Category Archives: Opioids

Dental Opioid Prescriptions Raises Risk of Overdose in Patients and Their Families

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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

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

Response: Prior studies suggest that opioid prescriptions for surgical procedures are associated with increased overdose risk in patients. Additionally, studies suggest that opioid prescriptions are associated with increased overdose risk in patients’ family members, who often have access to patients’ opioids. However, studies have not specifically assessed whether opioid prescriptions for dental procedures are associated with increased overdose risk in patients and their family members.

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Chronic Low Back Pain: Spinal Manipulation Therapy May Reduce Opioid-Related Adverse Effects

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PainRelief.com Interview with:
Jim Whedon DC, MS
Director of Health Services Research
SCU Health System
Southern California University of Health Sciences
Whittier, CA

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

Response:    Current evidence-based guidelines for clinical management of chronic low back pain (cLBP) include both pharmacological and non-pharmacological approaches.

Both Opioid Analgesic Therapy (OAT and Spinal Manipulative Therapy (SMT) are effective treatments for cLBP and are provided under Medicare for older adults with cLBP, but the long-term safety of OAT is uncertain, and the dangers of opioid misuse are well known. Older adults are at particularly high risk of adverse drug events (ADEs),but they nevertheless receive more opioid analgesics than any other age group. SMT is established as an effective non-pharmacologic treatment for cLBP, but little is known about the safety of long-term treatment with SMT. The objective of our study was to compare SMT and OAT to determine the impact of SMT on the risk of ADEs among older adults receiving long-term care for cLBP.

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Persistent Opioid Use for Pain Relief After Dental Procedures Higher Than Previously Reported

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PainRelief.com Interview with:
Kao-Ping Chua, M.D., Ph.D.
Assistant Professor, Department of Pediatrics
Susan B. Meister Child Health Evaluation and Research Center
University of Michigan

Dr. Kao-Ping Chua,

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

Response: Persistent opioid use occurs when opioid-naïve patients prescribed opioids after procedures continue to fill opioid prescriptions well past the time that acute post-procedural pain typically resolves. Studies have shown that privately insured adolescents and young adults undergoing wisdom tooth removal are more likely to develop persistent opioid use if they fill opioid prescriptions after the procedure than if they do not. However, it is unknown whether these findings generalize to a broader variety of dental procedures or to publicly insured patients covered by Medicaid.

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COVID-19: Lack of Access to Buprenorphine May Have Contributed to Opioid Overdoses During Pandemic

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PainRelief.com Interview with:
Janet Currie, PhD
Henry Putnam Professor of Economics and Policy Affairs
Co-Director, Center for Health and Wellbeing
Princeton University, Princeton NJ 08544

Janet Currie, PhD

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

Response: There has been a great deal of discussion and media reports of disrupted access to care because of the pandemic, as well as reports (including the most recent numbers from the CDC which were just released) about increases in drug overdoses linked to opioids. 

We wondered how this might be related to changes in patterns of opioid prescribing and also the prescribing of buprenorphine for opioid-use disorder.

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Does Medical Marijuana Prevents Opioid Overdoses?

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PainRelief.com Interview with:

Daniel Kaufman, MS Geisinger Commonwealth School of Medicine
Daniel Kaufman

Daniel Kaufman, MS
Geisinger Commonwealth School of Medicine

Brian J. Piper, PhD, MS
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton, PA 18510

Dr. Piper










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

Response: The opioid epidemic has stricken the United States and caused thousands of deaths nationally. Researchers continue to search for a solution to the ongoing escalation in opioid related deaths, with some states turning to medical cannabis as a potential alternative treatment for chronic pain. The objectives of this study were to:

  1. To determine if medical cannabis program implementation had any effect on opioid overdoses at a state-wide level
  2. To contribute to the discussion of researchers searching for a solution to the opioid epidemic facing the United States
  3. Begin the discussion on the standardization of autopsy procedures, including death/overdose determination
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Opioids Not Only Option for Pain Relief After Cesarean Delivery

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PainRelief.com Interview with:
Cristina Wood, MD
Obstetric and Fetal Anesthesiologist
Children’s Hospital Colorado

Dr. Wood

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

Response: ​We all know that opiate abuse is a national crisis, but also is one of the top causes of maternal mortality in the state of Colorado. At the Colorado Fetal Care Center at Children’s Hospital Colorado, we wanted to see what we could do to reduce the need for opiate medications after cesarean delivery. We started by using wound soakers to reduce the opiate requirement and demonstrated an almost 30% reduction in postoperative opiate use. Then, when the Society of Obstetric Anesthesia and Perinatology (SOAP) published guidelines for Early Recovery

After Cesarean (ERAC), we incorporated these into our practice to determine if these interventions would decrease the opiate requirements further. We were so pleased to see that we could further reduce the opiate need for our moms postoperatively. In fact, we reduced it by approximately 80%, with 1/3 of our patients never taking a single narcotic medication after cesarean delivery. 

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No Decrease in Pain Relief With Less Opioids After Surgery

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PainRelief.com Interview with:
Ryan Howard, MD
Academic Development Time Year 1
Resident, General Surgery
University of Michigan

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

Response: Opioids are commonly prescribed to control pain after surgery, but they also carry significant risks such as overdose, long-term dependence, and diversion into the community. While some have advocated for decreasing or eliminating opioids from postoperative pain control regimens, others are concerned that this would lead to uncontrolled pain and dissatisfied patients. To study whether that’s true, we compared two groups of patients undergoing the same surgical procedures. One group received “opioid-sparing” prescriptions after surgery and the other group received “normal-sized” prescriptions.

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Conditioned Open-Label Placebos Provide Pain Relief in Some Post-Surgical Patients

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PainRelief.com Interview with:
Kristin Schreiber, MD, PhD
Neuroscientist and Clinical Regional Anesthesiologist
Brigham and Women’s Hospital
Assistant Professor of Anesthesia
Harvard Medical School

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

Response: Traditionally, the placebo effect has involved deceiving patients, where they think they may be taking a real medication. “Open-label placebos” are when placebos are given to patients, and patient are told that they are in fact a placebo. Recent research has suggested that these open-label placebos may actually reduce a number of symptoms in patients, including chronic low back pain. We were interested whether this strategy could be used to help reduce pain and opioid use around the time of surgery. We decided to combine the use of OLP with a conditioning approach, so that anytime a patient took an opioid analgesic, they would take the open-label placebo, so that the OLP pills would be associated with pain relief. That way when patients took them on their own, it would serve to trigger an expectation of pain relief, which is thought to at least partially explain the placebo effect.  

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Study Discusses Overlap of Opioid Therapy for Physical and Social Pain Relief

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PainRelief.com Interview with:
Mark Sullivan, MD, PhD
Professor, Psychiatry and Behavioral Sciences
Adjunct Professor, Anesthesiology and Pain Medicine, Bioethics and Humanities
Medical Co-Director, UW Telepain

Dr. Sullivan

University of Washington
Seattle, WA 98195

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

Response: This is a review paper than synthesizes neuroscience, pharmacological and epidemiological research on the opioid epidemic. It has been known since at least the 1970s that opioids treat not only pain due to physical damage, but also separation distress.

Functional neuroimaging (fMRI) studies have shown that physical pain (tissue injury) and social pain (social rejection) activate the same limbic brain centers (insula, cingulate cortex). Both chronic pain and depression are associated with dysfunction of the endogenous opioid system in the human brain. Studies of opioid prescribing have shown that patients with chronic pain, who also have anxiety and depressive disorders are more likely to be prescribed long-term opioid therapy at high doses and with concurrent sedatives.

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Opioid Analgesic Use For Pain Relief in Chronic Noncancer Pain

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PainRelief.com Interview with:
Dr Stephanie Mathieson
NHMRC Health Professional Research Early Career Fellow
The University of Sydney
Faculty of Medicine and Health, Sydney School of Public Health
Institute for Musculoskeletal Health
Royal Prince Alfred Hospital Australia

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

Response: Chronic non-cancer pain, such as chronic non-specific low back pain has a substantial impact on society by costing billions of dollars each year in health care costs and lost productivity.

Current clinical practice guidelines for the management of chronic non-cancer pain, such as those from the Centers for Disease Control and Prevention, now recommend avoiding the initial use of opioid analgesics, as the risk of harms, such as overdose and death.

We wanted to establish the extent to which opioid analgesics are used by people with chronic noncancer pain. This is important, as many studies report how many opioids are prescribed, but this may not represent the actual use of opioid analgesics.

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