Tag Archives: #pain

Study Finds Modest Decrease in Opioid Prescriptions after Insurer Opioid Prescribing Limit

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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?

Response: Almost every state has implemented a policy to restrict the duration of opioid prescriptions for acute pain, as have many major insurers. Prior studies have evaluated the effects of these limits on opioid prescribing, but there are no large-scale studies that have evaluated the effects of limits on patient-reported outcomes, such as pain control.

In this study, we evaluated the effect of a major Michigan insurer’s
5-day opioid prescribing limit in February 2018 on both opioid prescribing and patient-reported outcomes after surgery.

To do so, we leveraged our access to a statewide surgical registry in Michigan that has been collecting data on opioid prescribing and patient-reported outcomes from adult patients undergoing common general surgical procedures since 2017.

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Cannabis-Related Hospitalizations Following Legalization in Canada

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PainRelief.com Interview with:
Daniel Myran, MD, MPH, CCFP, FRCPC
Canada Research Chair, Social Accountability, University of Ottawa
Investigator, Bruyère Research Institute 
Assistant Professor, Department of Family Medicine
Lecturer, School of Epidemiology and Public Health
Adjunct Scientist, ICES
University of Ottawa

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

Response: Canada legalized recreational, or non-medical, cannabis in October 2018. Legalization in Canada took a phased approach initially, only the sale of flower-based cannabis products and oils was permitted and there were very few legal cannabis stores and legal sales. Starting in early 2020, Canada allowed the sale of expanded products (e.g. cannabis edibles, vape pens, concentrates), and the number of retail stores began expanding. In this study, we took advantage of this evolution of the legal cannabis market to understand how different phases of legalization were associated with hospitalizations due to cannabis.  

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Columbia Model Predicts Return-to-Use Risk After Treatment for Opioid Use Disorder

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PainRelief.com Interview with:
SEAN X. LUO, M.D., PH.D.
Assistant Professor of Clinical Psychiatry
Data Science Research Group
Division on Substance Use Disorders
Department of Psychiatry
Columbia University

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

Response: Opioid use disorder presents a major public health crisis, with increasing overdose death through the last 5 years. Treatment delivery continues to be difficult, with a large number of patients not stably maintained on Medication for Opioid Use Disorder (MOUD) after the initial treatment engagement.

In this study we applied novel statistical methods to a newly harmonized dataset incorporating 3 large clinical trials from the National Drug Treatment Clinical Trials Network (CTN) to develop individual level risk prediction models for opioid use disorder. We showed that urine toxicology data in the first 3 weeks after initiation of treatment can predict return-to-use at the end of 3 months with surprising accuracy.

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Miami Thoracic Surgeons Achieve Pain Control With Minimal or No Opioids

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PainRelief.com Interview with:
Dao Minh Nguyen, MD, MSc FRCSC FACS
Thoracic Cancers Group Go-Lead
Sylvester Comprehensive Cancer Center
University of Miami Miller School of Medicine

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

Response: Patients undergoing thoracic surgery operations experience significant acute incisional pain as well as chronic pain many months after.

The mainstay of treatment is based on frequent use of potent and addictive-prone opioids such as hydromorphone, oxycodone at high dosages and long duration.
There is a high incidence of persistent opioid users and chronic opioids users in surgical patient population. This certainly contributes to the opioid epidemic in the USA and worldwide.

We implemented a peri-operative care protocol for patients undergoing thoracic surgery operations called Enhanced Recovery after Thoracic Surgery (ERATS). The overarching goal of ERATS is to streamline care for thoracic surgery patients particularly in the postoperative period to mitigate pain with opioid-free strategy, to minimize postoperative complications, rapid return to baseline states and safe, early discharge home. This protocol follows guidelines of the ERAS principles and is developed for thoracic patients to address their unique needs.

Once pain is adequately addressed with opioid-free strategy with elimination of opioid-associated side effects, rapid recovery after surgery can be achieved.

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Newly Studied Pain Pathway May Provide Pain Relief Without Opioid Side Effects

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PainRelief.com Interview with:
Daniel McGehee, PhD
Professor
Chair, Committee on Neurobiology
Department of Anesthesia & Critical Care
University of Chicago

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

Response: Chronic pain conditions are major challenges for those suffering with pain and the clinicians who struggle to find effective treatments. Identifying novel strategies for relieving pain will help limit availability of opioid drugs, as they offer alternatives to replace or reduce opioids in the clinic. 

Along with overdose and addiction issues, there are other complications and side effects of opioids, including tolerance, where the pain relieving properties diminish with repeated use, hypersensitivity to pain when patients stop taking the drug, constipation, and other peripheral side effects. 

Pain relief without those side effects would certainly be valuable for individuals struggling to treat painful conditions. 

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Fibromyalgia: Imaging Studies Find Cognitive Behavioral Therapy Reduces Pain Catastrophizing

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PainRelief.com Interview with:
Jeungchan Lee, Ph.D.,
Instructor
MGH/HST Athinoula A. Martinos Center for Biomedical ImagingSpaulding Rehabilitation Hospital
Harvard Medical School
Charlestown, MA 024129

Jeungchan Lee, Ph.D., Postdoctoral Research Fellow MGH/HST Athinoula A. Martinos Center for Biomedical ImagingSpaulding Rehabilitation Hospital Harvard Medical School Charlestown, MA 024129

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

Response: Cognitive behavioral therapy (CBT) has shown promise in alleviating fibromyalgia (FM) symptoms by targeting pain-related catastrophizing, which comprises negative cognitive and emotional processes amplifying pain perception.

However, the neurological mechanisms underlying CBT’s impact on pain catastrophizing in FM patients have remained unclear.

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Smaller Portions of Pain Relievers After ER Visits May Be Sufficient for Pain Relief

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PainRelief.com Interview with:
Raoul Daoust, MD, CSPQ, MSc
Clinical Professor and researcher
Departments of Family Medicine and Emergency Medicine
Hôpital du Sacré-Coeur de Montréal

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

Response: Usually patients are prescribed too large a quantity of opioids and unused opioids are available for misuse. The tendency in the USA is to not prescribe opioids at all, leaving some patient in agonizing pain. I wanted to provide a tailored approach to prescribing opioids so patients have enough to manage their pain but almost no unused opioids available for misuse.

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Unequal Access to Chiropractic Pain Relief Care for Back Pain in Patients with Opioid Use Disorder

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PainRelief.com Interview with:
Patience Moyo, Ph.D
Assistant Professor of Health Services, Policy and Practice
Center for Gerontology and Healthcare Research
Department of Health Services, Policy, and Practice
Brown University School of Public Health

Patience Moyo, Ph.D Assistant Professor of Health Services, Policy and Practice Center for Gerontology and Healthcare Research Department of Health Services, Policy, and Practice Brown University School of Public Health

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

Response: Clinical practice guidelines recommend nonpharmacologic treatments as first-line therapies for managing chronic pain. However, little is known about the use of guideline-recommended pain therapies and whether use varies in demographic subgroups. Individuals with co-occurring chronic pain and opioid use disorder deserve particular consideration because of their increased risk of harm from opioids and other pharmacologic therapies combined with their susceptibility to social and structural barriers to accessing health care.

We sought to understand whether the well-established racial and ethnic inequities in pain management extend to individuals with opioid use disorder and to nonpharmacologic pain treatments, specifically physical therapy and chiropractic care.

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Study Assesses Quality of Life After Cannabis Prescribed for Chronic Pain and Other Health Symptoms

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PainRelief.com Interview with:
Margaret-Ann Tait | PhD candidate
Project Manager, The QUEST Initiative
Research Manager, Faculty of Medicine and Health
Sydney Nursing School, Cancer Care Research Unit
University of Sydney

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

Response: In 2016 Australia passed legislation that allows cannabis use for medicinal purposes. Since then, an estimated 800,000 patients have received medicinal cannabis prescriptions. We wanted to know if patients with chronic health conditions in Australia are reporting their health outcomes differently after being prescribed medicinal cannabis. We used validated questionnaires to assess their health-related quality of life, levels of fatigue, pain, sleep disturbance, anxiety, and depression before starting therapy and then at regular intervals for three months after. 

We had 2327 patients participating from across Australia aged between 18 and 97 (the average age was 51), and nearly two thirds were female. Half of our participants were prescribed medicinal cannabis for more than one condition, with chronic pain conditions reported more frequently, followed by insomnia, anxiety, and mixed anxiety & depression.

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Hypertension Drug May Decrease Both Inflammation and Need for Knee Replacement

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PainRelief.com Interview with:

Iskandar Tamimi MD, PhD
Hospital Regional Universitario de Málaga
Faculty of Medicine, University of Málaga
Hospital HM
Málaga, Spain

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

Response: Knee osteoarthritis is a painful and limitting condition that affects a significant percentage of the world’s population. The treatment of end stage knee osteoarthritis is a undergoing a total knee replacement. This procedure is considered a major surgery and it’s associated with a significant number of complications, such as infections, deep vein thrombosis, residual knee pain, etc,,

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