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

Posted on by

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 →

Nerve Pathway Identified That May Mitigate Pain from Endometriosis

Posted on by

PainRelief.com Interview with:
Robert N. Taylor, MD PhD
Professor of Obstetrics and Gynecology
Investigator, Clinical and Translational Research Center
Jacobs School of Medicine and Biomedical Sciences
University at Buffalo

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

Response: Our laboratory has been interested in the hormonal modulation of endometriosis-associated pain for decades. This disease and its manifestations are multifactorial. In the current study we focused on the role of nerve growth factors and their receptors, interactive proteins that direct the growth of new nerves and allow their circuits to communicate to regions of the brain that sense pain.

Continue reading →

Cannabis Smoke Exposure is Not Risk Free

Posted on by

PainRelief.com Interview with:
Beth Cohen, MD MAS
Professor of Medicine, UCSF
Co-Director, PRIME Internal Medicine Residency Program
Staff Physician, San Francisco VA Medical Center

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

Response: Though rates of tobacco use are declining, rates of cannabis use are increasing as it becomes more widely legal and available. Though there is not as much research on the long-term health effects of cannabis, cannabis and tobacco smoke contain many of the same carcinogens and toxins and both have particulate matter than is harmful when inhaled.

Continue reading →

Medical Music Therapy: Another Tool in Pain Relief Treatment

Posted on by

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 →

Study Finds TENS Device, Usually Used for Pain Relief, May be Useful in Sleep Apnea

Posted on by

PainRelief.com Interview with:
Joerg Steier PhD
Professor of Respiratory and Sleep Medicine
Guy’s & St. Thomas NHS Foundation Trust
King’s College London

PainRelief.com: What is the background for this study? Where is the TENS unit applied?

Response: Patients with obstructive sleep apnoea hold their breath at night, which fragments their sleep and leads to daytime symptoms like excessive daytime sleepiness. Keeping the tone of the neuromuscular structures, particularly the hypoglossal nerve and the genioglossus muscle, elevated at night using electrical current has become an established treatment over the last decade.

Hypoglossal nerve stimulation, however, is using an implantable device, is costly, and requires surgical intervention. The novelty in the current study is that using a transcutaneous electrical neurostimulator (TENS) that is placed underneath the chin in the submental area can achieve significant improvements sleep apnoea severity and associated symptoms as well.

Continue reading →

NEJM: Vertex Pharma Study Demonstrates Potential for First-in-Class Non-Opioid Treatment For Moderate to Severe Acute Pain

Posted on by

PainRelief.com Interview with:
Vertex Pharma Company Spokesperson

PainRelief.com: What is the background for this study? How does VX-548 work?

Response: VX-548 is an oral, selective NaV1.8 inhibitor that is highly selective for NaV1.8 relative to other NaV channels. NaV1.8 is a voltage-gated sodium channel that plays a critical role in pain signaling in the peripheral nervous system. NaV1.8 is a genetically validated target for the treatment of pain, and Vertex has previously demonstrated clinical proof-of-concept with a small molecule investigational treatment targeting NaV1.8 in multiple pain indications including acute pain, neuropathic pain and musculoskeletal pain.

 Vertex’s approach is to selectively inhibit NaV1.8 using small molecules with the objective of creating a new class of medicines that have the potential to provide superior relief of pain without the limitations of opioids, including their addictive potential. VX-548 is the most advanced NaV1.8 inhibitor in Vertex’s program.

Continue reading →

NYU Lab Harnesses Gene Therapy to Tackle Chronic Pain

Posted on by

PainRelief.com Interview with:
Rajesh Khanna, PhD

Director, NYU Pain Research Center
Professor, Department of Molecular Pathobiology
Professor, Department of Neuroscience and Physiology
Investigator, Neuroscience Institute
New York University


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

Response: Chronic pain affects an estimated 20-30% of the global population, significantly impacting quality of life and mental health. It poses substantial socioeconomic burdens, with costs relating to healthcare and lost productivity. Despite its prevalence, chronic pain remains underdiagnosed and undertreated worldwide, highlighting a crucial need for enhanced awareness, research, and therapeutic strategies.

Among the many targets being pursued for the development of drugs against chronic pain conditions are key proteins in neurons that are involved in the signaling of pain. A key family of these targets is the voltage-gated sodium channel family. Among them, the Nav1.7 sodium channel plays a critical role in the development and maintenance of chronic pain. It is an integral part of the peripheral nervous system and is highly expressed in nociceptive (pain-sensing) neurons, including the dorsal root ganglia and sympathetic ganglion neurons.

Nav1.7 channels act as a threshold channel, amplifying small sub-threshold depolarizations and generating action potentials, which are the electrical signals responsible for transmitting sensory information, including pain, to the brain. In essence, they work as a key amplifier of signals from peripheral pain-sensing neurons to central pain pathways.

Certain genetic mutations that cause either a gain or loss of Nav1.7 function can lead to conditions associated with altered pain perception. Gain-of-function mutations, which increase the activity of the channel, can lead to pain syndromes like Inherited Erythromelalgia (IE) and Paroxysmal Extreme Pain Disorder (PEPD). In contrast, loss-of-function mutations, which decrease or eliminate the activity of Nav1.7, result in Congenital Insensitivity to Pain (CIP), a condition where individuals are unable to feel pain.

Given this integral role, Nav1.7 has become a focus of interest as a target for new analgesic drugs. The development of Nav1.7 inhibitors could offer a new avenue for more effective and targeted treatment strategies for chronic pain conditions. It’s a promising area of research, though there are still challenges to be met, such as achieving sufficient specificity for the Nav1.7 channel to avoid side effects associated with other sodium channels.

In the NYU Pain Research Center in the College of Dentistry at New York University (https://dental.nyu.edu/research/pain-research-center.html), the Khanna lab is pursuing alternative ways to target Nav1.7 for pain relief.

Continue reading →

State-Level Policies May Reduce Disparities in Pain Prevalence

Posted on by

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 →

Study Demonstrates Feasibility of Engineering Biomechanical Scaffolds for Cartilage Repair

Posted on by

PainRelief.com Interview with:
Prof. Hongbin Li
Department of Chemistry
The University of British Columbia,
Vancouver, British Columbia, Canada

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

Response: Cartilage degeneration and damage are significant health issues, and cartilage repair is a major challenge because cartilage has a limited capacity for self-repair. One of the strategies for cartilage regeneration is to use scaffolds to promote the growth and differentiation of chondrocytes. For this, the scaffolds need to be tough and stiff to meet the requirements of cartilage regeneration. However, it is challenging to engineer highly stiff and tough materials, as stiffness and toughness are often self-conflicting to each other. In this work, we developed a novel strategy to engineer stiff yet tough protein hydrogels whose mechanical properties mimic those of cartilage. Such engineered stiff and tough protein hydrogels were tested as implants to repair osteochondral defect in an animal model.

Pages: 1 2

Study Finds Opioids No Better Than Placebo for Back or Neck Pain Relief

Posted on by

PainRelief.com Interview with:
Christine Lin | Professor
The University of Sydney                                           
Sydney Musculoskeletal Heatlh
Faculty of Medicine and Health, Sydney School of Public Health
Institute for Musculoskeletal Health                             
Gadigal Country King George V Building
Royal Prince Alfred Hospital NSW Australia

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

Response: Opioids are one of the most commonly prescribed pain medicines for low back pain and neck pain, but before this trial we did not have robust, direct evidence that they are effective for acute low back pain and neck pain.

PainRelief.com: What are the main findings?

Response: We found that taking opioids did not relieve acute low back pain and neck pain in the short term, and led to worse outcomes in the long term. We randomly assigned people with acute low back pain or neck pain to take opioids or placebo (identical tablets but with no active ingredients) for up to 6 weeks, in addition to getting the best advise on how to manage their pain from their doctor. We followed these people up for 1 year.

At 6 weeks, people in the opioid group did not report lower pain levels compared to people in the placebo group. Nor were there differences in pain outcomes at 2 and 4 weeks, or in other outcomes such as physical function, recovery time, or quality of life.

Surprisingly at 1 year, people who took opioids had slightly worse pain and an increased risk of opioid misuse.

Pages: 1 2