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

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.

Acid Suppressing Drugs Associated with Increased Risk of Migraine

PainRelief.com Interview with:
Margaret Slavin, PhD, RDN
Associate Professor
Department of Nutrition and Food Science
University of Maryland
College Park, MD 20742

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

Response: Headache is a common side effect for a lot of drugs, but there have been a few studies recently in the U.K., Taiwan, and the U.S. suggesting that proton pump inhibitors (the most common acid suppressing drugs) might be associated more specifically with migraine. We used a different data source from the U.S. National Health and Nutrition Examination Survey to further explore this topic, and to ask about other classes of acid suppressing drugs

Annals of IM: Both Resistance Training and Neuromuscular Exercise Improved Function and Pain in Hip Osteoarthritis

PainRelief.com Interview with:
Troels Kjeldsen
PhD Student, MSc
Department of Orthopedic Surgery, Aarhus University Hospital
Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Indgang J, J501 
Department of Clinical Medicine, Aarhus University
The Research Unit PROgrez,
Department of Physiotherapy and Occupational Therapy
Næstved-Slagelse-Ringsted Hospitals

Troels-Kjeldsen

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

Response: Hip osteoarthritis (OA) is a very common degenerative joint disease that results in hip pain and impaired physical function among other consequences for the individual.

Systematic reviews of randomized controlled trials of exercise and hip OA have established that exercise is an effective conservative treatment option for reducing pain and improving physical function. In most clinical guidelines, exercise is the recommended first line treatment in combination with patient education and a weight loss intervention if necessary.

However, we know very little about which types of exercise are most effective and there is currently not an evidence basis on which doctors and physiotherapists can make recommendations of one type of exercise over another type.

Empathetic Care By Physicians Provides Better Pain Relief Than Most Other Modalities

PainRelief.com Interview with:
John C. Licciardone, DO, MS, MBA, FACPM
Regents Professor and Richards-Cohen Distinguished Chair in Clinical Research
Department of Family Medicine, MET-568
University of North Texas Health Science Center
Fort Worth, TX 76107

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

Response: The Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation focuses on the patient-physician relationship and its association with chronic pain treatment and outcomes.

Previous studies involving physician empathy often have been limited to pain clinics and involved short-term follow-up. Our study aimed to study the impact of physician empathy on outcomes among patients with chronic low back pain in community settings throughout the United States over 12 months of follow-up.

Adolescents View Overwhelming Lack of Empathy for Popular TV Characters Experiencing Pain

PainRelief.com Interview with:
Melanie Noel, PhD, RPsych
Professor of Clinical Psychology
University of Calgary
Full Member of the Alberta Children’s Hospital Research Institute and
Hotchkiss Brain Institute
Director, Alberta Children’s Pain Research Lab
at the Vi Riddell Pain & Rehabilitation Centre
Alberta Children’s Hospital in Canada.

PainRelief.com: What are the main findings of the study?

Response: We examined 10 movies and the first seasons of 6 TV Netflix shows based on popularity among adolescents.  

Across the 616 scenes showing painful events, the majority showed violence and injuries and not the kinds of pain kids experience in real life (e.g., medical procedures, chronic pain. Characters from marginalized (gender diverse, girls) and minoritized groups (individuals with racialized identities) were underrepresented.

Overall, there was an overwhelming LACK of empathy shown to characters observing others in pain. The media perpetuated gender and racialized stereotypes.

Stanford Study Finds Migraine Patients Treated with OnabotA tend to Elect Extended Treatment

PainRelief.com Interview with:
Leon S. Moskatel, MD
Clinical Assistant Professor
Division of Headache, Department of Neurology
Stanford University
Palo Alto, CA

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

Response: OnabotulinumtoxinA (onabotA) is one of the most effective and well-tolerated treatments for chronic migraine, which the FDA approved for the prevention of chronic migraine in 2010.

OnabotA for chronic migraine is usually administered according to the PREEMPT protocol every 12 weeks for at least 3 treatments. Previous studies examining the long-term use of onabotA have been limited by either relatively short duration or small sample size. At the Stanford Headache Center, we were able to query our electronic medical records and create a prescription database to examine long-term persistence to onabotA over 11 years, between 2011-2021.

Frequent Musculoskeletal Pain Linked to Early Retirement

PainRelief.com Interview with:
Dr Nils Niederstrasser
Senior Lecturer
Department of Psychology
University of Portsmouth

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

Response: The number of people living with musculoskeletal pain increases with age, but few studies have specifically focused on the effects of chronic pain on the employment status of older populations.

Study Finds Reduced Pain and Fatigue with Exercise in Patients with Metastatic Breast Cancer

PainRelief.com Interview with:
Dr Anouk Hiensch PhD
Julius Center for Health Sciences and Primary Care
University Medical Center Utrecht, Utrecht University
Utrecht, The Netherlands

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

Response: Patients with metastatic breast cancer (mBC) often experience cancer- and treatment-related side effects that can impair daily life activities and health-related quality of life (HRQoL). Interventions are needed that improve HRQoL by alleviating fatigue and other side effects during metastatic BC cancer treatment. Recent evidence-based international guidelines (ASCO, ACSM) recommend exercise for patients with BC during adjuvant treatment for reducing side effects. However, evidence of the effectiveness of exercise in patients with mBC is scarce. The PREFERABLE-EFFECT study (NCT04120298) was designed to assess the effects of a 9-month supervised exercise program in patients with mBC on fatigue, HRQoL, and other cancer- and treatment-related side effects.

Virgina Tech Study Demonstrates Focused Brain Ultrasound Can Reduce Both Pain Perception and Response to Pain

PainRelief.com Interview with:
Wynn Legon, Ph.D.
Assistant professor at the Fralin Biomedical Research Institute at VTC and in the
School of Neuroscience in Virginia Tech’s College of Science.
The Fralin Biomedical Research Institute, located in Roanoke, Virginia, is a top-level research institute of Virginia Tech.

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

Response: My lab is focused on identifying new indications for which low-intensity focused ultrasound, or LIFU, might provide a benefit. In particular, we are focused on the insula and dorsal anterior cingulate, areas deep inside the brain implicated in a range of conditions. Chronic pain is among these.

These two papers provide proof-of-principle to confirm that focused ultrasound energy applied to these regions can impact both the perception of pain and the body’s reaction to a painful stimulus. Participants in the studies reported a reduction in perceived pain that depended on which site was targeted. Further, the application of low-intensity focused ultrasound also reduced physical responses to pain as measured by heart rate variability, again depending on which site was targeted.

Socially Disadvantaged Women Received Fewer Epidurals for Pain Relief During Childbirth

MedicalResearch.com Interview with:
Dr Lucy Halliday
School of Medicine, Dentistry and Nursing
University of Glasgow
Glasgow, UK

pregnancy-woman-belly-hands-46207 (1)

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

Response: Socioeconomic deprivation is associated with adverse maternal and childhood outcomes. Epidural analgesia is the gold standard for labour analgesia, and is associated with improved maternal pain scores and satisfaction, reduced rates of post-traumatic stress disorder and postnatal depression and may reduce severe maternal morbidity. Scotland is a country with a fully publicly funded national health service that aims to provide equitable treatment that is free at the point of care. We wanted to look at the association between socioeconomic deprivation and utilisation of labour epidural analgesia.

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