PainRelief.com Interview with: Richard L. Nahin, MPH, PhD National Center for Complementary and Integrative Health National Institutes of Health, Bethesda, Maryland
PainRelief.com: What is the background for this study?
Response: While there has been extensive research examining the prevalence of chronic pain, far less is known about the incidence of chronic pain. Understanding the incidence of chronic pain is critical to understanding how such pain manifests and evolves over time.
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
PainRelief.com: What is the background for this study? What are the main findings?
Response: U.S. dentists account for approximately 11 million opioid prescriptions each year. Excessive opioid prescriptions from dentists can result in leftover opioids that can be diverted or misused. In part to prevent this, most states enacted policies between 2016 and 2018 that restricted the duration of opioid prescriptions for acute pain, such as dental pain.
The objective of this study was to evaluate whether these state opioid prescribing limits were associated with reductions in the duration of opioid prescriptions from dentists. Using national prescription dispensing data from 2014-2020 and a rigorous quasi-experimental study design, we found that this duration did not change after limit enactment. A likely explanation is that most limits allow up to a 7-day supply of opioids, but the typical duration of dental opioid prescriptions during the study period was about a 3-day supply. For this reason, state limits had little ability to reduce this duration in the first place.
PainRelief.com Interview with: Wendy C. King, PhD Epidemiology Data Center School of Public Health University of Pittsburgh Pittsburgh, PA
Dr. King
PainRelief.com: What is the background for this study?
Response: Previous studies had provided evidence that bariatric surgical procedures are associated with improvements in pain, physical function and work productivity. However, most prior studies only followed participants 1-2 years, at which point participants were at the peak of their weight loss.
Among a large cohort of US adults, we wanted to evaluate how much initial improvements in pain, physical function and work productivity declined during long-term follow-up, when some degree of weight regain is not uncommon. We limited our study to adults who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG), the two most common bariatric surgical procedures done today.
Joel M. Trugman, MD Associate Vice President Neuroscience Development AbbVie
PainRelief.com: What is the background for this study? What are the main findings?
Response: Migraine is a disabling chronic disease characterized by recurrent headache attacks and associated symptoms, including nausea, phonophobia, or sensitivity to sound, and photophobia, or sensitivity to light.
The ADVANCE clinical trial is a phase 3, randomized, double-blind, placebo-controlled trial and examined the safety and efficacy of atogepant, an oral, small-molecule calcitonin gene-related peptide receptor antagonist in patients with episodic migraine. The primary efficacy endpoint was the change from baseline in mean monthly migraine days (MMD) across the 12-week treatment period. This analysis that was recently published examined the efficacy of atogepant using 4 levels of mean monthly migraine day (MMD) responder rates.
This analysis found that all doses of atogepant significantly increased the proportion of participants who achieved a ≥25%, ≥50%, ≥75% and 100% reduction in mean monthly migraine days over 12 weeks of treatment.
Jason E. Goldstick, PhD Injury Prevention Center Department of Emergency Medicine University of Michigan, Ann Arbor
PainRelief.com: What is the background for this study? What are the main findings?
Response: In 2016, the CDC released the Guideline for Prescribing Opioids for Chronic Pain. A primary goal of this voluntary guideline is that individuals should receive pain management care that provides the greatest overall benefit. Among other things, this may entail beginning opioid treatment only when the clinician determines that the expected benefits outweigh the risks.
Other research has shown reductions in opioid prescribing as reduced since the guideline release; this report examines whether there were changes in nonopioid pain medication prescribing.
Our overall findings were that nonopioid prescribing increased nationally following the guideline release, above and beyond what would’ve been predicted based on the pre-guideline trends, and this finding was generally consistent across patient subpopulations (e.g., those with vs. without prior opioid exposure).
PainRelief.com Interview with: Katie Fitzgerald Jones MSN, APN PhD candidate Connell School of Nursing Boston College Jonas Mental Health Scholar 2021-2023 American Academy of Nursing Jonas Policy Scholar Ruth L. Kirschstein National Service Award (F31NR019929-01)
PainRelief.com: What is the background for this study?
Response: I am a Palliative and Addiction Nurse Practitioner at VA Boston and a Ph.D. candidate at Boston College Connell School of Nursing. In my clinical practice, I regularly care for people with cancer who have a co-occurring substance use disorder.
How to best care for people with substance use disorders, such as opioid use disorder is especially complex in people with cancer because opioid management is a standard of cancer-pain management and cancer prognoses can influence opioid decisions and vary. It is important when prescribing opioids that you attend to safety while also addressing pain. People with untreated opioid use disorder or concerning opioid behaviors (such as taking more opioids than prescribed or using opioids with unprescribed medications that increase the risk for opioid-related harm such as benzodiazepines) have an increased risk for opioid related-harms. It is also an area that lacks consensus and is absent from cancer-specific pain guidelines.
This study was conducted with leaders in palliative care including senior author, Jessica Merlin to tackle the question of what is consensus among palliative care and addiction clinicians to caring for people with opioid misuse or use disorder and cancer-related pain and how this is influenced by prognosis?
PainRelief.com Interview with: Daniel Myran, MD, MPH, CCFP, FRCPC Family and Public Health and Preventive Medicine Physician CIHR Fellow, Ottawa Hospital Research Institute Department of Family Medicine Innovation Fellow University of Ottawa
Dr. Myran
PainRelief.com: What is the background for this study?
Response: Canada legalized recreational, or non-medical, cannabis in October 2018. Canada took phased approach to legalization initially only allowing flower-based cannabis products and oils and after one year permitting the sale of commercial cannabis edibles (e.g. THC containing candies, baked goods, and drinks). In this study we took advantage of this phased roll out of legal cannabis to understand the impact of legalization on cannabis exposures or poisonings in children aged 0-9 years and the contribution of different types of cannabis products to these events.
PainRelief.com Interview with: Maryann Mason, PhD Department of Emergency Medicine Northwestern University Feinberg School of Medicine Buehler Center for Health Policy and Economics, Northwestern University, Chicago, Illinois
PainRelief.com: What is the background for this study?
Response: This study came about because we were looking at data for Cook County, Illinois and saw an increase in older adult opioid overdose deaths. That made us wonder if there was a national trend or the observation was limited to our local area. We undertook the research to determine that and found that it is indeed a national phenomenon.
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