To MME or Not to MME, Is There a Question? | PAIN POD

Let’s face it, when it comes to pain management, one of the most painful efforts of the last few years has involved, in one way, shape, form, or fashion: Morphine Milligram Equivalents (MMEs). As we discussed with the PharmD author of the 2022 CDC Opioid Guideline Update , there are no MME factor changes on the horizon, so just when will we have our minds wrapped around the concept?!?
 
Join the Mark “Pain Guy” Garofoli on the Pain Pod for a dynamic discussion on wrestling (yes, you read that right!), pain management, our healthcare system, and the “street” version of MMEs. Wait, there’s a street version of MMEs? Yes, yes there is, so tune in now to the Pain Pod as you’ll only utilize the edge of your seat even though ya paid for the whole seat!
 
Come one, come all, to the Pain Pod!!!
 
Episode Notes
 
Pre-2016 MME Charts Review
· Nielson S. et. al. A synthesis of oral morphine equivalents (OME) for opioid utilization studies. Pharmacoepidemiology and drug safety 2016; 25: 733–737
 2016 CDC Chronic Pain Opioid Guideline MME Chart
·      CDC Chronic Pain Opioid Guidelines: MMWR March 2016. Updated 2017.
o   Tramadol: 0.1
o   Codeine: 0.15
o   Tapentadol: 0.4
o   Morphine: 1
o   Hydrocodone: 1
o   Oxycodone: 1.5
o   Oxymorphone: 3
o   Hydromorphone: 4
o   Methadone (Up to: 20mg, 40mg, 60mg, >60mg): 4, 8, 10, 12
o   Transdermal Fentanyl: 7.2 (Divided by the # of Days Applied)
o   Transdermal Buprenorphine: 12.6 (Divided by the # of Days Applied)
o   Buprenorphine (SL or Buccal): 0.03 (for mcg calculations) or 30 (for mg calculations)
 
2015 Cat and Dog MME Article
· https://burrardvet.com/2015/04/08/pain-control-in-dogs-cats
 
2016 CDC Chronic Pain Opioid Guideline MME Chart
· CDC Chronic Pain Opioid Guidelines: MMWR March 2016. Updated 2017.
 
2022 CDC Opioid Guideline Revision Resources
· https://www.federalregister.gov/documents/2022/02/10/2022-02802/proposed-2022-cdc-clinical-practice-guideline-for-prescribing-opioids
 
2010 to 2014 MME Relative Risk of Overdose/Death
· https://i1.wp.com/face-facts.org/wp-content/uploads/2017/04/Opioid-dose-vs-overdose-risk.jpg
 
Missouri Marijuana Equivalents (MMEs)
· https://north.life/demystifying-missouri-medical-marijuana-equivalency-units-mmes/
 
 
Audio Add-in’s
Let’s Get Ready to Rumble (Michael Buffer)
· https://www.youtube.com/watch?v=jgopHWACUXs
 
Cash sound
· https://www.youtube.com/watch?v=ZeET7Z1ZGlw
 
Ron Burgundy “That Escalated Quickly”
· https://www.youtube.com/watch?v=FONN-0uoTHI
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