Miami Thoracic Surgeons Achieve Pain Control With Minimal or No Opioids

PainRelief.com Interview with:
Dao Minh Nguyen, MD, MSc FRCSC FACS
Thoracic Cancers Group Go-Lead
Sylvester Comprehensive Cancer Center
University of Miami Miller School of Medicine

PainRelief.com: What is the background for this study?

Response: Patients undergoing thoracic surgery operations experience significant acute incisional pain as well as chronic pain many months after.

The mainstay of treatment is based on frequent use of potent and addictive-prone opioids such as hydromorphone, oxycodone at high dosages and long duration.
There is a high incidence of persistent opioid users and chronic opioids users in surgical patient population. This certainly contributes to the opioid epidemic in the USA and worldwide.

We implemented a peri-operative care protocol for patients undergoing thoracic surgery operations called Enhanced Recovery after Thoracic Surgery (ERATS). The overarching goal of ERATS is to streamline care for thoracic surgery patients particularly in the postoperative period to mitigate pain with opioid-free strategy, to minimize postoperative complications, rapid return to baseline states and safe, early discharge home. This protocol follows guidelines of the ERAS principles and is developed for thoracic patients to address their unique needs.

Once pain is adequately addressed with opioid-free strategy with elimination of opioid-associated side effects, rapid recovery after surgery can be achieved.

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Canadian Study Finds Cannabis Use Disorder Associated with Higher Risk of Heart Disease

PainRelief.com Interview with:
Anees Bahji, BSc(H), MD, CISAM, CCSAM, DABPN, FRCPC (pronouns: he/him/his)
Clinical Assistant Professor, Department of Psychiatry, University of Calgary
Ph.D. Student, Department of Community Health Sciences, University of Calgary
Addiction, Concurrent Disorder, and General Psychiatry
Opioid Dependency Program, Sheldon M. Chumir Centre
Rapid Access to Addiction Medicine Service, Calgary
Adult Addiction Centre, 6th Floor, Foothills Medical Centre

PainRelief.com: What is the background for this study?

Response: The background for this study is rooted in the need to understand the potential health implications of cannabis use disorder (CUD), especially in relation to cardiovascular health.

Cannabis has become increasingly popular for both recreational and medicinal purposes, and it is essential to assess its impact on various health outcomes.

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Newly Studied Pain Pathway May Provide Pain Relief Without Opioid Side Effects

PainRelief.com Interview with:
Daniel McGehee, PhD
Professor
Chair, Committee on Neurobiology
Department of Anesthesia & Critical Care
University of Chicago

PainRelief.com: What is the background for this study?

Response: Chronic pain conditions are major challenges for those suffering with pain and the clinicians who struggle to find effective treatments. Identifying novel strategies for relieving pain will help limit availability of opioid drugs, as they offer alternatives to replace or reduce opioids in the clinic. 

Along with overdose and addiction issues, there are other complications and side effects of opioids, including tolerance, where the pain relieving properties diminish with repeated use, hypersensitivity to pain when patients stop taking the drug, constipation, and other peripheral side effects. 

Pain relief without those side effects would certainly be valuable for individuals struggling to treat painful conditions. 

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Fibromyalgia: Imaging Studies Find Cognitive Behavioral Therapy Reduces Pain Catastrophizing

PainRelief.com Interview with:
Jeungchan Lee, Ph.D.,
Instructor
MGH/HST Athinoula A. Martinos Center for Biomedical ImagingSpaulding Rehabilitation Hospital
Harvard Medical School
Charlestown, MA 024129

Jeungchan Lee, Ph.D.,
Postdoctoral Research Fellow
MGH/HST Athinoula A. Martinos Center for Biomedical ImagingSpaulding Rehabilitation Hospital
Harvard Medical School
Charlestown, MA 024129

PainRelief.com: What is the background for this study?

Response: Cognitive behavioral therapy (CBT) has shown promise in alleviating fibromyalgia (FM) symptoms by targeting pain-related catastrophizing, which comprises negative cognitive and emotional processes amplifying pain perception.

However, the neurological mechanisms underlying CBT’s impact on pain catastrophizing in FM patients have remained unclear.

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Smaller Portions of Pain Relievers After ER Visits May Be Sufficient for Pain Relief

PainRelief.com Interview with:
Raoul Daoust, MD, CSPQ, MSc
Clinical Professor and researcher
Departments of Family Medicine and Emergency Medicine
Hôpital du Sacré-Coeur de Montréal

PainRelief.com: What is the background for this study?

Response: Usually patients are prescribed too large a quantity of opioids and unused opioids are available for misuse. The tendency in the USA is to not prescribe opioids at all, leaving some patient in agonizing pain. I wanted to provide a tailored approach to prescribing opioids so patients have enough to manage their pain but almost no unused opioids available for misuse.

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Unequal Access to Chiropractic Pain Relief Care for Back Pain in Patients with Opioid Use Disorder

PainRelief.com Interview with:
Patience Moyo, Ph.D
Assistant Professor of Health Services, Policy and Practice
Center for Gerontology and Healthcare Research
Department of Health Services, Policy, and Practice
Brown University School of Public Health

Patience Moyo, Ph.D
Assistant Professor of Health Services, Policy and Practice
Center for Gerontology and Healthcare Research
Department of Health Services, Policy, and Practice
Brown University School of Public Health

PainRelief.com: What is the background for this study?

Response: Clinical practice guidelines recommend nonpharmacologic treatments as first-line therapies for managing chronic pain. However, little is known about the use of guideline-recommended pain therapies and whether use varies in demographic subgroups. Individuals with co-occurring chronic pain and opioid use disorder deserve particular consideration because of their increased risk of harm from opioids and other pharmacologic therapies combined with their susceptibility to social and structural barriers to accessing health care.

We sought to understand whether the well-established racial and ethnic inequities in pain management extend to individuals with opioid use disorder and to nonpharmacologic pain treatments, specifically physical therapy and chiropractic care.

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Study Assesses Quality of Life After Cannabis Prescribed for Chronic Pain and Other Health Symptoms

PainRelief.com Interview with:
Margaret-Ann Tait | PhD candidate
Project Manager, The QUEST Initiative
Research Manager, Faculty of Medicine and Health
Sydney Nursing School, Cancer Care Research Unit
University of Sydney

PainRelief.com: What is the background for this study?

Response: In 2016 Australia passed legislation that allows cannabis use for medicinal purposes. Since then, an estimated 800,000 patients have received medicinal cannabis prescriptions. We wanted to know if patients with chronic health conditions in Australia are reporting their health outcomes differently after being prescribed medicinal cannabis. We used validated questionnaires to assess their health-related quality of life, levels of fatigue, pain, sleep disturbance, anxiety, and depression before starting therapy and then at regular intervals for three months after. 

We had 2327 patients participating from across Australia aged between 18 and 97 (the average age was 51), and nearly two thirds were female. Half of our participants were prescribed medicinal cannabis for more than one condition, with chronic pain conditions reported more frequently, followed by insomnia, anxiety, and mixed anxiety & depression.

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Hypertension Drug May Decrease Both Inflammation and Need for Knee Replacement

PainRelief.com Interview with:

Iskandar Tamimi MD, PhD
Hospital Regional Universitario de Málaga
Faculty of Medicine, University of Málaga
Hospital HM
Málaga, Spain

PainRelief.com: What is the background for this study?

Response: Knee osteoarthritis is a painful and limitting condition that affects a significant percentage of the world’s population. The treatment of end stage knee osteoarthritis is a undergoing a total knee replacement. This procedure is considered a major surgery and it’s associated with a significant number of complications, such as infections, deep vein thrombosis, residual knee pain, etc,,

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Cannabis Use May Expose Users to Lead and Cadmium

PainRelief.com Interview with:
Tiffany R. Sanchez, PhD (she/her)
Assistant Professor
Environmental Health Sciences 
Columbia University Mailman School of Public Health

PainRelief.com: What is the background for this study?

Response: We’ve known that the cannabis plant is good at accumulating metals, like lead and cadmium, and long-term exposure to these metals carry important health risks. What was unclear before our study was whether or not people who use cannabis actually have higher metal levels in their body compared to non-users.

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Gabapentin in Overdose Patients Not Necessarily the Cause of the Overdose

MedicalResearch.com Interview with:
Matthew S. Ellis, PhD, MPE
Department of Psychiatry
School of Medicine
Washington University in St. Louis

Kevin Xu MD, MPH
Instructor in Psychiatry
Co-Director, PGY2 Substance Use Disorders Rotation
Department of Psychiatry
School of Medicine
Washington University in St. Louis

MedicalResearch.com: What is the background for this study?

Response: Gabapentin is one of the most commonly prescribed psychotropic medications, as it is used (primarily off-label) to treat a myriad of conditions, ranging from anxiety disorders and insomnia to chronic pain, seizure disorders, and substance use disorders.
This is even more true for individuals receiving treatment for opioid use disorder, who often have multiple physical and mental co-morbid conditions.

Unfortunately, it  has increasingly been found in people who overdose, causing physicians and policymakers to consider restricting access to gabapentin and tapering/deprescribing it in stable patients taking it in the long-term.

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