Publications by authors named "W Allen Hauser"

837 Publications

[Critical discussion of new data regarding prevalence of opioid use disorder in patients with chronic pain in Germany].

Schmerz 2021 Sep 10. Epub 2021 Sep 10.

Innere Medizin, Klinikum Saarbrücken, Saarbrücken, Deutschland.

Background: There is no opioid crisis in Germany. However, new studies involving patients with chronic noncancer pain (CNCP) in Germany show an unexpectedly high prevalence of opioid use disorder according to DSM‑5 (Diagnostic and Statistical Manual for Psychiatric Diseases).

Objectives: Critical discussion of new study results on the prevalence of opioid use disorder in CNCP patients in Germany.

Materials And Methods: Selective literature search and multiprofessional classification of results by an expert panel (pain therapy, neurology, psychiatry, palliative medicine, general medicine and addiction therapy).

Results: The DSM‑5 criteria for the diagnosis of "opioid use disorder" have limited applicability to patients with CNCP, but may raise awareness of problematic behavior. The diagnosis of opioid use disorder is not the same as the diagnosis of substance dependence according to ICD-10, as the DSM‑5 diagnosis covers a much broader spectrum (mild, moderate, severe). Risk factors for opioid use disorder include younger age, depressive disorders, somatoform disorders, and high daily opioid doses. The interdisciplinary guideline on long-term opioid use for CNCP (LONTS) includes recommendations intended to reduce the risk for opioid use disorder.

Conclusion: An adaptation of the DSM‑5 diagnostic criteria of opioid use disorder to the specific situation of CNCP patients and a validation of these criteria could help to collect more accurate data on opioid use disorders of patients with chronic pain in Germany in the future. Prescribers should be sensitized to this problem without pathologizing or even stigmatizing patients. Further research is needed to classify this previously underestimated phenomenon.
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http://dx.doi.org/10.1007/s00482-021-00582-1DOI Listing
September 2021

Diagnostic and therapeutic care pathway for fibromyalgia.

Clin Exp Rheumatol 2021 May-Jun;39 Suppl 130(3):120-127. Epub 2021 Jun 21.

Rheumatology Unit, Internal Medicine Department, ASST Settelaghi, Ospedale Di Circolo, Fondazione Macchi, Varese, Italy.

Early diagnosis and timely and appropriate treatments positively influence the history of fibromyalgia syndrome (FM), with favourable repercussions at clinical, psychological, social and economic levels. Notwithstanding, there are still significant problems with timeliness of diagnosis, access to pharmacological therapies - particularly to innovative ones - and appropriate and effective taking in charge of patients. All the aforementioned factors have a great impact on FM patients' quality of life. Indeed, even though the World Health Organisation recognised FM as a chronic condition in the International Classification of Diseases 10th edition (ICD-10), many countries still fail to recognise the syndrome, and this negatively influences the capability to appropriately protect and care for patients. This is the case in several European Countries. In Italy, a few Regions have started to put in place precise indications for people suffering from FM, aiming at the implementation of diagnostic-therapeutic pathways. The Diagnostic-Therapeutic Care Pathway (DTCP) provides an important tool to meet the needs of patients suffering from chronic diseases. They present the organisation of an integrated assistance network. This includes a seamless path for disease prevention, diagnosis and treatment, by means of cooperation among physicians and other healthcare professionals.
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June 2021

Cannabis use of patients with inflammatory bowel disease in Germany: a cross-sectional survey.

Z Gastroenterol 2021 Jun 22. Epub 2021 Jun 22.

Department for Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany.

Background And Aims:  Progressive legalization and increasing utilization of medical cannabis open up potential new applications, including for inflammatory bowel disease (IBD). This study aimed to collect current figures on the use of and experience with cannabis among IBD patients in Germany.

Methods:  A 71-item questionnaire was mailed to a randomly selected representative sample of 1000 IBD patients.

Results:  Questionnaires were returned by 417 patients (mean age 49.1 ± 17.0 years; 55.8 % women; 43.4 % ulcerative colitis and 54.7 % Crohn's disease). Seventy-three respondents (17.5 %) stated past cannabis use for recreational purposes, while 12 users mentioned usage at the time the questionnaire was completed (2.9 %). Seventeen patients (4.1 %) indicated past use of cannabis, and 18 participants (4.3 %) reported current use of cannabis to treat IBD. Perceived benefits of cannabis use by its users included reduced abdominal pain, improved sleep quality, and relief of unease and worry. They reported lower quality of life and higher levels of anxiety or depression than non-users. Of notice, 52.9 % of cannabis users obtained their cannabis from the black market. A total of 76.5 % of former and 50 % of current users did not report their cannabis use to the physician.

Conclusion:  This survey reveals the largest data set on cannabis use among IBD patients in Germany, with the potential for further research. Cannabis is mainly procured from the black market, with unknown quality.
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http://dx.doi.org/10.1055/a-1400-2768DOI Listing
June 2021

Nociplastic pain: towards an understanding of prevalent pain conditions.

Lancet 2021 05;397(10289):2098-2110

Department Internal Medicine I, Klinikum Saarbrücken, Saarbrücken, Germany; Department of Psychosomatic Medicine and Psychotherapy, Technische Universität München, München, Germany.

Nociplastic pain is the semantic term suggested by the international community of pain researchers to describe a third category of pain that is mechanistically distinct from nociceptive pain, which is caused by ongoing inflammation and damage of tissues, and neuropathic pain, which is caused by nerve damage. The mechanisms that underlie this type of pain are not entirely understood, but it is thought that augmented CNS pain and sensory processing and altered pain modulation play prominent roles. The symptoms observed in nociplastic pain include multifocal pain that is more widespread or intense, or both, than would be expected given the amount of identifiable tissue or nerve damage, as well as other CNS-derived symptoms, such as fatigue, sleep, memory, and mood problems. This type of pain can occur in isolation, as often occurs in conditions such as fibromyalgia or tension-type headache, or as part of a mixed-pain state in combination with ongoing nociceptive or neuropathic pain, as might occur in chronic low back pain. It is important to recognise this type of pain, since it will respond to different therapies than nociceptive pain, with a decreased responsiveness to peripherally directed therapies such as anti-inflammatory drugs and opioids, surgery, or injections.
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http://dx.doi.org/10.1016/S0140-6736(21)00392-5DOI Listing
May 2021

[Pain therapy-neglected by gynecology? Endometriosis-neglected by pain medicine?]

Schmerz 2021 06 27;35(3):157-158. Epub 2021 May 27.

Medizinisches Versorgungszentrum für Schmerzmedizin und seelische Gesundheit Saarbrücken St. Johann, Saarbrücken, Deutschland.

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http://dx.doi.org/10.1007/s00482-021-00553-6DOI Listing
June 2021
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