Public Health Crises: Not Just Opioids

Leading causes of death in America 2013:

  • Intentional Self-Harm (Suicide)  41,149
  • Motor Vehicle Accidents  35,369
  • Firearm deaths  33,000
  • Alcohol-Induced Deaths 29,001
  • Overdose deaths *invovlving* opioids  16,500

These figures do NOT justify the enormous allocation of pubic funds to combat the least deadly of these preventable causes of death. If the goal is truly to prevent the most deaths, there should be no need to harass pain patients and take away their opiates, which only exacerbates the other public heath crisis: chronic pain itself. Continue reading

Chronic Pain : The Invisible Public Health Crises

Practical Bioethics : Chronic Pain : The Invisible Public Health Crises – Richard Payne, MD – John B. Francis Chair, Bioethics – Center for Practical Bioethics

“I am invisible, simply because people refuse to see me.”
- Ralph Ellison

Because pain is subjective — and therefore difficult to measure by the usual medical tests — it is often doubted. As someone once said, my pain is real, your pain is in doubt.

Also, we live in profound cultural ambivalence about pain. Cultural icons such as  Julius Caesar and Albert Schweitzer have been quoted as saying that pain is worse than death, but there is also an ethos of “no pain, no gain.”

For these and other reasons, on an individual and societal level, we prefer to ignore the problem of chronic pain, unless confronted by it in our personal lives. Continue reading

Coping Skills Key to Pain Management

Coping Skills Key to Pain Management

Practical coping skills are often an overlooked element of pain management

Dr. Jones teamed up with his colleagues at the Pain Consultants of East Tennessee, Knoxville, to teach coping skills within the practice… …settled on a program that offers pain patients asingle, 2-hour, group session.

The sessions focus on teaching the five key pain coping skills:

  • Understanding includes providing educational information to the patients about how pain works (types of pain and an explanation of pain gates) as well as understanding specific treatment options.

The difference between pain and suffering is also highlighted.

  • Acceptance uses cognitive behavioral concepts to help patients have realistic expectation about therapy and reduce catastrophizing, a key variable in outcomes.

many pain patients blame themselves for being a burden to their families, etc. The “shoulds” are a real problem … Continue reading

Neurological manifestations of Ehlers-Danlos Syndrome

Neurological manifestations of Ehlers-Danlos syndrome(s): A review – Oct 2014

The term “Ehlers-Danlos syndrome” (EDS) groups together an increasing number of heritable connective tissue disorders mainly featuring joint hypermobility and related complications, dermal dysplasia with abnormal skin texture and repair, and variable range of the hollow organ and vascular dysfunctions.

Although the nervous system is not considered a primary target of the underlying molecular defect, recently, increasing attention has been posed on neurological manifestations of EDSs, such as musculoskeletal pain, fatigue, headache, muscle weakness and paresthesias.

The emerging picture defines a wide spectrum of neurological manifestations that are unexpectedly common and potentially disabling. Continue reading

App for Patients to Manage their Opioids

MyOM – My Opioid Manager App

Dr. Andrea Furlan and Amy Robidas (RN) have developed a new mobile app called My Opioid ManagerTM (MyOM) available for iOS (iPhone/iPad), and Android devices. The app is accompanied by iBook content as an educational and informational resource to help patients suffering from chronic pain understand and manage their pain with opioid use.

This app for patients contains several parts:

  1. Pain Diary
  2. Medication List
  3. Other Treatments
  4. Questionnaires
  5. Resources/Info

The pain diary collects detailed information about all aspects of your pain, not just intensity and location, but also a description, and it offers you ratings for standard list of life activities that pain interferes with: Continue reading

Stress reduces our ability to cope with physical pain

Stress reduces our ability to cope with physical pain, study finds Medical News Today

psychological stress significantly increases pain intensity while reducing the ability to cope with it.

The researchers found that the men who experienced higher levels of psychological stress had a much lower ability to withstand pain, compared with men who had lower stress levels. “The higher the perceived stress, the more dysfunctional the pain modulation capabilities became. In other words, the type of stress and magnitude of its appraisal determine its interaction with the pain system,” explains Prof. Defrin.

The researchers say their findings were surprising. People who are injured during sports, for example, are reported to have better pain modulation, so they expected to see similar findings in their study.

“But we were surprised to find quite the opposite,” says Prof. Defrin. “While there was no visible effect of acute stress on the subject’s pain threshold or tolerance, pain modulation decreased in a very dramatic way.

New rules on opioid pain meds cause grief for veterans

New rules on narcotic painkillers cause grief for veterans and VA

New federal rules that make it harder to get narcotic painkillers are taking an unexpected toll on thousands of veterans who depend on these prescription drugs to treat a wide variety of ailments, such as missing limbs and post-traumatic stress

The restrictions, adopted last summer by the Drug Enforcement Administration to curb a national epidemic of opioid abuse, are for the first time, in effect, forcing veterans to return to the doctor every month to renew their medication, although many were already struggling to get appointments at overburdened VA health facilities.

Although the tighter regulation applies to everyone on opioid painkillers, it’s hitting veterans especially hard because so many are being treated for horrific injuries sustained during the long wars in Iraq and Afghanistan.

It literally sickens me to hear how the war on drugs has now turned on the people that have already suffered so much for our country. It’s criminal to torture our returning troops by withholding effective pain relief. Continue reading

Relentless pain results in young woman’s suicide

‘My daughter’s relentless pain was so bad she committed suicide’ | Daily Mail Online

Julia Kelly spent most of her short life racked by pain. Plagued by excruciating gynaecological complaints from the age of 11, she went on to suffer daily agony from two car accidents – neither of which were her fault. After the first, 10 years ago, she battled to retain a sense of normality. But over time, with her body giving up, she struggled to come to terms with how the pain so drastically altered the course of her life.

At 37, when most women dream of having a family, Julia was so immobile she couldn’t tie her own shoelaces. Forced to move home to her parents and quit her beloved job, the lack of a ‘proper life’ and independence became unbearable for the sociable and extremely intelligent charity worker.

Three months ago, on November 2, Julia ended her life aged just 39, no longer able to bear her constant suffering. Continue reading

Fentanyl Patch Replacement Interval Too Long

Can Fentanyl Patches Be Replaced Sooner to Improve Pain Control?

This article verifies what patients have long known: the extended release pain medications do NOT last as long as advertised.

The FDA-approved and recommended dosing interval for transdermal fentanyl is every 72 hours. However, some patients who may require a shorter dosing interval to obtain adequate uninterrupted pain relief, and the literature supports this as a way to achieve the desired continual analgesia. For example, dosing intervals were decreased to 60 hours and 48 hours in certain adult studies

After the transdermal fentanyl patch is applied, the skin absorbs the drug and forms a depot in the upper skin layers. This results in a concentration gradient that drives drug release from the system into the skin at a relatively constant rate. The rate of fentanyl delivery to the skin over the 72-hour application varies among individuals and groups of patients. Once in the skin, the drug is absorbed transdermally via systemic circulation Continue reading

CINK Study | The Ehlers-Danlos National Foundation

CINK Study | The Ehlers-Danlos National Foundation

The Ehlers-Danlos National Foundation is officially sponsoring this trial of an alternative medicine therapy.

What is CINK?

CINK or Corrective Integrated Neuro-Kinetics is a revolutionary approach to movement training and treatment of chronic pain by focusing on changing dysfunctional nerve impulses that create insufficient support and poor alignment.

All day long our nerves fire impulses to our muscles causing contractions that create movement. Most of these movements happen with such regularity that the movements are achieved with little cognitive awareness. We call these “movements”, reflexes.

The reflex creating a particular swing of a bat is noticeable but our bodies have much more subtle reflexes affecting how we breathe, sit, stand, and walk. In these daily activities our nerves fire in a set sequence and direction. CINK calls these patterns, energy lines. Continue reading