Chronic Pain Extends Beyond Mere Physical Symptoms

PainRelief.com Interview with:
Dahee Wi, PhD, RN
Department of Biobehavioral Nursing Science
University of Illinois Chicago
College of Nursing, Chicago, Illinois

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

Response: Chronic pain, defined as persistent or recurrent pain lasting longer than three months, is a significant health problem, particularly among U.S. active duty service members (ADSM). ADSMs are at an elevated risk for chronic pain due to the nature of military service and related job training. Chronic pain is a leading cause of disability and medical discharge in the military, significantly impacting readiness and mission capabilities.

Chronic pain is often accompanied by multiple comorbid conditions, making it essential to view it not just as a single symptom but in relation to co-occurring symptoms of other conditions. The study conducted network analysis, an analytic technique that provides graphical representations of the relationships between selected measures. This approach can offer new insights into the complex interplay of physical, emotional, and social factors in chronic pain

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WashU Study Surveys Cannabis Use for Sleep

PainRelief.com Interview with:
Carrie Cuttler, Ph.D.
Associate Professor
The Health & Cognition (THC) Lab
Department of Psychology
Washington State University

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

Response: We know that one of the top 5 reasons cannabis users report using cannabis is for sleep disturbances, but we don’t know very much about the types of products they prefer to use for sleep or their perceptions of its effects and side effects relative to more conventional sleep aids (e.g., benzodiazepines, antihistamines, melatonin).

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Dental Pain: Progress Toward Reducing Opioids for Pain Relief Slowed During Pandemic

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
Dr. Kao-Ping Chua

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

Response: Using national data, we show that U.S. dental opioid prescribing decreased 45% between 2016-2022, but this decrease slowed during the COVID-19 pandemic.

If pre-pandemic trends had continued, we estimated that 6.1 million fewer opioid prescriptions from dentists would have been dispensed between June 2020 and December 2022.

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Mass General Studies Molecule Linking Sleep Deprivation with Increased Pain Sensitivity

PainRelief.com Interview with:
Shiqian Shen, M.D.
Assistant Anesthetist
–Anesthesia & Crit. Care, Massachusetts General Hospital
Associate Professor of Anaesthesia
–Harvard Medical School
Physician Investigator (Cl)
–Anesthesia, Critical Care and Pain Medicine, Mass General Research Institute

PainRelief.com: What is the background for this study? Would you describe the function of NADA?

Response:  Both sleep disorders and chronic pain are very prevalent among adults. For example, about one third of U.S. adults report some level of sleep disturbance. Both common life experience and medial research strongly suggest that sleep deprivation leads to heightened pain experience/perception. However, the mechanisms of this link are not entirely clear. Hence we decide to study this important question.

NADA, N-arachidonoyl dopamine was first discovered to be an agonist for the Cannabinoid Receptor 1 and it was found in the brain of animals. It belongs to the endocannabinoid family. Additionally, NADA also belongs to the endovanilloid family. Administration of NADA to rodents produces a wide variety of behavioral changes, including behaviors mimicking the physiological paradigms association with cannabinoids. However, its physiological function is not well characterized.

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Post C-Section Pain Relief: Noninvasive Bioelectronic Device Reduced Need for Opioids

PainRelief.com Interview with:
Jennifer Grasch, MD
Fellow, Maternal-Fetal Medicine
Department of Obstetrics and Gynecology
The Ohio State University Wexner Medical Center

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

Response: Cesarean delivery is the most commonly performed major surgery in the US. Almost all patients who have a cesarean delivery take opioid pain medications for postoperative pain, but we know that opioids have many short- and long-term side effects.

We conducted a triple-blind sham-controlled randomized clinical trial testing the efficacy of adding transcutaneous treatment with a high-frequency (20,000 Hz) electrical stimulation device to a multimodal analgesic protocol after cesarean delivery. 

Participants who were randomly assigned to the functional device used 47% less opioid medication postoperatively in the hospital and were prescribed fewer opioids at discharge than those who received treatment with a sham device.  

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PainRelief Through Optogenetics: Scientists Make Flexible Gel to Deliver Light to Peripheral Nerves

PainRelief.com Interview with:
Xinyue Liu, Ph.D.

Assistant Professor
Department of Chemical Engineering and Materials Science
Michigan State University
Siyuan Rao, Ph.D.
Assistant Professor
Biomedical Engineering Department
Binghamton University, SUNY

Dr. Liu

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

Response: The background lies in the field of optogenetics and its application to the study and modulation of pain perception. Optogenetics is a powerful tool that allows precise control of neural cell populations using light. It has been widely used in neuroscience to investigate how different cells in the brain and nervous system function and how their activity can be modulated. Specifically, in the context of pain research, optogenetics offers the potential to explore the neural mechanisms underlying pain perception and to develop new therapeutic interventions for pain management.

However, one of the challenges in applying optogenetics to the study of pain and nociceptive circuits is the delivery of light to peripheral nerves that experience mechanical strain during locomotion. Traditional light-delivery devices made from rigid materials, such as glass fibers, are not well-suited for this purpose. They can impede the natural behaviors of animals and may cause tissue damage when used in dynamic conditions.

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Buprenorphine Initiation and Retention Through Telehealth for Opioid Use Disorder

PainRelief.com Interview with:
Lindsey Hammerslag, Ph.D.
Assistant Research Professor
Division of Biomedical Informatics
University of Kentucky
Lexington, KY 40536

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

Response: This study was designed to examine whether COVID-related changes to buprenorphine prescribing policies, which allowed the use of telehealth during treatment initiation, were associated with benefits for people with opioid use disorder. There’s a push to return to normalcy, with some COVID-related policies being rolled back during the unwinding, and we felt that it was important to make sure that we could provide the evidence policy makers need to make good decisions for patients.

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Study Finds Modest Decrease in Opioid Prescriptions after Insurer Opioid Prescribing Limit

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
Dr. Kao-Ping Chua

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

Response: Almost every state has implemented a policy to restrict the duration of opioid prescriptions for acute pain, as have many major insurers. Prior studies have evaluated the effects of these limits on opioid prescribing, but there are no large-scale studies that have evaluated the effects of limits on patient-reported outcomes, such as pain control.

In this study, we evaluated the effect of a major Michigan insurer’s
5-day opioid prescribing limit in February 2018 on both opioid prescribing and patient-reported outcomes after surgery.

To do so, we leveraged our access to a statewide surgical registry in Michigan that has been collecting data on opioid prescribing and patient-reported outcomes from adult patients undergoing common general surgical procedures since 2017.

Columbia Model Predicts Return-to-Use Risk After Treatment for Opioid Use Disorder

PainRelief.com Interview with:
SEAN X. LUO, M.D., PH.D.
Assistant Professor of Clinical Psychiatry
Data Science Research Group
Division on Substance Use Disorders
Department of Psychiatry
Columbia University

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

Response: Opioid use disorder presents a major public health crisis, with increasing overdose death through the last 5 years. Treatment delivery continues to be difficult, with a large number of patients not stably maintained on Medication for Opioid Use Disorder (MOUD) after the initial treatment engagement.

In this study we applied novel statistical methods to a newly harmonized dataset incorporating 3 large clinical trials from the National Drug Treatment Clinical Trials Network (CTN) to develop individual level risk prediction models for opioid use disorder. We showed that urine toxicology data in the first 3 weeks after initiation of treatment can predict return-to-use at the end of 3 months with surprising accuracy.

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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.

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