How US Doctors Respond to Painkiller Misuse

Here’s What’s Wrong With How US Doctors Respond to Painkiller Misuse – Substance.com

[To keep this short, I’ve skipped over an interesting case that introduces the topic in this article.]

What should doctors do if they discover a patient is “doctor shopping” or has developed an addiction?

Sadly, the typical response is to refuse to prescribe more pain drugs—and, if the patient is lucky, to provide a referral to treatment. Alternatively, people caught misusing opioids or obtaining illicit prescriptions by prescription drug monitoring programs or pharmacists who serve as gun-toting narcotics control agents can be arrested and prosecuted.

Studies show that long-term maintenance on either methadone, Suboxone or even heroin—without time limits—is best.  Continue reading

Sympathetic activity and pain intensity in fibromyalgia

Relationship between sympathetic activity and pain intensity in fibromyalgia. – PubMed – NCBI – Clin Exp Rheumatol. 2015 Mar-Apr

OBJECTIVES: Fibromyalgia (FM) is a syndrome characterised by chronic musculoskeletal pain, hyperalgesia on specific areas of tenderness (tender points) and by an autonomic nervous system dysfunction consistent with sympathetic overactivity.

It is not known whether there is any relationship between the amount of cardiovascular sympathetic activity and the magnitude of pain. Our objective was to assess this potential relationship in patients with FM.  Continue reading

Managing Adverse Drug Effects of Muscle Relaxants

Managing Adverse Drug Effects in Pain: Focus on Muscle Relaxants – June 1, 2012

The skeletal muscle relaxants are a diverse class of drugs that are used for treating painful muscle spasticity or spasms, which can substantially affect a patient’s ability to function (Table 1). About 2 million people annually report using muscle relaxants, with about 15% being elderly. The muscle relaxant class is a heterogeneous group of agents, with individual differences in drug interactions, comorbidity considerations, and ADEs. (Adverse Drug Effects)

These agents are categorized as either antispasmodics or antispasticity agents:

The antispasmodics are either benzodiazepines (eg, diazepam) or nonbenzodiazepines (eg, cyclobenzaprine) and are used for muscular pain and spasms associated with peripheral musculoskeletal conditions.

The antispasticity agents reduce hypertonicity associated with upper motor neuron disorders like multiple sclerosis and cerebral palsy.  Continue reading

Tolerance: A Personal Story

Novel Research into Opioid Tolerance May Provide Future Pain Relief with Lower Levels of Pain Medicine – National Pain Report  

Many readers of our readers remember a time early in their chronic pain history when a low-dose opiate, like codeine, relieved a majority of their pain. When I was first diagnosed with degenerative spine disease, I was treated with a low-power opioid medication that is no longer in use – Darvocet-N with 30mg of codeine as needed for breakthrough pain.

The Darvocet (containing the opioid medication propoxyphene) was highly effective in reducing my neck and shoulder pain by 75% on average, and one or two Tylenol #3 tablets easily handled any breakthrough pain. That efficacy against pain lasted for years.  Continue reading

Nerve Growth Factor and the Relief of Pain

Antagonism of Nerve Growth Factor-TrkA Signaling and the Relief of Pain | Anesthesiology. 2011 Jul;  | Free Full Text PubMed PMC article

Nerve growth factor (NGF) was originally discovered as a neurotrophic factor essential for the survival of sensory and sympathetic neurons during development.

However in the adult, NGF has been found to play an important role in nociceptor sensitization following tissue injury.

Here we outline mechanisms by which NGF activation of its cognate receptor, tropomyosin-related kinase A receptor, regulates a host of ion channels, receptors, and signaling molecules to enhance acute and chronic pain

Further, we document that peripherally restricted antagonism of NGF-tropomyosin-related kinase A receptor signaling is effective for controlling human pain while appearing to maintain normal nociceptor function  Continue reading

When Chronic Pain is Trauma

When Chronic Pain is Trauma: Processing Chronic Pain Memories from a Trauma Framework | Life in Slow Motion

After some thought, I am seeing the benefit of processing chronic pain memories from a trauma framework.

When connecting chronic pain and trauma, almost all of the literature is solely related to traumatic events that directly or indirectly lead to chronic pain.

Sometimes trauma does not create chronic pain; sometimes chronic pain is the trauma.

This makes sense to anyone suffering from chronic pain without any detectable physical trauma. No one can deny that it is traumatic when your normal life is ripped out of your grasp forever. Continue reading

Fed Report Blames DEA for Painkiller Shortages

Fed Report Blames DEA for Painkiller Shortages — Pain News Network

Poor oversight by the U.S. Drug Enforcement Agency has led to a sharp increase in shortages of some prescription drugs – including many opioid painkillers – according to a new government study that calls the shortages “a risk to public health.

The lengthy report by U.S. Government Accountability Office (GAO) faults the DEA for “weak internal controls” and poor management of the quota system under which controlled substances are produced and distributed.

Between 2001 and 2013, the GAO said there were 87 “critical” shortages of drugs containing controlled substances, over half of them pain relievers. There were also shortages of anti-anxiety medications, sedatives, and stimulants. All of the drugs belong to a class of medications that affect the central nervous system and are used to treat seizures, manage anxiety, and relieve pain.

The vast majority of drug shortages lasted over a month and some dragged on for years. Continue reading

3 New Studies Showing Health Positives Of Cannabis

3 New Studies Showing Health Positives Of Cannabis – Reset.me

Here are three of the most recent discoveries science has brought us on cannabis consumption and health:

1. Men who use cannabis are less likely to get bladder cancer… among many cancers.

The February edition of the journal Urology reports on a review of California health data that found tobacco smokers had a 52 percent increased risk of bladder cancer, but those who smoked both cannabis and tobacco had just a 28 percent increased risk. The shocker was that among those men who were cannabis-only smokers, they had a 45 percent reduced risk of bladder cancer. Not compared to tobacco smokers, but compared to men who don’t smoke anything.  Continue reading

Our health care system making pain patients worse

How the health care system is making pain patients worse Sridhar | Vasudevan, MD | March 3, 2015

Despite newer, expensive and invasive treatments like spinal fusions and disc surgery, spinal cord stimulators, steroid and painkiller injections, nerve  “burning” and of course the excessive use of opioid drugs, chronic pain is becoming worse in the U.S. adult population not better!

How does contemporary pain treatment make it worse? Through its blind allegiance to a controversial medical procedure called the “wallet biopsy,”

In the last 20 years, the “wallet biopsy” has elevated to wide use chronic pain treatments that are uncoordinated, expensive and have disappointing outcomes. For example, almost nine million Americans got pain injections such as corticosteroids in 2010. The injections draw lucrative reimbursements but have limited if any long-term benefit according to the medical literature.  Continue reading

Collagens in Energy Metabolism and Metabolic Diseases

Function of Collagens in Energy Metabolism and Metabolic Diseases | Open Access | OMICS Publishing Group

This article shows a link between collagen production and energy problems associated with Metabolic Diseases. Could this be a new avenue of research?

Defining the cellular sources of collagens in the normal and diseased states of the above metabolic tissues is thus critical to understanding metabolic disease. Under certain pathological conditions, the excess accumulation or collapse of collagens may disrupt normal cell-cell interactions, and cause the loss of tissue compliance or elasticity.

Finally, these disruptions of collagens result in tissue dysfunction such as atherosclerosis of the blood vessels, pulmonary fibrosis, liver cirrhosis and fibrosis in other organs.

This review will focus on the role of collagens in metabolic tissues, and attempt to summarize the function of collagens in energy metabolism.  Continue reading