Tory R. Spindle, Ph.D. Postdoctoral Research Fellow Behavioral Pharmacology Research Unit Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine
Dr. Spindle
PainRelief.com: What is the
background for this study? What are the
main findings?
Response: Cannabis and hemp products that contain CBD as the primary constituent have become widely available in the U.S. and are often used for various therapeutic purposes. However, there is presently little research to understand how such products could impact drug testing for cannabis which is commonly conducted in workplace, criminal justice, and other settings.
Drug testing for cannabis targets a common metabolite of THC called THCCOOH; THC is the primary psychoactive component of cannabis. Our results suggest that single use of a product that contains pure CBD would not produce a positive result on a standard urine drug test. However, we found that 2 of 6 participants tested positive for cannabis after they used a CBD-dominant strain of cannabis that contained a very low concentration of THC: only 0.39% THC.
PainRelief.com Interview with: Alex Fauer, RN, OCN® Ph.D. Candidate University of Michigan School of Nursing
PainRelief.com: What are the main findings?
Response: Our primary finding of the paper is that the age-, sex-, and US region-adjusted percentage of adults who used a gabapentinoid increased from 2.34% to 5.60% from 2005 to 2015. The total number of gabapentinoid prescriptions filled among US adults diagnosed with cancer was approximately 1.19 million in 2005, but increased to 3.52 million in 2015.
We also found that adults aged 18-44 were the highest users of gabapentinoids.
Professor, University of California, San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences San Diego Supercomputer Center
PainRelief.com: What is the
background for this study? What are the
main findings?
Response: The background for this study was concern about unknown side effects of tramadol that became a popular treatment for chronic pain. With our informatics approach and access to millions of the FDA reports we were in a position to look for those adverse effects and we found that hyperglycemia (low blood sugar) is one of those concerns. There have been a few small-scale studies and case reports of tramadol use associated with hypoglycemia and hospitalizations related to it. The dramatic increase in tramadol prescription rates, especially in light of tighter control over hydocodone/acetaminophen (went from schedule III to II), warranted a larger scale postmarketing study of FDA FAERS reports.
As we compared the hypoglycemia side effect between different opioids we found that only one other drug, methadone (used to treat drug abuse and addiction), has a comparable association with hypoglycemia.
PainRelief.com: What should readers take away from your report?
Response:
Patients using tramadol should should be aware of
hypoglycemia symptoms such as shakiness, dizziness, sweating, hunger,
irritability, moodiness, anxiety/nervousness, and headache, or, in severe cases,
blurred vision, seizures or loss of consiousness. The same applies to
methadone, also known as Dolophine.
PainRelief.com: What recommendations do you have for future research as
a result of this work?
Response:
It may be beneficial to perform controlled studies to
confirm and understand this association. Our study looked at other drugs with
the known pharmacology of tramadol (mu-opioid agonism, serotonin/norepinephrine
re-uptake inhibition, and NMDAR antagonism), but did not find an association
with hypoglycemia with a specific class. Would be interesting to learn
more about additional/other pharmacology of tramadol and methadone behind the
etiology of hypoglycemia.
PainRelief.com: Is there anything else you would like to add?
Response:
We think that studies of this nature are beneficial since
rare side effects often go unnoticed in clinical trials due to a limited number
of participants. Additionally, hypoglycemia effects may often be attributed to
other medications and medical conditions, while tramadol or methadone were
unlikely to cause suspicion.
Any disclosures?
Non of the authors have any financial or non-financial conflicts
of interest to disclose.
Citation:
Tigran Makunts, Andrew U, Rabia S. Atayee, Ruben Abagyan. Retrospective analysis reveals significant
association of hypoglycemia with tramadol and methadone in contrast to other
opioids. Scientific Reports, 2019; 9 (1) DOI: 10.1038/s41598-019-48955-y
[wysija_form id=”3″]
[last-modified]
The information on PainRelief.com
is provided for educational purposes only, and is in no way intended to
diagnose, cure, or treat any medical or other condition. Always seek the advice
of your physician or other qualified health and ask your doctor any questions
you may have regarding a medical condition. In addition to all other
limitations and disclaimers in this agreement, service provider and its third
party providers disclaim any liability or loss in connection with the content
provided on this website.
Dr Yousuf El Mokhallalati MD, MPH and PhD candidate Research Assistant, and PhD candidate Academic Unit of Palliative Care Leeds Institute of Health Sciences (LIHS) University of Leeds Leeds, UK
PainRelief.com: What is the
background for this study? What are the
main findings?
Response: We examined the factors
associated with good pain relief at before death, using data which was drawn
from responses to the National Bereavement Survey (VOICES) in England between
2011 and 2015, which asked families or close relatives to reflect on the quality
of care provided to a person who had died.
Just 10% of patients who
died of a non-cancerous disease received palliative care at home, compared to
63% of cancer patients.
The
study revealed that people who accessed palliative care at home were 2.7 times
more likely to have experienced good pain relief compared to those who did not
receive palliative care.
The
association between good pain relief and palliative care at home occurred
regardless of the type of disease that patients had, but access to palliative
care was not provided equally.
This research
shows that palliative care is associated with significant benefits to people
with every kind of progressive disease, but this is not reflected in the spread
of people that are being offered palliative care.
The study
also suggests that patients who had planned where they wanted to die are nearly
twice as likely to experience good pain relief compared to those who had not,
showing the value of planning ahead and coordinating the support of healthcare
professionals.
Only a quarter of patients were found to have recorded a preferred place of death. Cancer patients were nearly three times more likely to have a preference recorded compared to non-cancer patients (36.6% of cancer patients versus 13.1% of non-cancer patients).
PainRelief.com Interview with: Eve Ling-Khoo,MSc. OT Candidate, BSc. Hons Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
PainRelief.com: What is the
background for this study? What are the
main findings?
20%
of adults worldwide suffer from chronic pain which impacts all facets of
well-being.
Cognitive
behavioral therapy (CBT) is the current gold standard for psychological
intervention, but not everyone responds to it.
Mindfulness-based
stress reduction (MBSR) is an alternative with the potential to improve the
quality of life of patients with chronic pain.
Manuela L. Ferreira PhD Institute of Bone and Joint Research The Kolling Institute, Sydney Medical School
Paulo H. Ferreira PhD Musculoskeletal Health Research Group Faculty of Health Sciences University of Sydney, Sydney, NSW, Australia
PainRelief.com: What is the
background for this study? What are the
main findings?
Response: One in four Australians experience back pain or neck pain. Diabetes
is also a worldwide prevalent condition, and currently affects over 382 million
people. These two diseases often co-exist and have very similar underlying
mechanisms, such as obesity and physical inactivity. We were unsure whether
having one condition would lead to developing the other, however.
We have found 11 studies published to date, and assessing the relation between back or neck pain and diabetes. The studies included over 165,000 participants published in the USA, Canada, Finland, Denmark, Iran and Spain.
When we pooled the results of these studies together, we observed that people with type 2 diabetes are 35% more likely to also have low back pain (compared to people without diabetes). The risk of having severe back pain symptoms in people with type 2 diabetes is 63% higher and the risk of having severe neck pain is almost 30% higher, than in people with no diabetes. We could not identify, however, whether type 2 diabetes can lead to back or neck pain, and it is possible that the two conditions are associated via other underlying mechanisms such as obesity and physical inactivity.
Chronic Pain Patients: Opioid Induced Constipation a Serious Concern After Surgery
PainRelief.com Interview
with:
Jonathan Jahr, MD, DABA, FASA
Dr. Jonathan Jahr is an anesthesiologist in Los
Angeles, California and is affiliated with multiple hospitals in the area,
including UCLA Medical Center and UCLA Medical Center-Santa Monica. He received
his medical degree from New York Medical College and has been in practice for
more than 20 years.
PainRelief.com: What is the
background for this study? Why is it important?
Response: I have
worked in the hospital setting for the past 25 years and have conducted
multiple studies on different opioid and non-opioid strategies for managing
both chronic and acute pain. I also co-edited a textbook entitled Essence
of Analgesia and Analgesics. My background and the research I’ve done
sets the stage for newer pain management protocols that can provide patients
with significant pain relief, and improved satisfaction and outcomes due to
fewer or avoided opioid related side effects (ORADS) such as opioid-induced
constipation (OIC).
The “Women and Weed Survey”, conducted online by CVI (Canadian Viewpoint Inc.), on behalf of Van der Pop, found women used cannabis ‘for wellness reasons versus for social experiences’, with many regular users citing their primary reason for doing so was “to manage stress or relieve anxiety, followed by to manage pain or to combat symptoms of a medical condition (27%) and to relax (17%).”
This study is systematic review and meta-analysis to evaluate the tolerability and efficacy of intranasal sumatriptan for the treatment of acute migraine attacks. Taste disturbance was a leading side effect.
Medtronic announces the U.S. launch of the Intellis platform for management of certain types of chronic intractable pain which can be managed on the Samsung Galaxy Tab S2 tablet interface.
The information on PainRelief.com is provided for educational purposes only, and is in no way intended to diagnose, endorese, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website. None of the content on PainRelief.com is warranted by the editors or owners of PainRelief.com or Eminent Domains Inc.
Thank you for visiting PainRelief.com
Senior Editor, Marie Benz MD.
For more information, or for advertising options please email: [email protected] or [email protected]
