Moodle at CCNM

Traditional naltrexone has been used to help patients struggling with addiction to opiates or alcohol. However, for decades we have recognized that at lower dosages, aptly named Low Dose Naltrexone (LDN), we see an entirely different effect on the body. LDN has been shown to have a significant impact on immune function and inflammation. It has been studied and used clinically in Multiple Sclerosis (MS), Crohn’s, Sjogren’s, Hashimoto’s, Lupus, Rheumatoid Arthritis and more. Understanding its mechanisms of action and analyzing literature as well as clinical practice can help practitioners ascertain which patients might benefit from LDN as part of their treatment protocol. There will be a short discussion of adjunctive compounded therapies used in these various conditions, such as biotin and methylcobalamin in MS, topicals for Sjogren’s and thyroid for Hashimoto’s.

The numerous issues with oral analgesics are well known. Many patients do not get adequate pain relief from these medications, while struggling with significant adverse effects that limit their use. Some patients need to take opioids, risking dependence, constant dose escalation and possible addiction just to get pain relief.  Not all pain conditions can be helped with topical pain medications, but many conditions involving neuropathy, spasms, muscle or joint pain can benefit from local application of these analgesics. Studies have shown minimal risk for systemic absorption so minimal adverse effect profile along with higher local concentrations than when used orally to increase benefit. Knowing when these topical pain medications might be useful is a great tool in treating your patients struggling with pain.  This talk will discuss the different medications that have been studied for topical use, along with literature discussion and how they work. Lastly, we’ll go through case studies on how to design these combination topical pain medications for practical use.