Latest news with #substanceusedisorder
Medscape
4 days ago
- General
- Medscape
Fact or Fiction: Postoperative Pain Management
Effective postoperative pain management is crucial for enhancing patient recovery and reducing complications. Guidelines emphasize a multimodal approach, integrating pharmacologic and nonpharmacologic strategies to address the complex nature of postoperative pain. This includes using regional anesthesia techniques, non-opioid analgesics, and complementary therapies tailored to individual patient needs. Such comprehensive strategies aim to minimize opioid consumption and associated adverse effects, thereby promoting better outcomes. Persistent opioid use is reported in up to 10% of opioid-naive patients more than 90 days after surgery. Among those discharged with opioid prescriptions, approximately 70% retain a supply at home — and of that, 90% is stored insecurely. A recent study published in JAMA found that spinal surgery, older age, longer hospital stay, history of substance use disorder, and previous opioid discontinuation before surgery were associated with new-onset persistent opioid use after surgery. These findings underscore the importance of minimizing opioid exposure in the perioperative period. Learn more about opioid abuse. The FLACC scale is a validated tool recommended for assessing postoperative pain in children 2 months to 19 years of age. However, it may be less suitable for evaluating procedural pain. In preverbal or nonverbal children with cognitive impairments, standard FLACC assessments can be less reliable. In such cases, the revised FLACC scale, which incorporates individualized behavioral cues, may offer a more accurate assessment. Learn more about pain assessment. Combined guidelines from the World Society of Emergency Surgery, Global Alliance for Infection in Surgery, Italian Society of Anesthesia, Analgesia, and Resuscitation, and the American Association for the Surgery of Trauma recommend multimodal analgesia, rather than the use of a single class of drugs, to manage postoperative pain. This approach enhances pain relief and helps reduce opioid consumption as well as adverse effects associated with a single drug class. In the absence of contraindications, acetaminophen, gabapentinoids, and nonsteroidal anti-inflammatory drugs are recommended as components of multimodal anesthesia. A step-up strategy that incorporates major opioid drugs when necessary should be employed. The Centers for Disease Control and Prevention similarly recommends a multimodal approach in their opioid prescribing guidelines. Learn more about perioperative medication management. IV administration provides the most rapid onset of analgesia but does not offer superior pain control compared to the oral route. As such, IV analgesics should be reserved for situations where oral administration is not feasible, as in cases of gastrointestinal dysfunction. Postoperative pain management guidelines concur that the oral route is the preferred route of postoperative analgesic administration. Learn more about local and regional anesthesia. Guidelines state that the TAP block is both a safe and effective approach to managing postoperative pain. Abdominal wall blocks serve as an effective component of multimodal analgesia, contributing to opioid-sparing strategies. TAP blocks have been shown to significantly reduce pain scores at 12 hours postoperatively. For laparoscopic abdominal procedures, a rectus sheath block may be considered an appropriate alternative to a TAP block within a multimodal analgesia plan. Learn more about the TAP block.
Yahoo
01-06-2025
- General
- Yahoo
St. Paul family nonprofit seeks to break the stigma of addiction in the Hmong community
Xianna MouaYang, Yeng Moua and Mai Moua are a family — one with a story of resilience, using the past to change the futures of those around them. Each of them has battled substance use disorder, which started in their teenage years. Together, they started a St. Paul nonprofit with the aim of destigmatizing addiction and mental health issues in the Hmong community. Koom Recovery was registered by the state and officially opened in November 2024, offering culturally specific peer support to Hmong Minnesotans across generations, seeking treatment, community, education and empowerment. 'The word Koom in English means 'join,' so we want all Hmong people to join us to talk about substance use disorder,' Yeng Moua said. 'We know that we cannot do this ourselves. We need elders, we need leaders, we need women and men, stories of success and individuals that have been living in long-term recovery to join together to be able to break the silence, break the stigma and break the shame.' The trio regularly connects with those experiencing homelessness and visits encampments to build trust and assess the needs of Hmong individuals. They use surveys to identify substance use disorder awareness, often provide food and harm-reduction supplies and assist people in obtaining IDs, which are needed for accessing housing and county assistance programs. 'A lot of individuals, without support, they become hopeless,' MouaYang said. MouaYang, whose brother has experienced homelessness, said the people they meet at encampments often lack support. She said if they are suffering from addiction or mental health issues, there often isn't anyone around to encourage them to seek recovery and provide the tools and resources to do so, especially if there are cultural barriers. 'Koom Recovery wants to be that support where they can feel safe and can come to,' MouaYang said. 'That's why we came up with this.' One couple Koom works with now said they could have used their help back when they first lost their home. Kim Thao and Toua Moua, a married couple from St. Paul, became homeless in 2017 after 'spiraling down a path of addiction' as Thao turned to drugs early in their marriage after a car crash. 'It took everything from us: our house, our job and most of our children that we lost to child protective services,' Toua Moua said. It was their first time living on the streets in tents, Toua Moua said, a life they hadn't before imagined. They were homeless for 3½ years, he said, and didn't realize how bad their addiction was until it started impacting their mental health and he began to consider taking his own life. 'If there were such an organization like this (Koom Recovery) when we were homeless and struggling with addiction, it would have helped so much,' Toua Moua said. The Woddle: A techy diaper-changing pad with a touchscreen and AI Prisons routinely ignore guidelines on dying inmates' end-of-life choices Astronaut one day, artist the next: How to help children explore the world of careers Former Sen. Bob Casey reflects on Biden's diagnosis, his own cancer fight Dozens sickened in expanding salmonella outbreak linked to recalled cucumbers Toua Moua and Thao were connected with Koom Recovery while in treatment at Minnesota Adult and Teen Challenge. The two have been in recovery for over a year and attend Narcotics Anonymous meetings and events with Koom Recovery. Toua Moua described Koom Recovery as a 'safe space,' and said that being in NA groups has allowed him and his wife to meet others like them, share their stories with vulnerability and receive support. 'We are so grateful that there is Koom Recovery, because in our (Hmong) community, there's no such organization or resource that supports brokenness or people who are homeless and addicted and now that there's such an organization, it's really helpful,' Toua Moua said. Yeng Moua, who grew up on the East Side of St. Paul with his sister Mai, said he got involved with a gang at age 12 and began using drugs. Mai Moua used from ages 14 to 17 and said the experience was common where they grew up. 'During that time, a lot of the kids that grew up in the same kind of environment really banded together more than anything, and that's kind of how the gangs started: people banding together to protect themselves from being the outsiders,' Yeng Moua said. To their Hmong elders and parents, however, drug use is shameful and seeking therapy or recovery didn't often feel like an option, Yeng Moua said. Now he said, he understands that his parents didn't have the education or the resources to help. 'They didn't know those two components to find us help, and so all they did was degrade us or compare us to others,' Yeng Moua said. 'But that played a role of breaking us down and it crushed us.' MouaYang said she was forced to marry at 16 as a punishment for skipping school and staying out overnight with a boy. Her drug use worsened with her then-husband and she said her family didn't fully understand how to help her. 'With the lack of education and knowledge our parents have, they can't say, 'if you're going through some stuff, go talk to your social worker,' or 'let's take you a doctor,' because they themselves don't utilize the service,' MouaYang said. Being forced to marry as a Hmong teenager as a solution for violating cultural values, even if it was based on an assumption, was common, MouaYang said. At 18, she divorced her then-husband because the marriage was unsafe and put her in danger, she said. In 2023, she married Yeng Moua, inspired by his love for God and his commitment to recovery, she said. MouaYang and Yeng and Mai Moua said they don't blame their parents for not knowing how best to support them. Where they step in is by taking on the responsibility to educate others on what support looks like. 'You can't change the future if you don't start with the youth, but then you can't help the people now if you don't try to enrich the knowledge of the elders,' MouaYang said. When beginning a substance abuse recovery journey, it's necessary to be understood, Mai Moua said. If someone doesn't speak the same language or understand their cultural context, it creates a barrier between them and their ability to seek resources or even understand what resources exist for their circumstances. 'When we're talking about recovery, we think that if you've got addiction, you just need to talk to anybody, but that's not true. It helps so much to talk to somebody who gets you or maybe understands the fears,' said Caddy Johnson, program director at Minnesota Recovery Connections. At Koom Recovery, culturally specific programming looks like incorporating traditional Hmong values and practices, language and shared experiences in their work. 'Sticking to the traditional modern American practices is not going to be effective for Hmong people,' MouaYang said. 'So if you're going to introduce mental illness to Hmong people, you've got to understand how they understand mental illness. You've got to look at their history.' MouaYang created events like Pho Recovery, a weekly gathering at Recovery Cafe in Frogtown, where anyone is welcome to join and share a pho dinner from 5 to 6 p.m. Mondays. Afterward, the gathering becomes more intimate, as those in or seeking recovery gather for a peer support group that fosters meaningful conversations, MouaYang said. She also created Beautifully Broken, a workshop inspired by the Japanese pottery technique kintsugi, which uses broken pottery to create a new, abstract and functional design. The process represents resilience and healing, MouaYang said – it shows how imperfections are a beautiful part of the story of a person in recovery and not something to be ashamed of. 'Events like that keep people motivated and it's like a fellowship where we build up one another,' Toua Moua said. 'What is Koom Recovery not doing,' Johnson said. They are at every outreach they can get their hands on, she said, because their work holds value in the Hmong community. Other regularly scheduled events include a weekly support group, All Recovery Meeting, hosted Wednesdays from 5:30 to 7 p.m. at Anything Helps, 3859 Fremont Ave. N. in Minneapolis; virtual recovery meetings from 6 to 7 p.m. every Friday; NA meetings from 9:30 to 10:30 a.m. Saturdays at Talent Masters Staffing, 96 Maryland Ave. in St. Paul; and Recovery Run, a weekly group run around Lake Phalen, every Saturday at 11 a.m. As a new and small organization, they utilize project-based contracts to fund initiatives and have yet to secure state grants, Yeng Moua said. To further fund their efforts, the trio uses out-of-pocket money and relies on donations and sponsorships to support their mission. 'Funding is hard, but we are going out of our way, even if it means sacrificing our own income, because that's just how much heart we have for this, because we know that these people need this,' MouaYang said. 'We know the Hmong community needs this seed planted.' When the desire for recovery grows within Minnesota's Hmong community, the need for qualified certified peer recovery specialists and accessible resources will increase, Yeng Moua said. However, training and certification are costly, he said. 'This support is vital to sustain our impact, raising awareness, educating about substance use disorder, and encouraging openness to modern treatment while honoring traditional practices,' Yeng Moua said. MouaYang and Yeng and Mai Moua currently balance working full-time jobs while continuing their education and building Koom Recovery from their home in St. Paul. 'Our community has long needed a dedicated recovery organization,' MouaYang said. 'We must break the stigma, shame and silence surrounding addiction. No one should suffer alone – support should be accessible in the most effective way, culturally specific and in a language every minority group can understand.' Koom Recovery's long-term goal is to have a dedicated space and expand their reach. By the end of 2025, the nonprofit hopes to be officially recognized as a recovery community organization (RCO) by the Minnesota Alliance of Recovery Community Organizations, Yeng Moua said, which, to his knowledge, would make them the first Hmong-led RCO in the nation. June 15: Better Together BBQ from 11 a.m. to 3 p.m. at Recovery Cafe, 499 Charles Ave., St. Paul. Koom Recovery joins this family-friendly event, which includes food, music and resources, hosted by Anything Helps, MRC and the Peer Advisory Council. Ellison drops objection to appointment of Otto Bremer Trust trustee's daughter One person revived the Memorial Day flags tradition at Fort Snelling National Cemetery. Here's why. U of M researchers are planting 'survivor' trees in hopes of defeating Dutch elm disease Judicial cookout for the homeless renamed for late founder Jim Randall In 17th year, Rick's Bike Sale surpasses $600K in donations for Dakota County nonprofits June 15: Peb Recover Family BBQ from 2:30 to 8 p.m. at Lake Phalen Island Picnic Shelter,1600 Phalen Drive, St. Paul. Families are encouraged to come out and share a meal together while sharing resources about preventing substance use disorder and recovery, hosted by Koom Recovery. June 17: Healing Out Loud from 8:30 a.m. to 4 p.m. at Wilder Foundation, 451 N. Lexington Pkwy., St. Paul. This public event is a partnership between local recovery organizations that provides opportunities to learn about substance use disorder and engage in conversations. For more information and events, visit This story was created in partnership with Power 104.7. To listen to this story, visit and click 'listen live.'
