Category Archives: Opioids

Home Sensors Developed for Overnight Monitoring in Opioid Use Disorder

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PainRelief.com Interview with:
Marian Wilson, PhD, MPH, RN, PMGT-BC 
Associate Professor
Assistant Editor, Pain Management Nursing
Washington State University College of Nursing

Dr. Wilson

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

Response: People with opioid use disorder often experience withdrawal symptoms that can interfere with recovery success. Our team was interested in whether noninvasive home sensors could provide accurate information to detect overnight restlessness and sleep problems that could indicate opioid withdrawal for adults prescribed methadone for opioid use disorder.

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Novel Protocol Reduced Use of Opioid Pain Relievers After Knee and Shoulder Surgeries

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PainRelief.com Interview with:
Nicole Simunovic, MSc
On behalf of the NO PAin Principal Investigators

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

Response: Orthopaedic surgeons prescribe more opioids than any other type of surgeon in North America. Opioids have the potential to be highly addictive and can cause serious harm or even death if taken in excess. The goal of our clinical study was to determine if an opioid sparing approach to postoperative pain management was safe and effective in patients undergoing arthroscopic knee and shoulder surgery.

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States with Mandated Prescription Monitoring Programs Had Marked Increase in Heroin-Related Deaths

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PainRelief.com Interview with:
Dr. Tongil “TI” Kim,
Assistant professor of marketing
Naveen Jindal School of Management
The University of Texas at Dallas (abbreviated UT Dallas)

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

Response: We examine the early deployment of mandated prescription drug monitoring program (PDMP) use (2006-2015) in the U.S., when 19 states mandated PDMP use. We find 6.37 more heroin-related deaths per million population per year—a 50.1% increase—following PDMP mandates compared to states that did not.

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Uninsured Pay Higher Out-of-Pocket Costs for Opioid Antidote Naloxone

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PainRelief.com Interview with:
Evan D. Peet, PhD Professor
Pardee RAND Graduate School

Dr. Peet

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

Response: This study is part of a broader CDC funded project looking at access to naloxone and naloxone’s impacts on opioid-related overdose deaths. There have been increasing efforts to expand access to naloxone, with a variety of different laws being passed by states across the nation. But one part of access that has been understudied is the cost borne by patients.

High out-of-pocket costs may act as a barrier to this life-saving drug, so in this study we look at trends in out-of-pocket costs of naloxone and how they vary by payor and drug brand.

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More Nonopioid Medications Prescribed for Pain Relief since CDC Released Chronic Pain Guidelines

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PainRelief.com Interview with:

JASON GOLDSTICK
Dr. Goldstick

Jason E. Goldstick, PhD
Injury Prevention Center
Department of Emergency Medicine
University of Michigan, Ann Arbor

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

Response: In 2016, the CDC released the Guideline for Prescribing Opioids for Chronic Pain. A primary goal of this voluntary guideline is that individuals should receive pain management care that provides the greatest overall benefit. Among other things, this may entail beginning opioid treatment only when the clinician determines that the expected benefits outweigh the risks.

Other research has shown reductions in opioid prescribing as reduced since the guideline release; this report examines whether there were changes in nonopioid pain medication prescribing.

Our overall findings were that nonopioid prescribing increased nationally following the guideline release, above and beyond what would’ve been predicted based on the pre-guideline trends, and this finding was generally consistent across patient subpopulations (e.g., those with vs. without prior opioid exposure).

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Study Highlights Challenges of Opioid Use Disorder in Patients with Cancer Pain

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PainRelief.com Interview with:
Katie Fitzgerald Jones MSN, APN
PhD candidate Connell School of Nursing
Boston College
Jonas Mental Health Scholar 2021-2023
American Academy of Nursing Jonas Policy Scholar 
Ruth L. Kirschstein National Service Award (F31NR019929-01)

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

Response: I am a Palliative and Addiction Nurse Practitioner at VA Boston and a Ph.D. candidate at Boston College Connell School of Nursing. In my clinical practice, I regularly care for people with cancer who have a co-occurring substance use disorder. 

How to best care for people with substance use disorders, such as opioid use disorder is especially complex in people with cancer because opioid management is a standard of cancer-pain management and cancer prognoses can influence opioid decisions and vary. It is important when prescribing opioids that you attend to safety while also addressing pain. People with untreated opioid use disorder or concerning opioid behaviors (such as taking more opioids than prescribed or using opioids with unprescribed medications that increase the risk for opioid-related harm such as benzodiazepines) have an increased risk for opioid related-harms. It is also an area that lacks consensus and is absent from cancer-specific pain guidelines.

This study was conducted with leaders in palliative care including senior author, Jessica Merlin to tackle the question of what is consensus among palliative care and addiction clinicians to caring for people with opioid misuse or use disorder and cancer-related pain and how this is influenced by prognosis?

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Concurrent Opioid and Benzodiazepine Prescriptions for Pain Relief Fall But Still Common

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PainRelief.com Interview with:
Kun Zhang PhD
Senior Service Fellow and Health Scientist
Opioid Overdose Prevention Health Systems Team
Division of Unintentional Injury Prevention
Centers for Disease Control and Prevention

Dr. Zhang

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

Response: When taken together by patients, opioids and benzodiazepines can result in synergistic respiratory depression which elevates overdose risk; however, these two medications have been commonly co-prescribed in the U.S.

Since 2016 there has been efforts to address the concurrent use of these two drugs, for example the 2016 FDA Boxed Warning and the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain.

Our study aimed at tracking and analyzing recent trends in concurrent use of these two medications using national level data.

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Policymakers Can Mitigate Prescription Opioid Misuse Associated with Delayed Dispensing for Pain Relief after Procedures

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

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

Response: Opioid prescriptions written by dentists and surgeons are almost always written for the immediate relief of acute pain after procedures. However, current federal and state laws allow these prescriptions to be dispensed well after the time that they are written. When this occurs, that could be a potential sign that the prescription was used in a time frame or for a reason other than intended by the prescriber, both of which are forms of prescription opioid misuse.

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Chronic Pain: Sex Differences in Pain Relief from High vs Low Spinal Cord Stimulation

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PainRelief.com Interview with:
Imanuel Lerman MD MSc
Associate Professor 
Affiliate Electrical and Computer Engineering 
VA San Diego Healthcare System
Center for Stress and Mental Health
Center for Pain Medicine 
UC San Diego Health 
Qualcomm Institute 
California Institute for Telecommunications and Information Technology (Calit2)

Dr. Lerman

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

Response: Spinal Cord Stimulation (SCS) offers an implantable, non-pharmacologic treatment for patients with intractable chronic pain conditions.  There is extensive clinical literature that offers support for efficacy in chronic pain treatment for both Low frequency and High frequency based  spinal cord stimulation. While Low Frequency SCS has been heavily examined since its inception, High Frequency SCS paradigms have recently been clinically approved.

Emerging preclinical work also show sex may alter certain immunological pathways that contribute to chronic pain.  But to date few report have identified interactions between sex and SCS.  Therefore, we aimed to fill this knowledge gap through a single site (University of California San Diego), large (n=237) retrospective (2004–2020) analyses that compared SCS paradigm Low vs High Frequency SCS, efficacy (pain relief and opiate sparing effects) across sex.

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Identification of the Muscle-Relaxant Carisoprodol (Soma) and Non-Controlled Prescription Substances in Drug-Arrests

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PainRelief.com Interview with:
Maaz Siddiqui, BS
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton, Pennsylvania

Maaz Siddiqui

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

Response: Over the last twenty years, the rise of deaths due to drug overdoses have been mainly and rightfully attributed to opioids. However, many investigations identify non-opioid drugs and drug classes that additionally contribute to deaths due to polysubstance overdoses. Through the Maine Diversion Alert Program (DAP) data, we examined drugs that often escape the attention of healthcare providers and directly or indirectly contribute to substance misuse, arrests, addiction, and deaths due to overdose.

The goal of this study was to utilize a novel dataset to uncover and identify the noncontrolled drugs that have shown potential to be misused.

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