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Record W2345654859 · doi:10.1093/pm/pnw085

The Opioid Pendulum and the Need for Better Pain Care

2016· article· en· W2345654859 on OpenAlexaffabout
Mary Lynch

Bibliographic record

VenuePain Medicine · 2016
Typearticle
Languageen
FieldMedicine
TopicOpioid Use Disorder Treatment
Canadian institutionsDalhousie University
Fundersnot available
KeywordsMedicineContext (archaeology)Medical prescriptionAddictionOpioidPsychological interventionPsychiatryHeroinChronic painFamily medicineNursingDrug

Abstract

fetched live from OpenAlex

Conflicts of interest: The author is a founding director of a small start up company researching nonpsychotropic cannabinoid formulations for treatment of pain and inflammation Panag Pharma Inc. There is a growing and disturbing trend against the use of medical opioids in the developed world. The fear of addiction continues to contribute to the under treatment of pain and further stigmatization of people living with chronic pain conditions. This fear has recently been fueled by reports of increasing opioid related deaths in a context of what came to be known as nonmedical prescription opioid use (NMPOU) [1]. A number of publications left the impression that the general medical use of opioids was the problem, leading to overly simplistic analyses and interventions that would limit the availability of and access to opioid medications [2,3]. In addition, the media have published articles that are unbalanced, using headlines that exaggerate and polarize the issue and ignore the contribution of other medications [4]. For example, a recent study has identified that the rate of overdose death among those also receiving a benzodiazepine was 10 times higher [5]. This has not been helpful in finding solutions to a complex problem and may have contributed to a fear among physicians of prescribing opioids. In fact, as presented below, the evidence from national surveys supports that since 2011 in the United States and Canada, the general use of opioids has decreased to a significant degree such that those of us on the front lines of pain management are finding that patients are experiencing difficulty accessing opioids when they are medically appropriate. In addition, the negative attention to “pain killers” has further stigmatized and harmed people suffering with pain [6]. The pendulum has swung too far …

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.003
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.891
Threshold uncertainty score0.315

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0030.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.001
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.008
GPT teacher head0.254
Teacher spread0.246 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations12
Published2016
Admission routes2
Has abstractyes

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