Minerals such as selenium and zinc can also help reduce oxidative stress and support liver enzymes, Cherkaoui says, while choline aids fat transport. Dr. Williams says choline is the “unsung hero” in the liver health story.
Cognitive and affective responses may be influenced by spouses or other family members. Spirituality is often overlooked during pain assessment.
D., clinical dietitian manager at The Liver Clinic. Oxidative stress plays a role in liver disease progression to liver fibrosis and cirrhosis, according to a 2023 study in Antioxidants
Another option for opioid tolerant patients is buprenorphine, transdermal or buccal. Compared to full agonist therapy, buprenorphine has no ceiling on respiratory depression, generally provides good analgesia, gives consistent serum plasma levels, and does not lead to hyperalgesia or tolerance with the same frequency.
Disposal. Advise patients how to dispose of unused opioid medications safely and securely. Many options for disposal exist. Having unneeded opioids in the home is a vulnerability for patients and their families.
“A lot of people smoke to help calm anxiety and deal with stress,” says Dr. Solanki. “If you try one of these relaxation techniques it can boost your parasympathetic response. That helps diminish your anxiety, increases your level of focus and your ability to stay calm.”
Chronic pain differs from acute pain. Chronic pain is not acute pain Shop Now that failed to resolve. It is a distinct condition that is better understood as a disease process than as a symptom. Use a biopsychosocial approach in assessment and management.
“It’s a journey and everybody is in a different place in their journey,” says Dr. Solanki. “You may quit, then return to smoking at a later date and then try to quit again.”
Buprenorphine. Buprenorphine is a partial agonist opioid that is potent and long-acting. Consider prescribing it when a safer, lower adverse effect profile is preferred over full agonist opioids, or for patients who have developed tolerance to other opioids.
Compounded topical 5% morphine can provide local wound analgesia and may promote healing. It is only available at compounding pharmacies and can be expensive.
Beetroot is high in antioxidants like betalains that support liver detoxification, says Cherkaoui. Animal studies have supported this, but more human research on its effects is warranted.
Potential risks of opioid use for all patients include: physical adverse effects; cognitive impairment; social, personal, and family risks; failing urine screening; potential for opioid misuse.
“It’s OK if you have to start over again,” says Dr. Solanki. “A lot of people feel guilty about it. Relapsing doesn’t make you a failure.”
Read the medication guide. Read the medication guide for patients so that you understand how and when to take your medicine and what the major potential side effects are. If you have any questions, ask your pharmacist or health care provider.