Tag Archives: #opioids

Potent Synthetic Opioids Driving Current Overdose Crisis

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PainRelief.com Interview with:
Shravani Durbhakula, MD, MPH, MBA
Associate Professor of Anesthesiology, 
Division of Pain Medicine 
Vanderbilt University School of Medicine 
Medical Director, Comprehensive Pain Service 
Vanderbilt University Medical Center 

Shravani Durbhakula, MD, MPH, MBA Associate Professor of Anesthesiology,  Division of Pain Medicine  Vanderbilt University School of Medicine  Medical Director, Comprehensive Pain Service  Vanderbilt University Medical Center 
Dr. Durbhakula

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

Response: Our study highlights the rapid rise of nitazenes—extremely potent and dangerous synthetic opioids—silently driving the current overdose crisis. Developed in the 1950s by a pharmaceutical company and never approved for clinical use, nitazenes are up to 20 times more potent than fentanyl and are undetectable with standard drug tests available in emergency rooms.

These opioids are often mixed into counterfeit pills or other street drugs, posing an unseen threat. Furthermore, nitazenes interact with opioid receptors in a unique way, increasing overdose risk, heightening respiratory depression, and accelerating tolerance development, which makes them even more dangerous for users.

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CMAJ Study Evaluates Risk of Health Outcomes after Opioids Prescribed in ER

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PainRelief.com Interview with:

Dr. Innes

Grant Innes MD
Departments of Emergency Medicine and Community Health Sciences
University of Calgary, Calgary
Editor-in-Chief, The Canadian Journal of Emergency Medicine

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

Response: Opioid prescriptions for acute pain have been identified as a possible factor in opioid epidemic mortality. The proposed causal model is that physicians provide opioid prescriptions for acute pain, which lead to prescription opioid misuse followed by illicit opioid use, subsequent overdose and death.

This paradigm has driven widespread describing initiatives, including the elimination of opioids from emergency care (“opioid free emergency departments”), but there is no research describing the link between an opioid prescription for acute pain and downstream opioid-related harm. 

Our objectives were to quantify for emergency patients filling an opioid prescription the likelihood of adverse outcomes as well as the incremental risk to opioid-treated patients vs. propensity-matched controls.

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Experimental “bitopic” Opioid Suppresses Pain With Fewer Side Effects

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PainRelief.com Interview with:

Susruta Majumdar, PhD
Professor in the Department of Anesthesiology
Washington University School of Medicine
Nokomis Ramos-Gonzalez, PhD
Postdoctoral Trainee in the Majumdar Lab
Washington University School of Medicine
Balazs R. Varga PhD
Center for Clinical Pharmacology
University of Health Sciences & Pharmacy at St. Louis
Department of Anesthesiology and Washington University Pain Center
Washington University School of Medicine
St. Louis, Missouri 63110

Jay McLaughlin, Ph.D
Professor of Pharmacodynamics
College of Pharmacy
University of Florida

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

Response:    Opioid medications tap into the body’s natural system for mitigating pain by activating pain-suppressing opioid receptors on neurons. Although meant to help, sometimes these medications do harm.  Opioid medications offer people relief from debilitating pain, but these drugs come with dangers: the risk for addiction, miserable withdrawal symptoms and the potential for fatal overdose.  New mechanistic insights into the function and regulation of the opioid receptors present the opportunity to design new, safer opioid painkillers. The team’s previous research utilized a strategy to design functionally selective “bitopic” opioids by targeting the sodium binding allosteric site in the opioid receptor.

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NEJM: Despite Removal of DEA Waiver Requirement, Buprenorphine Still Widely Underprescribed for Opioid Addiction

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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

Kao-Ping-Chua

PainRelief.com: What is the background for this study?
Response: Buprenorphine is one of 3 FDA-approved medications to treat opioid addiction. It is the only one of the 3 that can be prescribed during office visits. Although buprenorphine is highly effective in treating opioid addiction, it is widely underused. Addressing this underuse is a key step towards slowing the epidemic of U.S. opioid overdose deaths.

In 2000, the federal government allowed clinicians to prescribe buprenorphine if they obtained a waiver from the Drug Enforcement Administration. Clinicians have cited the waiver requirement as a key barrier to buprenorphine prescribing. In part because of this, the government eliminated this requirement on January 12, 2023.

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Neuropathy: Repeated High Concentration Capsaicin Patches Provided Back Pain Relief and Reduced Need for Opioids

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PainRelief.com Interview with:
Kai-Uwe Kern MD, PhD
Institute of Pain Medicine/Pain Practice
Wiesbaden, Germany

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

Response: In recent studies a progressive response to high-concentration capsaicin patch (HCCP) with repeated treatment was observed, meaning that patients with insufficient pain relief after the first application of HCCP, still may respond to a second, third, or even fourth application. Based on these latest findings, and also on my personal clinical experience, we aimed to systematically analyse the pool of patients in my Pain Practice with at least two HCCP treatments.

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Prenatal Opioids Increase Risk of Multiple Adverse Health Effects

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PainRelief.com Interview with:
Erin Kelty PhD
Research Fellow
NHMRC Emerging Leader
School of Population & Global Health

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


Response: Recent research from Dr Lauren Jantzie at John Hopkins found that in mice prenatal opioid exposure altered the immune system.
Our research aimed to see if the same was true in children who had been exposed to opioids in utero.

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Rutgers Study Evaluates Telehealth Delivered Mindfulness Therapy in OUD Patients with Chronic Pain

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PainRelief.com Interview with:
Nina A. Cooperman, PsyD
Department of Psychiatry
Division of Addiction Psychiatry
Rutgers Robert Wood Johnson Medical School
Piscataway, New Jersey

Dr Nina Cooperman, Photo by John O’Boyle

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

Response: This study aimed to evaluate the impact of a novel intervention, Mindfulness Oriented Recovery Enhancement (MORE), on opioid use and chronic pain among individuals receiving methadone treatment (MT).

The main goal of this study was to conduct a clinical trial to assess online MORE, delivered remotely, through secure video or phone conferencing, with respect to a range of clinical outcomes.

This study will involve a 2-arm individually randomized controlled trial design that compares MORE and treatment as usual (TAU). 

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Cancer Doctors Prescribing Fewer Opioids Since Opioid Crisis

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PainRelief.com Interview with:
Joshua Kra, MD
Assistant Professor of Medicine, Rutgers NJMS
Division of Hematology/Oncology
Rutgers Cancer Institute of New Jersey at University Hospital

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

Response: We aimed to characterize pain management practices by medical oncologists to assess whether CDC guidelines from 2017 for nononcologic settings changed prescribing patterns for oncologists.

PainRelief.com: What are the main findings?

Response: There was a significant decrease in opioid prescriptions from medical oncologists starting in 2017, which coincided with the recognition of the opioid crisis as a national public health emergency and the publication of CDC guidelines for opiate prescribing in non-cancer settings. This would suggest these factors contributed to how oncologists changed their management of opioid prescriptions for cancer patients.

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Rutgers Study Finds Modest Decrease in Non-Prescription Opioid Use with Cannabis Legalization, But Concentrated in People Addicted to Cannabis

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PainRelief.com Interview with:
Hillary Samples, PhD, MHS
Assistant Professor of Health Systems and Policy
Rutgers School of Public Health
Core Faculty
Center for Pharmacoepidemiology and Treatment Science

Rutgers Institute for Health, Health Care Policy and Aging Research
New Brunswick, NJ 08901

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

Response: Early studies suggesting that cannabis legalization is associated with lower rates of opioid-related harms received considerable media attention. At the time, overdose deaths were driven by prescription opioids, and medical cannabis was often framed as a policy approach to address the opioid epidemic. However, as research in this area grew, the relationship between medical cannabis legalization and opioid-related harms became less clear. Many studies of cannabis legalization were unable to examine opioid use by individual people, and individual-level studies outside the legal context showed links between cannabis use and higher risk of opioid-related harms. Thus, our goal was to build evidence of the relationship between medical cannabis legalization and individual-level opioid use.

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

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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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