Steroid Over-Prescribing

Almost half of patients with rheumatoid arthritis (RA) in the U.K. receive glucocorticoids from primary care physicians, and of those who are prescribed glucocorticoids, more than half receive more than 10 mg a day…

Glucocorticoids have been used for RA for more than 60 years, and are effective for easing the pain and swelling associated with the disease. However, these drugs are associated with many potentially serious adverse effects, and current guidelines recommend that they be used for the shortest possible time and at the lowest effective dose.

“In the general population, glucocorticoids account for 2.5% of all adverse drug reactions leading to hospital admission,” Black and colleagues observed…

The median cumulative time spent on glucocorticoids was 10 months, the authors noted. “This highlights that some patients are taking glucocorticoids for longer than recommended, placing them at increased risk of developing side effects,” they observed…

When Steroids Cause Psychosis published at The Rheumatologist in 2010

Corticosteroids are used to treat inflammatory manifestations of many rheumatologic conditions. Doses necessary to control disease are frequently high (e.g., 1 mg/kg or greater), and therapy may be maintained for prolonged periods of weeks to months. In this setting, one out of every two to three patients prescribed steroids may develop psychiatric symptoms including psychosis, mania, delirium, and depression. The most common symptoms reported with corticosteroid therapy are hypomania, mania, and psychosis…

Glucocorticoid medications have been known to be associated with significant side effects involving behavior and mood, regardless of previous psychiatric or cognitive condition, since the early 1950s. But cognitive side effects of steroid medications involving memory and attention are not as widely publicized and may be misdiagnosed as separate conditions, such as attention deficit disorder (ADHD or ADD) in children or early Alzheimer’s disease in elderly patients…

(2010) Steroids as pain relief adjuvants

Withdrawal symptoms from corticosteroids include pain, nausea or vomiting, weight loss, depression, fatigue, fever, dizziness, and rebound symptoms that are unmasked when there is loss of symptom control once the corticosteroid is removed…

Posted at the Facebook page for Opposition to Kentucky HB 1-Reform HB 217 aka “Pill Mill Bill”:

(17 hours ago) Harmed Patient:  It should also be noted that in KY it is not only chronic pain patients being denied care, but also acute pain. Urgent care centers are prescribing toxic steroids for short term injury pain.

Plaintiff, currently age 41, suffered from low back pain and was given the recommendation to go to a pain clinic for treatment per her primary care physician. Plaintiff presented to Defendant doctor at his advertised pain clinic in June of 2008. Defendant reviewed Plaintiff’s recently performed MRI scans, diagnosed her with scar tissue and arthritis, and indicated to her “I can fix this”. Defendant, who is not a trained radiologist, disagreed with the radiological interpretation that Plaintiff was suffering from a herniated disc, and instead believed she had scar tissue and an arthritic condition.

Defendant’s treatment regimen consisted of injecting plaintiff with corticosteroids, predominantly 40 mg Kenalog injections, at the L-4/L-5 disc space. Between June 2, 2008 and October 10, 2008, a time frame of only four months, Defendant performed 9 separate corticosteroid injection procedures upon Plaintiff…

After Plaintiff had undergone several of the injections, her toes went numb bilaterally. Defendant assured her this was not an issue and stated “Don’t worry about it”. One month later after additional steroid injections, her left thigh went numb from her knee to her hip. Following the October 10, 2008 injection, Plaintiff’s pain and numbness increased and she stopped seeing Defendant doctor. Plaintiff contacted the licensing board and was informed that Defendant had not been certified as a pain management specialist and according to the licensing board representative, Defendant was practicing outside his scope of practice.

Plaintiff was hospitalized for an infection following the second corticosteroid procedure and subsequently has developed high blood pressure requiring medication. Furthermore, she has been diagnosed with an auto immune process that was proximately caused by the massive overuse of steroid injections by Defendant doctor. Plaintiff has also had to undergo disc fusion surgery in her lumbar spine by a neurosurgeon to stabilize the area where Defendant injected her with massive doses of steroids…

(10/26/2015) Common steroid does not reduce chronic pain after heart surgery

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