Category Archives: Opioids

Nemours Children’s Study Evaluates Adherence to Opioid Guidelines for Pain Relief in Sickle Cell Patients

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PainRelief.com Interview with:
Ibrahim Gwarzo, DrPH, MPH, MBBS
Research Scientist at Nemours Children’s Health

dr_gwarzo_ibrahim-1.jpg
Dr. Gwarzo

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

Response: Clinical guidelines for the management of sickle cell disease (SCD) pain crisis in the emergency department (ED) recommend administration of the first analgesic dose within 1 hour or arrival to the ED and subsequent doses given within 30 minutes interval according to the National Heart, Lung, and Blood Institute (NHLBI) guidelines, and within 30 to 60 minutes intervals according to American Society of Hematology (ASH) guidelines. However, reports suggest patients with SCD pain suffer extensive delays in the ED before receiving pain interventions.

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Swedish Study Examines Risks of ASD/ADHD After Prescribed Opioids During Pregnancy

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PainRelief.com Interview with:

Emma N. Cleary (she/her)
Clinical Psychology PhD Candidate
Developmental Psychopathology Lab
Indiana University Bloomington

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

Response: Pain is common during pregnancy and one of the options for managing it is with prescribed opioid pain medications. When pregnant patients and their physicians try to make decisions about using these medications, there are often concerns about impacts on fetal development given that these medications cross the placenta.

Previous studies have identified associations between prenatal exposure to opioids pain medications and increased risk of neurodevelopmental disorders like autism spectrum disorder (ASD) and  attention-deficit/hyperactivity disorder (ADHD), but it is unclear whether this is causal.

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Potent Synthetic Opioids Driving Current Overdose Crisis

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PainRelief.com Interview with:
Shravani Durbhakula, MD, MPH, MBA
Associate Professor of Anesthesiology, 
Division of Pain Medicine 
Vanderbilt University School of Medicine 
Medical Director, Comprehensive Pain Service 
Vanderbilt University Medical Center 

Shravani Durbhakula, MD, MPH, MBA Associate Professor of Anesthesiology,  Division of Pain Medicine  Vanderbilt University School of Medicine  Medical Director, Comprehensive Pain Service  Vanderbilt University Medical Center 
Dr. Durbhakula

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

Response: Our study highlights the rapid rise of nitazenes—extremely potent and dangerous synthetic opioids—silently driving the current overdose crisis. Developed in the 1950s by a pharmaceutical company and never approved for clinical use, nitazenes are up to 20 times more potent than fentanyl and are undetectable with standard drug tests available in emergency rooms.

These opioids are often mixed into counterfeit pills or other street drugs, posing an unseen threat. Furthermore, nitazenes interact with opioid receptors in a unique way, increasing overdose risk, heightening respiratory depression, and accelerating tolerance development, which makes them even more dangerous for users.

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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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