Australia; across most of Europe it is well below 1%.
Heightened stress may activate the dormant virus (herpes simplex) to cause cold sores and chapped lips.
Do not use flavored balms which will tempt you to lick your lips often, leading to dehydration.
Although there are indications that opioids are also being abused in Asia and Africa, Niaz adds, there is not yet any good data on the prevalence.a€?The extent of misuse of prescription opioids in Europe is not in any way comparable to North America,a€? says Niaz.
In contrast, rates of heroin use are roughly the same on both continents.The extent of misuse of prescription opioids in Europe is not in any way comparable to North Americaa€?We havena€™t got a huge problem with misuse and diversion of opioids in the UK, with the possible exception of tramadol,a€? agrees Catherine Stannard, a consultant in pain medicine at Southmead Hospital in Bristol. Canada and the United States lead the world in per-capita consumption of prescription opioids a€” the United States alone, with 5% of the worlda€™s population, uses more than 80% of the worlda€™s oxycodone and 65% of the hydromorphone (Palladone).Differences in prescribing practices also play their part. Weaker regulatory restrictions, higher patient demand for a€?effective treatmenta€™, and a more pronounced for-profit organisation of healthcare in North America, particularly the United States, may have exacerbated the problem in this region[1].
In contrast, tighter control and surveillance over prescriptions in the UKa€™s NHS has probably kept the problem from reaching the same level, says Stannard.Doctorsa€™ greater flexibility and willingness to prescribe medications open to abuse in the United States is reflected in the way most people obtain these drugs.
Rather than getting them from illegal dealers, most of the drugs that are abused are prescribed legally and then diverted elsewhere, as friends or family members share them or leave them unguarded in medicine cabinets. This is particularly true of young people, who are at the highest risk of starting to abuse prescription drugs.Most do not pay, three-quarters of adolescents and young adults get them free from their friendsa€?For adolescents, the primary source is friends and relatives,a€? says Carol Boyd, who studies prescription medicine abuse at the University of Michigan in Ann Arbor.
For this reason, she feels that a large part of the responsibility for preventing abuse falls upon prescribers.a€?Every prescriber should tell their patients four things,a€? she says. In 2012, the agency introduced a requirement that the manufacturers of slow-release opioids make educational materials available to doctors and patients.

So far around 20,000 prescribers have taken educational courses, and the FDA hopes to increase that number to around 80,000 this year.
These are electronic systems that can show doctors, pharmacists and law enforcement officials what a patient has been prescribed over the past three to six months, who prescribed it, how many times a prescription has been refilled and other data.There is some patchy evidence from the United States that such systems can reduce overprescribing, but getting doctors on board is tricky.
Drug monitoring programmes are usually separate from other e-health records, and often have clunky or slow user interfaces.
Every state except Missouri has a system in place but participation rates are only around 35%, says Haffajee. Even in the 22 states where the programmes are mandatory, opposition from doctors a€” who, says Haffajee, a€?dona€™t like to be told what to doa€? a€” often delays full implementation[3].Deterring abuseAnother approach is to make the drugs themselves harder to use improperly. Stamford, Connecticut-based Purdue Pharma, which makes the often-abused painkiller OxyContin, was the first to add an a€?abuse deterrent formulationa€™ to its pills in 2010. The new pills are harder, so they can no longer be ground into a fine powder that can be snorted, and include a polymer that turns to gel when mixed with water, so they cannot be drawn into a syringe. To clarify the situation for the pharmaceutical industry, in April 2015 the FDA released guidelines on how it will evaluate abuse deterrence, so that companies can put the claims on their labels. It will probably involve adding a a€?prodruga€™ that will only activate the main ingredient when in the presence of a certain intestinal enzyme, he says.
To combat excessive pill-popping, it will also contain a small amount of a compound that inactivates that enzyme a€” if too many pills are taken at once, there will be enough of the compound to shut down the reaction.
A California-based company, Signature Therapeutics, is currently working on developing prodrug-protected pills.Drugs against drugsBut no matter how much effort is put into stopping abuse, it will be impossible to crack down on it completely, and some people will become dependent on, or addicted to, prescription drugs. The best way to treat addiction is with medication, says Kelly Clark, president-elect of the American Society of Addiction Medicine in Chevy Chase, Maryland, but there are not many medications available.a€?In the United States, there is only one prescribed drug class for which there are FDA-approved medications to treat addiction, and thata€™s the opioids,a€? she says.
In the United States, the opioid replacement therapy methadone can only be administered at specialised clinics, and doctors are limited in the number of patients they are allowed to treat with a combination of opioid replacement therapy buprenorphine and opioid antagonist naloxone (Suboxone). In much of Europe, methadone is also tightly controlled, but it can be provided in community pharmacies rather than special clinics.Many of the private clinics in the United States that treat addiction are also philosophically opposed to using drugs to help fight addictions, preferring to rely on 12-step type programmes that focus on willpower and behavioural change. But Clark says that approaches like these that can be successful for alcohol addiction simply do not work for drugs like opioids. Relapse rates after short detox treatments are greater than 90% within a week, and longer rehabilitation courses are similarly unsuccessful, according to Clark.Addiction is a chronic brain disease, and needs to be treated that waya€?They are not embracing the evidence,a€? she says. The number of overdose deaths from prescription drugs has levelled off since 2011, and seems to be on the decline.Overdose deaths from some opioid painkillers also seem to have plateaued in the UK in the past few years, but the overall picture is less rosy. Tramadol was recently reclassified in the UK, which Stannard hopes will lead to more careful prescribing and a drop in the number people misusing it.
The trick now, though, is to determine which of the myriad different interventions put in place by various groups around the country are having the biggest effect, so that they can be expanded and less successful ones scrapped or adjusted.It may be too soon to celebrate though.
As prescription opioids gained popularity among drug users over the past decades, rates of heroin use plummeted. But now, as authorities have cracked down, and prescription drugs such as OxyContin have become harder to get hold of and abuse, heroin is making a big comeback. The number of heroin overdose deaths in the United States increased fivefold between 2001 and 2013.

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