Category Archives: Opioids

CMAJ Study Evaluates Risk of Health Outcomes after Opioids Prescribed in ER

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PainRelief.com Interview with:

Dr. Innes

Grant Innes MD
Departments of Emergency Medicine and Community Health Sciences
University of Calgary, Calgary
Editor-in-Chief, The Canadian Journal of Emergency Medicine

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

Response: Opioid prescriptions for acute pain have been identified as a possible factor in opioid epidemic mortality. The proposed causal model is that physicians provide opioid prescriptions for acute pain, which lead to prescription opioid misuse followed by illicit opioid use, subsequent overdose and death.

This paradigm has driven widespread describing initiatives, including the elimination of opioids from emergency care (“opioid free emergency departments”), but there is no research describing the link between an opioid prescription for acute pain and downstream opioid-related harm. 

Our objectives were to quantify for emergency patients filling an opioid prescription the likelihood of adverse outcomes as well as the incremental risk to opioid-treated patients vs. propensity-matched controls.

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Experimental “bitopic” Opioid Suppresses Pain With Fewer Side Effects

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PainRelief.com Interview with:

Susruta Majumdar, PhD
Professor in the Department of Anesthesiology
Washington University School of Medicine
Nokomis Ramos-Gonzalez, PhD
Postdoctoral Trainee in the Majumdar Lab
Washington University School of Medicine
Balazs R. Varga PhD
Center for Clinical Pharmacology
University of Health Sciences & Pharmacy at St. Louis
Department of Anesthesiology and Washington University Pain Center
Washington University School of Medicine
St. Louis, Missouri 63110

Jay McLaughlin, Ph.D
Professor of Pharmacodynamics
College of Pharmacy
University of Florida

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

Response:    Opioid medications tap into the body’s natural system for mitigating pain by activating pain-suppressing opioid receptors on neurons. Although meant to help, sometimes these medications do harm.  Opioid medications offer people relief from debilitating pain, but these drugs come with dangers: the risk for addiction, miserable withdrawal symptoms and the potential for fatal overdose.  New mechanistic insights into the function and regulation of the opioid receptors present the opportunity to design new, safer opioid painkillers. The team’s previous research utilized a strategy to design functionally selective “bitopic” opioids by targeting the sodium binding allosteric site in the opioid receptor.

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CMAJ Study Suggests Clinicians Adapt Opioid Prescriptions to Specific Types of Acute Pain

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PainRelief.com Interview with:
Raoul Daoust MD CSPQ MSc
Professeur titulaire/ full professor
Département Médecine de Famille et Médecine d’Urgence
Université de Montréal
Clinicien chercheur / Clinician Researcher
Médecine d’Urgence / Emergency Medicine
CEMU-HSCM (Centre d’Étude en Médecine d’Urgence)
SCEM-HSCM (Study Center in Emergency Medicine)
Hôpital Sacré-Coeur de Montréal
CIUSSS Nord-de-l’ile

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

Response: Overprescribing is linked to opioid misuse and overdose, with household supplies of opioids associated with an increased risk of overdose as many people do not dispose of unused medications safely. In Canada, more than 7570 people died of opioid overdoses in 2021, and more than 68 000 people died in the United States in 2020 from these same drugs.

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NEJM: Despite Removal of DEA Waiver Requirement, Buprenorphine Still Widely Underprescribed for Opioid Addiction

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PainRelief.com Interview with:
Kao-Ping Chua, MD, PhD|
Susan B. Meister Child Health Evaluation and Research Center
Department of Pediatrics, University of Michigan Medical School
Ann Arbor MI 48109

Kao-Ping-Chua

PainRelief.com: What is the background for this study?
Response: Buprenorphine is one of 3 FDA-approved medications to treat opioid addiction. It is the only one of the 3 that can be prescribed during office visits. Although buprenorphine is highly effective in treating opioid addiction, it is widely underused. Addressing this underuse is a key step towards slowing the epidemic of U.S. opioid overdose deaths.

In 2000, the federal government allowed clinicians to prescribe buprenorphine if they obtained a waiver from the Drug Enforcement Administration. Clinicians have cited the waiver requirement as a key barrier to buprenorphine prescribing. In part because of this, the government eliminated this requirement on January 12, 2023.

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Neuropathy: Repeated High Concentration Capsaicin Patches Provided Back Pain Relief and Reduced Need for Opioids

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PainRelief.com Interview with:
Kai-Uwe Kern MD, PhD
Institute of Pain Medicine/Pain Practice
Wiesbaden, Germany

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

Response: In recent studies a progressive response to high-concentration capsaicin patch (HCCP) with repeated treatment was observed, meaning that patients with insufficient pain relief after the first application of HCCP, still may respond to a second, third, or even fourth application. Based on these latest findings, and also on my personal clinical experience, we aimed to systematically analyse the pool of patients in my Pain Practice with at least two HCCP treatments.

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NCCIH Study Finds Marked Increase in Complementary Health Approaches Among US Adults, Including for Pain Management

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PainRelief.com Interview with:
Richard L. Nahin, Ph.D., M.P.H
Lead Epidemiologist
National Center for Complementary and Integration Health
NCCIH

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

Response: Millions of US adults use complementary health approaches (CHAs) each year. CHAs are health approaches typically not part of conventional medical care or with origins outside of Western medicine that are used together with conventional medical practice.

Some of the most well-known complementary health approaches include meditation, acupuncture, and yoga. While the safety and efficacy of many of these approaches previously lacked rigorous clinical trials, the last two decades saw an increase in evidence supporting the use of select approaches to manage health and pain.

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Prenatal Opioids Increase Risk of Multiple Adverse Health Effects

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PainRelief.com Interview with:
Erin Kelty PhD
Research Fellow
NHMRC Emerging Leader
School of Population & Global Health

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


Response: Recent research from Dr Lauren Jantzie at John Hopkins found that in mice prenatal opioid exposure altered the immune system.
Our research aimed to see if the same was true in children who had been exposed to opioids in utero.

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Opioid Use Disorder: Rutgers Study Demonstrates Improved Mood and Emotional Regulation with Guided Mindfulness

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PainRelief.com Interview with:
Suchismita Ray, Ph.D.
Associate Professor                                      
Department of Health Informatics            
Rutgers School of Health Professions
Rutgers Biomedical and Health Sciences
Rutgers, The State University of New Jersey
Newark, NJ 07101

Dr. Suchismita Ray
Photo by John O’Boyle

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

Response: In this pilot study, we examined longer-term changes after the Mindfulness-Oriented Recovery Enhancement (MORE) intervention and immediate effects of a brief MORE guided meditation session in women with opioid use disorder (OUD) who were on medications for OUD (MOUD). Participants completed the first assessment, then the 8-week MORE intervention (once weekly for two hours) during residential treatment, and then the second assessment.


The assessments were identical and conducted at Rutgers University Brain Imaging Center in Newark.

First, participants completed an emotion regulation questionnaire, and then they entered the magnetic resonance imaging (MRI) environment for scanning. Participants listened to a 10-minute guided MORE meditation in the scanner while viewing a picture of an outdoor garden, and brain images were recorded to measure functional connectivity (i.e., brain communication) during the meditation. We examined the immediate effects of a 10-minute guided MORE meditation on mood and craving. We further examined the effects of 8-week MORE intervention on changes in emotional regulation difficulty and brain communication.

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Cancer Doctors Prescribing Fewer Opioids Since Opioid Crisis

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PainRelief.com Interview with:
Joshua Kra, MD
Assistant Professor of Medicine, Rutgers NJMS
Division of Hematology/Oncology
Rutgers Cancer Institute of New Jersey at University Hospital

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

Response: We aimed to characterize pain management practices by medical oncologists to assess whether CDC guidelines from 2017 for nononcologic settings changed prescribing patterns for oncologists.

PainRelief.com: What are the main findings?

Response: There was a significant decrease in opioid prescriptions from medical oncologists starting in 2017, which coincided with the recognition of the opioid crisis as a national public health emergency and the publication of CDC guidelines for opiate prescribing in non-cancer settings. This would suggest these factors contributed to how oncologists changed their management of opioid prescriptions for cancer patients.

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Opioid Prescriptions by Surgeons for Post-Op Pain Relief Decline, but Progress Has Slowed

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PainRelief.com Interview with:
Kao-Ping Chua, MD, PhD
Susan B. Meister Child Health Evaluation and Research Center
Department of Pediatrics, University of Michigan Medical School
Ann Arbor MI 48109

Dr. Kao-Ping Chua
Dr. Kao-Ping Chua

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

Response: Surgery is one of the most common reasons for opioid prescribing. Ensuring the appropriateness of opioid prescribing by surgeons is important, as prescriptions that exceed patient need result in leftover pills that can be a source for misuse or diversion. Although there have been numerous recent policy and clinical efforts to improve opioid prescribing by surgeons, recent national data on this prescribing are unavailable.

In this study, we analyzed a comprehensive prescription dispensing database that captures 92% of prescriptions from U.S. pharmacies. From 2016 to 2022, we found that the rate of surgical opioid prescriptions at the population level declined by 36%, while the average amount of opioids in these prescriptions declined by 46%. As a result of these two changes, the total amount of opioids dispensed to surgical patients declined by 66%.

However, there were two caveats:

First, the decline in surgical opioid prescribing was most rapid before 2020 and has slowed since then.

Second, the average surgical opioid prescription in December 2022 still contained the equivalent of about 44 pills containing 5 milligrams of hydrocodone, far higher than most patients need after surgery.

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