Moderate to Severe Pain Linked With Increased Risk of Opioid Addiction

Moderate to Severe Pain Linked With Increased Risk of Opioid Addiction
A new study finds people with moderate to severe pain have a 41 percent higher risk of opioid addiction, compared to those without pain. Columbia University researchers surveyed more than 34,000 Americans, HealthDay reports. Males and younger adults were at increased risk for opioid abuse, the researchers report in the American Journal of Psychiatry. “In evaluating patients who present with pain, physicians should also be attentive to addiction risk factors such as age, sex and personal or family history of drug abuse,” study senior author Mark Olfson, MD, MPH said in a news release. “If opioids are prescribed, it is important for clinicians to monitor their patients carefully for warning signs of opioid addiction.”
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Switching to Other Pain Treatments Can be Challenging

Switching to Other Pain Treatments Can be Challenging
As the Obama Administration and public health officials push for a reduction in prescription opioids, they are facing some resistance from both patients and doctors, experts tell The New York Times. Insurance coverage for alternative treatments is inconsistent, the article notes. The plans may not cover all treatments, or they may impose strict limits on coverage. Alternative pain treatments include acupuncture, yoga, chiropractic and osteopathic manipulation, massage, meditation and cognitive behavioral therapy. Medicaid does cover physical therapy for patients who gained coverage under the Affordable Care Act, but the level of coverage varies by state. Matt Salo, Executive Director of the National Association of Medicaid Directors, says benefits for alternative treatments are often the first to be eliminated when budgets are cut, because they are considered optional. A complicating factor is the widely varying amounts of evidence about the effectiveness of these treatments. Many patients resist nondrug treatments for pain, because...
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AMA Drops Pain as Vital Sign

AMA Drops Pain as Vital Sign
The nation’s largest medical society is recommending that pain be removed as a “fifth vital sign” in professional medical standards – a move critics say will make it even more difficult for pain sufferers to have their pain properly diagnosed and treated. Delegates at the annual meeting of the American Medical Association in Chicago also passed several other resolutions aimed at reducing opioid prescribing and increasing access to addiction treatment. The AMA represents over 200,000 physicians in the U.S. and is very influential in setting public health policy. The AMA’s new president said physicians played a key role in starting the so-called opioid epidemic by overprescribing pain medication, and now must do their part to end it. “We have taken ownership of that, and physicians have taken ownership of being part of the solution,” AMA president Andrew Gurman, MD, told Modern Healthcare.The AMA’s main “solution” to the opioid problem is to...
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Patients in Pain Say It Has Become Harder to Get Opioid Painkillers

Patients in Pain Say It Has Become Harder to Get Opioid Painkillers
Patients suffering from chronic pain say they are finding it more difficult to get prescriptions for opioid painkillers, The Boston Globe reports. Federal and state regulations to reduce access to opioids have made doctors and pharmacists more reluctant to prescribe and dispense the drugs. Chronic pain patients say they are frequently required to prove they are not addicted to opioids, the article notes. An estimated 100 million adults in the United States are thought to suffer from chronic pain. In many cases, the pain is caused by injury, disease or nervous system problems. There are a number of non-opioid treatments available, including anti-seizure drugs, antidepressants, devices such as spinal stimulators, physical therapy and meditation. While these treatments rarely stop the pain, patients often use a variety of these options to help them cope with it. Some patients see opioids as critical in helping them deal with their pain. Claire Sampson, Co-Chairwoman...
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Study Shows Opioids Increase Risk of Death When Compared To Other Pain Treatments

Study Shows Opioids Increase Risk of Death When Compared To Other Pain Treatments
Long-acting opioids are associated with a significantly increased risk of death when compared with alternative medications for moderate-to-severe chronic pain, according to a Vanderbilt study released in the Journal of the American Medical Assocation (JAMA). Not only did long-acting opioids increase the risk of unintentional overdose deaths, but they were also shown to increase mortality from cardiorespiratory events and other causes. The story appeared in Vanderbilt University’s Research News @ Vanderbilt. Lead author Wayne Ray, Ph.D., and colleagues with the Vanderbilt Department of Health Policy studied Tennessee Medicaid patients between 1999-2012 with chronic pain, primarily back and other musculoskeletal pain, who did not have cancer or other serious illnesses. Researchers compared those starting a long-acting opioid to those taking an alternative medication for moderate-to-severe pain. Alternative medications included both anticonvulsants — typically prescribed to prevent seizure activity in the brain, treat bipolar disorder or neuropathic pain — and low doses of...
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Emergency Room in New Jersey Tries Alternatives to Opioids to Treat Pain

Emergency Room in New Jersey Tries Alternatives to Opioids to Treat Pain
A New Jersey hospital emergency department has been treating pain with alternative regimens, in an attempt to reduce opioid use. The treatments include non-narcotic infusions and injections, ultrasound guided nerve blocks, laughing gas, and “energy healing,” according to The New York Times. St. Joseph’s Regional Medical Center’s emergency department in Paterson, New Jersey, is one of the nation’s busiest, treating approximately 170,000 patients a year. Since January, it has been treating patients with common types of acute pain—such as migraines, fractures, kidney stones and sciatica—with alternative treatments. Almost 75 percent of patients seek emergency treatment because of pain. Emergency department personnel and patients have long thought that opioids are the quickest, most effective response to pain. “St. Joe’s is on the leading edge,” said Dr. Lewis S. Nelson, a professor of emergency medicine at New York University School of Medicine, a member of a panel that recently recommended opioid prescribing guidelines...
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Opioid Use Increases Chronic Pain, Rat Study Finds

Opioid Use Increases Chronic Pain, Rat Study Finds
A new study that finds opioid use increases chronic pain in rats may have important implications for humans, according to researchers from the University of Colorado-Boulder. The researchers found that rats who received morphine for five days experienced chronic pain that continued for several months, by triggering the release of pain signals from spinal cord immune cells called glial cells. The findings may help explain the recent surge in prescription painkiller addiction, Forbes reports. “We are showing for the first time that even a brief exposure to opioids can have long-term negative effects on pain,” study author Peter Grace said in a news release. “We found the treatment was contributing to the problem.” Study co-author Linda Watkins added, “The implications for people taking opioids like morphine, oxycodone and methadone are great, since we show the short-term decision to take such opioids can have devastating consequences of making pain worse and longer...
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Drug and Alcohol Abuse Linked to Self-Medicating Chronic Pain

Drug and Alcohol Abuse Linked to Self-Medicating Chronic Pain
Many people who abuse drugs or alcohol are self-medicating chronic pain, a new study suggests. Researchers at Boston University studied 589 people who fit the criteria for drug abuse or illicit drug use, and found 87 percent reported chronic pain. Of the 576 patients who used illicit drugs (marijuana, cocaine and/or heroin), 51 percent reported using drugs to treat pain. The study found 81 percent of the 121 people who said they misused prescription opioid painkillers reported they did so to treat their pain. Of the 265 patients who reported any amount of heavy drinking in the past three months, 38 percent said they were self-medicating chronic pain. The researchers found 79 percent of patients determined to be high-risk drinkers were self-medicating, according to Medical Daily. The results appear in the Journal of General Internal Medicine. “While the association between chronic pain and drug addiction has been observed in prior studies,...
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Health Experts Ask for Changes to Pain Treatment Guidelines to Reduce Opioid Use

Health Experts Ask for Changes to Pain Treatment Guidelines to Reduce Opioid Use
A group of state health officials, doctors and consumer advocates is asking the Center for Medicare and Medicaid Services (CMS) for changes to pain treatment guidelines to reduce the use of opioid painkillers. The group also has asked the body that accredits hospitals and clinics, the Joint Commission, to re-examine the pain management guidelines it requires institutions to follow, The Wall Street Journal reports. In the letter to CMS, the group said current standards for treating pain are too aggressive and contribute to overuse of opioid painkillers. The letter urges CMS to stop asking patients about how well their pain was controlled in the hospital. CMS uses the answers in making judgments about hospital performance and to determine payment. “Medication is not the only way to manage pain and should not be over-emphasized,” the group wrote. “Setting unrealistic expectations for pain relief can lead to dissatisfaction with care even when best...
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Meditation May Provide Non-Opioid Alternative for Pain Relief

Meditation May Provide Non-Opioid Alternative for Pain Relief
A new study suggests meditation can significantly reduce pain, without using the body’s opioid receptors. The findings are especially significant for people who have built up a tolerance to opiate-based medications and are seeking a non-addictive way to reduce pain, the researchers say. “Our finding was surprising and could be important for the millions of chronic pain sufferers who are seeking a fast-acting, non-opiate-based therapy to alleviate their pain,” lead researcher Dr. Fadel Zeidan of Wake Forest Baptist Medical Center said in a statement. The study included 78 healthy volunteers, who were injected with either a saline placebo solution or naloxone (Narcan), which blocks the pain-reducing effects of opioids. Naloxone is used to reverse the effects of a drug overdose. The participants were divided into four groups. The first group received naloxone and meditated; the second meditated with no naloxone; the third meditated and received a saline placebo; and the fourth...
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