But the impact of smoking is all around us, even if we don’t see it. Statistics rarely tell a provocative story to compel people to action. The numbers behind the global smoking epidemic are so stark, however, they are almost incomprehensible. Behind every data point, a real person, family or community is impacted.

Let’s start with the challenge: More than 1.3 billion people – 17 percent of the global population – smoke cigarettes or consumes other tobacco products. Since the first World No Tobacco Day in 1987, nearly 300 million people have died from smoking-related illnesses, including tens of millions who died or suffered respiratory or cognitive impairment from second-hand smoke. If the average day is any gauge, thousands of children took up smoking yesterday, including the fastest rising of all groups: teenage girls. Beyond the impact of lives lost or harmed, smoking costs the global economy roughly $2 trillion in economic damage every year.

With that money, with those lives lost, what could be done to improve the world? A lot, as it turns out. That sum would fund the attainment of many of humanity’s most ambitious sustainability and poverty alleviation goals. We could facilitate an equitable transfer to cleaner energy technologies for industrialized and emerging markets. And to be blunt, we would have an honest shot at dramatically reducing cancer rates and chronic disease when a massive chunk of the world’s people isn’t inhaling products that contain more than 7,000 different chemicals with each puff.

Perhaps eliminating smoking is a pipe dream. Governments have imposed stiff taxes against tobacco products; research is being used to counter cigarette advertising; social stigma has built in many countries and health systems have made smoking habits increasingly punitive. But that hasn’t slowed the epidemic. We need better tools.

Around 60 percent of smokers globally – 780 million people – say they want to quit, but only 30 percent have access to resources to help them achieve that goal. That represents a massive market opportunity for the right solutions. Education and support networks are essential. However, smokers need access to more powerful cessation products to deliver a knockout punch. Fortunately, there is some good news on that front.

While smoking cessation products have been available for nearly two decades, they can have serious side effects and rebound rates. Last week, results for a confirmatory Phase 3 clinical trial – ORCA-3 – showed statistically significant results over six and 12 weeks. The study features a new cessation treatment called cytisinicline, a plant-derived alkaloid.

Most of the trial’s participants have been smoking for more than 30 years and have tried to quit on average four times. In the study, cytisinicline demonstrated a six-fold increase in the odds of maintaining continuous smoking cessation at six months compared to the placebo.

The new cessation treatment also produces far fewer side effects than routinely reported by people using other smoking cessation products. This is particularly important since compliance with treatment is a significant barrier that keeps millions of people from following through with their goal of quitting.

Cytisinicline opens a new front in the war to end smoking. The task is to ensure it and other tools reach the people who need it most. Advocacy groups and government agencies can help with this important next step by breaking down the barriers to access that frequently inhibit people from acting on the dream of kicking their smoking habit. It’s time to lend them a hand.

The post It’s Time for New Tools to Overcome Smoking appeared first on Medika Life.

Many of those people first received an opioid drug, not from a drug dealer, but from a doctor, prescribing it in good faith to treat pain. The question is: are opiates good for treating pain that is not from cancer. The latest research says, “No.” 

Researchers from Australia randomized two groups of patients who had 1 or more bone fractures that required surgery to receive either oxycodone — what they called a “strong” opioid — or acetaminophen and codeine (aka “Tylenol #3) to treat pain after they were discharged to the hospital. 

They found no significant difference in pain between each group, despite the fact that the oxycodone group had a 6-fold higher opioid dose. The study authors concluded, “These findings suggest that ongoing first-line strong opioid use after discharge from the hospital should not be supported” in those patients who had a surgically managed bone fracture. 

This is an important study. It further strengthens the recommendation that strong opioids such as oxycodone should not be used for noncancer-related pain. In fact, when thinking about a bone fracture, the mechanism of the pain after surgery has nothing to do with the opioid receptors in the body, and they are more likely due to the inflammation after the fracture and the surgery to fix it. 

In fact, the absolute best pain medicine I’ve used to treat the surgical pain of patients recovering from heart surgery — and this was confirmed to me by a physician colleague who had the surgery himself — has been ketorolac, which is an NSAID like ibuprofen. The only thing is, NSAIDs such as ketorolac can cause serious complications like bleeding and kidney failure (which I’ve seen in my practice). 

Still, even though opioids are ubiquitously used for post surgery pain, they really are not good drugs for the pain. This also goes for pain after dental surgery and procedures. As clinicians, we need to use less of them. 

Of course, it is not our fault if we prescribe an opioid for pain in good faith and our patients abuse the medication. At the same time, we need to heed the science about opioids for noncancer pain. The literature increasingly suggests that opioids are not effective and can lead to abuse and complications. Thus, we should prescribe less of these medications as much as possible. 

The post Oxycodone No Better in Treating Post-Orthopedic Surgical Pain appeared first on Medika Life.