Marijuana May Be Substituting for Opioids for Cancer-Related Pain Relief

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PainRelief.com Interview with:
Yuhua Bao, PhD
Department of Population Health Sciences, Department of Psychiatry
Weill Cornell Medicine, New York, New York

Dr. Yuhua Bao

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

Response: We know that opioid use is declining among cancer patients. We also know that marijuana use is increasing among cancer patients; this increase is related to the recent wave of medical marijuana legalization (adopted by 37 states and D.C. as of Feb 2022).

We do not know if medical marijuana legalization has led to changes in opioid use for cancer patients and what were the implications for cancer pain outcomes.

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Study Uses Medicare Claims to Link Physician Beliefs About Benzodiazipene Safety and Prescription Fills

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PainRelief.com Interview with:
Donovan Maust, M.D., M.S. 
Associate Professor, Psychiatry
University of Michigan Medical School

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

Response: Benzodiazepine prescribing has been quite persistent and even increasing among middle aged adults even as we’ve learned more about the associated harms.

To develop effective interventions to address prescribing, it would be helpful to understand how clinicians make their prescribing decisions. But then it is a problem if you ask clinicians about a particular behavior (e.g., prescribing) but don’t have actual objective data about their prescribing behavior.

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Dentists Reports Patients Coming to Appointments High on Marijuana

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Survey from the American Dental Association

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

Response: Each year, the ADA surveys dentists and consumers around emerging issues or trends in healthcare. As legalization and use of marijuana continues to increase, oral health issues around marijuana use are beginning to emerge. This, combined with a lack of awareness and understanding of the potential adverse health effects of routine marijuana use, was the reason for including it in our survey work.

cannabis-marijuana

PainRelief.com: What should readers take away from your report?

Response: Because legalized marijuana, whether personal or medicinal, is still relatively new, people may not be aware of the effects marijuana can have on oral health and dental visits. Readers should be aware that marijuana use can effect oral health in general as well as limit the care delivered at dental visits if used before an appointment.

Dentists and patients should also take away the importance of open conversation about marijuana use during dental visits. Health history updates can be a natural place to start an open dialogue.

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Study Assesses Cannabis Therapies for Low Back Pain Relief

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PainRelief.com Interview with:
Dror Robinson, M.D., Ph.D
Department of Orthopedics, Hasharon Hospital
Rabin Medical Center
Petah Tikva, Israel

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

cannabis-marijuana

Response: The background of the study is my concern as an orthopedic surgeon, regarding the optimal pain relief therapy for low back pain.  I am interested in particular with patients who failed prior interventions, either pharmaceutical or surgical.  These patients are an unfortunately growing group of patients without a good therapeutic option.  Most of them become chronic pain patients with the resultant multi-domain dysfunction both physical and mental. 

Cannabis appears to be able to allow both mental recovery and physical function recovery in such patients.  The main findings in the current study is that in patients with chronic pain due to low back pathology inhaled high-THC cannabis therapy is superior to extract high-CBD cannabis therapy.  Maximal therapeutic effect is reached after 18 months of therapy and appears to require high THC concentrations as compared with more balanced THC:CBD chemovars.

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Ultrasound Guided Dry Needling Boosts Pain Relief for Patients with Knee Osteoarthritis

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PainRelief.com Interview with:
Dr PANG Chun Yiu Johnson
Assistant Professor
School of Health Sciences
Caritas Institute of Higher Education
Hong Kong

Mr PANG

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

Response: As a practicing physiotherapist for over 20 years in an outpatient setting at a government-based hospital, I had encountered difficult situations where patients were suffered with long-term pain that pervious treatments were ineffective or wasn’t long lasting.

Dry needling is a treatment technique that I had always been interested and practicing even during my college times. With years of practice, it has become a skill that I specialized in and received promising results from most of my patients.

However, like most techniques, it has its limitations. Microtrauma inducted by the puncturing of the needles elicit inflammatory response that activate mast cells proliferation to promote tissues healing. As a result, the effectiveness of dry needling depends on the expertise and skill of the practitioners to accurately locate the problematic structure for the insertion of needles.

The inconsistency results of studies with dry needling can be attributed to the absence of a standardized approach and inaccuracies related to needle targeting and advancement.

With that in mind, I wanted to investigate and validate a method that can enhance the accuracy of needle advancement and improve the effectiveness of dry needling. Through constantly researching evidence-based publications, coincidently I came across an article that incorporated ultrasound guidance into dry needling on treating shoulder impairments. The results were promising, both in patient’s feedback and ultrasound imaging, since the practitioner was able to clearly identify the problematic structure under ultrasound guidance. This had inspired me to further investigate the effectiveness of ultrasound-guided dry needling on different musculoskeletal conditions.

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Pain Relief from Osteoarthritis Achieved Through Digital and Face-to-Face Interventions

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PainRelief.com Interview with:
Thérése Jönsson, PT, PhD
Research group, Sport Sciences
Department of Health Sciences
Lund University

Dr. Jönsson

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

Response: Osteoarthritis (OA) is the most common joint disease and affects more than 300 million people worldwide. Exercise combined with patient education and weight control, if needed is the first-line treatment for OA. Traditionally, first-line treatment has been provided as a face-to-face intervention, requiring the patient to physically visit a primary care clinic or similar.

To increase access to healthcare for the wider community, digital health care interventions are recommended by the World Health Organization to complement traditional care. Digital care platforms have been introduced, but there is limited evidence for their efficacy compared with traditional face-to-face treatment modalities.

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Chronic Pain Linked to Later Life Pessimism and Joblessness

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PainRelief.com Interview with:
Alex Bryson PhD
Professor of Quantitative Social Science
UCL Social Research Institute
University College London  London

Prof. Bryson

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

Response: The authors were concerned to know more about both the incidence of chronic pain and its implications for health, wellbeing and labour market prospects later in life.  So we turned to a birth cohort study (The National Child Development Study) tracking all those born in Britain in a single week in 1958 through to age 62 to take a life-course approach.

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Yoga for Knee Arthritis: Some Improvement in Function but No Pain Reduction

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PainRelief.com Interview with:
Professor Kim Bennell FAHM
Barry Distinguished Professor | NHMRC Leadership Fellow
Dame Kate Campbell Fellow
Centre for Health Exercise and Sports Medicine
Department of Physiotherapy
Melbourne School of Health Sciences
The University of Melbourne, Victoria Australia

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

Response: Osteoarthritis is very common, and a major contributor to disability and decreased function. Exercise is a key treatment for osteoarthritis, but many people admit to not undertaking exercise. We investigated whether a free, online 12-week unsupervised yoga program (“My Joint Yoga”) could improve pain and function in people with knee osteoarthritis. Our team worked with yoga therapists, physiotherapists and people with lived experience of osteoarthritis to design an online yoga program tailored specifically to those with knee osteoarthritis.

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Pain Stimulates Protective Mucus Secretion in GI Tract

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PainRelief.com Interview with:
Isaac M. Chiu PhD
Associate Professor, Department of Immunology
Harvard Medical School
Boston, MA 02115

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

Response: The gut is densely innervated by pain fibers and we know that pain is associated with gut-related diseases. However, it is not so clear how pain fibers talk to the gut lining and barrier. We were interested to see that pain fibers were very close by the epithelial cells that line the gut, and in particular the goblet cells that produce mucus. We were wondering if mucus could be regulated by pain. Mucus is a key protective barrier that keeps our gut healthy by keeping harmful substances as well as bacteria away from the gut wall.

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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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