Miami Thoracic Surgeons Achieve Pain Control With Minimal or No Opioids

PainRelief.com Interview with:
Dao Minh Nguyen, MD, MSc FRCSC FACS
Thoracic Cancers Group Go-Lead
Sylvester Comprehensive Cancer Center
University of Miami Miller School of Medicine

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

Response: Patients undergoing thoracic surgery operations experience significant acute incisional pain as well as chronic pain many months after.

The mainstay of treatment is based on frequent use of potent and addictive-prone opioids such as hydromorphone, oxycodone at high dosages and long duration.
There is a high incidence of persistent opioid users and chronic opioids users in surgical patient population. This certainly contributes to the opioid epidemic in the USA and worldwide.

We implemented a peri-operative care protocol for patients undergoing thoracic surgery operations called Enhanced Recovery after Thoracic Surgery (ERATS). The overarching goal of ERATS is to streamline care for thoracic surgery patients particularly in the postoperative period to mitigate pain with opioid-free strategy, to minimize postoperative complications, rapid return to baseline states and safe, early discharge home. This protocol follows guidelines of the ERAS principles and is developed for thoracic patients to address their unique needs.

Once pain is adequately addressed with opioid-free strategy with elimination of opioid-associated side effects, rapid recovery after surgery can be achieved.

Continue reading

Canadian Study Finds Cannabis Use Disorder Associated with Higher Risk of Heart Disease

PainRelief.com Interview with:
Anees Bahji, BSc(H), MD, CISAM, CCSAM, DABPN, FRCPC (pronouns: he/him/his)
Clinical Assistant Professor, Department of Psychiatry, University of Calgary
Ph.D. Student, Department of Community Health Sciences, University of Calgary
Addiction, Concurrent Disorder, and General Psychiatry
Opioid Dependency Program, Sheldon M. Chumir Centre
Rapid Access to Addiction Medicine Service, Calgary
Adult Addiction Centre, 6th Floor, Foothills Medical Centre

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

Response: The background for this study is rooted in the need to understand the potential health implications of cannabis use disorder (CUD), especially in relation to cardiovascular health.

Cannabis has become increasingly popular for both recreational and medicinal purposes, and it is essential to assess its impact on various health outcomes.

Continue reading

Newly Studied Pain Pathway May Provide Pain Relief Without Opioid Side Effects

PainRelief.com Interview with:
Daniel McGehee, PhD
Professor
Chair, Committee on Neurobiology
Department of Anesthesia & Critical Care
University of Chicago

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

Response: Chronic pain conditions are major challenges for those suffering with pain and the clinicians who struggle to find effective treatments. Identifying novel strategies for relieving pain will help limit availability of opioid drugs, as they offer alternatives to replace or reduce opioids in the clinic. 

Along with overdose and addiction issues, there are other complications and side effects of opioids, including tolerance, where the pain relieving properties diminish with repeated use, hypersensitivity to pain when patients stop taking the drug, constipation, and other peripheral side effects. 

Pain relief without those side effects would certainly be valuable for individuals struggling to treat painful conditions. 

Continue reading

Fibromyalgia: Imaging Studies Find Cognitive Behavioral Therapy Reduces Pain Catastrophizing

PainRelief.com Interview with:
Jeungchan Lee, Ph.D.,
Instructor
MGH/HST Athinoula A. Martinos Center for Biomedical ImagingSpaulding Rehabilitation Hospital
Harvard Medical School
Charlestown, MA 024129

Jeungchan Lee, Ph.D.,
Postdoctoral Research Fellow
MGH/HST Athinoula A. Martinos Center for Biomedical ImagingSpaulding Rehabilitation Hospital
Harvard Medical School
Charlestown, MA 024129

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

Response: Cognitive behavioral therapy (CBT) has shown promise in alleviating fibromyalgia (FM) symptoms by targeting pain-related catastrophizing, which comprises negative cognitive and emotional processes amplifying pain perception.

However, the neurological mechanisms underlying CBT’s impact on pain catastrophizing in FM patients have remained unclear.

Continue reading

Smaller Portions of Pain Relievers After ER Visits May Be Sufficient for Pain Relief

PainRelief.com Interview with:
Raoul Daoust, MD, CSPQ, MSc
Clinical Professor and researcher
Departments of Family Medicine and Emergency Medicine
Hôpital du Sacré-Coeur de Montréal

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

Response: Usually patients are prescribed too large a quantity of opioids and unused opioids are available for misuse. The tendency in the USA is to not prescribe opioids at all, leaving some patient in agonizing pain. I wanted to provide a tailored approach to prescribing opioids so patients have enough to manage their pain but almost no unused opioids available for misuse.

Continue reading

Unequal Access to Chiropractic Pain Relief Care for Back Pain in Patients with Opioid Use Disorder

PainRelief.com Interview with:
Patience Moyo, Ph.D
Assistant Professor of Health Services, Policy and Practice
Center for Gerontology and Healthcare Research
Department of Health Services, Policy, and Practice
Brown University School of Public Health

Patience Moyo, Ph.D
Assistant Professor of Health Services, Policy and Practice
Center for Gerontology and Healthcare Research
Department of Health Services, Policy, and Practice
Brown University School of Public Health

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

Response: Clinical practice guidelines recommend nonpharmacologic treatments as first-line therapies for managing chronic pain. However, little is known about the use of guideline-recommended pain therapies and whether use varies in demographic subgroups. Individuals with co-occurring chronic pain and opioid use disorder deserve particular consideration because of their increased risk of harm from opioids and other pharmacologic therapies combined with their susceptibility to social and structural barriers to accessing health care.

We sought to understand whether the well-established racial and ethnic inequities in pain management extend to individuals with opioid use disorder and to nonpharmacologic pain treatments, specifically physical therapy and chiropractic care.

Continue reading

Hypertension Drug May Decrease Both Inflammation and Need for Knee Replacement

PainRelief.com Interview with:

Iskandar Tamimi MD, PhD
Hospital Regional Universitario de Málaga
Faculty of Medicine, University of Málaga
Hospital HM
Málaga, Spain

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

Response: Knee osteoarthritis is a painful and limitting condition that affects a significant percentage of the world’s population. The treatment of end stage knee osteoarthritis is a undergoing a total knee replacement. This procedure is considered a major surgery and it’s associated with a significant number of complications, such as infections, deep vein thrombosis, residual knee pain, etc,,

Continue reading

Buprenorphine Prescriptions for Opioid Use Disorder Increased During Pandemic, with Regional Variations

PainRelief.com Interview with:
Zhi-Shan Hsu
Abigail Geisinger Scholar
Geisinger Commonwealth School of Medicine
Scranton, PA.

Zhi-Shan Hsu MD
Abigail Geisinger Scholar
Geisinger Commonwealth School of Medicine
Scranton, PA.

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

Response: The opioid buprenorphine is a mu and nociceptin receptor partial agonist and serves as an antagonist to kappa and delta receptors. These properties contribute to this medication being an evidence-based and first-line agent in Opioid Use Disorder (OUD) treatment. Brand names of buprenorphine include Suboxone, Zubsolv, Butrans, and Sublocade. In the face of the COVID-19 pandemic and continued annual increases in drug overdoses, modifications to payment, privacy, and licensing regulations that were designed to improve access to telehealth services have likely had an impact on prescribing practices of buprenorphine.

The objective of this study (1) was to expand upon existing knowledge regarding geographic disparities in the distribution and access to buprenorphine (2) as well as consider coinciding modifications to Medicaid, Medicare, and telemedicine regulations. Data was obtained from Drug Enforcement Administration’s Automated Reports and Consolidated Ordering System (ARCOS),(3) a comprehensive drug reporting system of controlled substances from their point of manufacturing to point of sale and distribution and also Medicaid and Medicare.

Continue reading

Medical Music Therapy: Another Tool in Pain Relief Treatment

PainRelief.com Interview with:
Seneca Block, Ph.D(c), MT-BC  
The Lauren Rich Fine Endowed Director of Expressive Therapies
Adjunct Instructor, School of Medicine, Dept. of Psychiatry, CWRU
Director AMTA National Roster Internship
Board Certified Music Therapist
University Hospitals Connor Whole Health
Cleveland Medical Center
Cleveland Ohio 44106

PainRelief.com: What is the background for this study? What types of music do you utilize?

Response: We summarized a process improvement initiative aimed to increase a large scale medical music therapy group’s (13.3FTE) pre and post metrics collection of patient reported outcomes including stress, pain, anxiety and coping. Music Therapy sessions featured multiple interventions utilizing patient preferred music facilitated live by board certified music therapists. As a quality improvement initiative, a series of team training sessions were implemented to provide education on data capturing techniques of patient reported outcomes.

Continue reading

State-Level Policies May Reduce Disparities in Pain Prevalence

PainRelief.com Interview with:
Rui Huang MA

Department of Sociology
University at Buffalo
Buffalo, NY

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

Response: In the U.S., approximately 58.5 million people (23.7% of adults) have arthritis, and at least 15 million of them suffer from severe arthritis-attributable joint pain. Severe joint pain is strongly associated with impaired functioning, disability, mortality, and limited life chances. People with less education disproportionately suffer from joint pain and reduced quality of life.

However, existing research on social determinants of pain relies primarily on individual-level data; it rarely examines the role of macro sociopolitical contexts, such as state-level policies.  Moreover, relatively little is known about the geographic distribution of pain, and even less is known about geographic variation in socioeconomic disparities in pain. 

To our knowledge, this is the first study to look at how U.S. state-level policies and characteristics shape risk of pain, and educational disparities in pain.

Continue reading