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UrbanSpartan t1_j88s21r wrote

Reply to comment by designer_of_drugs in [OC]Combating The Opioid Epidemic Medicaid's Opioid Prescription Decline by Away-Pepper-9239

We literally use all of the drugs he listed for outpatient and inpatient management. In fact many of the post op patients now get High dose Ibuprofen, acetaminophen and Gabapentin as multi modal pain control as an alternative to opioids. I prescribe many of these daily.

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designer_of_drugs t1_j88sm4g wrote

Ketamine, alcohol, nitrous oxide… short acting injectable local anesthetic. None are reasonable for chronic pain management. Additionally the evidence for gabapentoids working outside neuropathy is extremely poor.

I didn’t say all were impractical, I said many.

…and high dose NSAIDs will end up killing more of your chronic pain patients than opioids.

Obviously multimodal is the way to go, but it’s also wrong to pretend we have easy, effective solutions for opioid replacement.

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