Can You Get Over an Addiction?

Can You Get Over an Addiction? | New York Times | Jun 2016 | by Maia Szalavitz

I SHOT heroin and cocaine while attending Columbia in the 1980s, sometimes injecting many times a day and leaving scars that are still visible. I kept using, even after I was suspended from school, after I overdosed and even after I was arrested for dealing, despite knowing that this could reduce my chances of staying out of prison.

They kept hoping I would just somehow stop, even though every time I tried to quit, I relapsed within months.

There are, speaking broadly, two schools of thought on addiction:

The first was that my brain had been chemically “hijacked” by drugs, leaving me no control over a chronic, progressive disease.

The second was simply that I was a selfish criminal, with little regard for others, as much of the public still seems to believe   Continue reading

Gabapentin/Neurontin And Pregabalin/Lyrica

Gabapentin And Pregabalin What You Should Know; Dr. Rodger Murphree

Neurontin (gabapentin) and the newer Lyrica (pregabalin) are two anticonvulsant and analgesic medications originally prescribed for the treatment of epilepsy.

Neurontin was originally licensed in the United States and Canada in December 1993 for use as an adjuvant medication to treat seizures and epilepsy.

Lyrica on the other hand, is a much newer drug that received approval for use in the treatment of epilepsy, diabetic neuropathic pain, and pos-therpetic neuralgia in 2005,

According to the US Food and Drug Administration (FDA), these antiepileptic drugs (AEDs) do in fact “increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication.   Continue reading

“Research” Behind the CDC’s Opioid Guidelines

Tracking Down the “Research” Behind the CDC’s Opioid Prescribing Guidelines – National Pain Report – Aug 2016 – By Richard “Red” Lawhern, PhD

I have tracked down some of the “research” behind the so-called CDC practice guidelines published in March 2016. And the research is an absolute CROCK!

Particularly astounding is the biased and unscientific way that the Consultants Working Group arrived at their recommendation that 90 Morphine Milligrams Equivalent Per Day (MMED) should be established as an upper bound on acceptable prescription practice.   Continue reading

The Brain Disease Model of Addiction

Neurobiologic Advances from the Brain Disease Model of AddictionNora D. Volkow, M.D., George F. Koob, Ph.D., and A. Thomas McLellan, Ph.D. | January 28, 2016

In this uncharacteristically sensible article, Nora Volkow, the head of the National Institute on Drug Abuse, acknowledges the drug-war has failed.

This article reviews scientific advances in the prevention and treatment of substance-use disorder and related developments in public policy.

In the past two decades, research has increasingly supported the view that addiction is a disease of the brain.

Although the brain disease model of addiction has yielded effective preventive measures, treatment interventions, and public health policies to address substance-use disorders, the underlying concept of substance abuse as a brain disease continues to be questioned, perhaps because the aberrant, impulsive, and compulsive behaviors that are characteristic of addiction have not been clearly tied to neurobiology.   Continue reading

Researcher examining impact of opioid restrictions

UVa researcher examining impact of opioid restrictions

When it comes to curbing opioid addiction, the cure can be worse than the condition.

A researcher at the University of Virginia says she believes many patients with chronic conditions are needlessly suffering with pain because of measures aimed at reducing the risk of opioid addiction.

Virginia LeBaron, an assistant professor at UVa’s School of Nursing, has received a $40,000 grant from the UVa Cancer Center to study what she calls the “concurrent epidemics” of opioid abuse and chronic pain caused by terminal illnesses or severe injuries.   Continue reading

Why pharma companies are fighting legal marijuana

One striking chart shows why pharma companies are fighting legal marijuana – By Christopher Ingraham July 2016

There’s a body of research showing that painkiller abuse and overdose are lower in states with medical marijuana laws.

These studies have generally assumed that when medical marijuana is available, pain patients are increasingly choosing pot over powerful and deadly prescription narcotics. But that’s always been just an assumption.

Now a new study, released in the journal Health Affairs, validates these findings by providing clear evidence of a missing link in the causal chain running from medical marijuana to falling overdoses

They found that, in the 17 states with a medical-marijuana law in place by 2013, prescriptions for painkillers and other classes of drugs fell sharply compared with states that did not have a medical-marijuana law.   Continue reading

5 Myths About the CDC Opioid Guidelines

5 Myths About the CDC Opioid Guidelines – Aug 2016 – By Pat Anson, Editor

In a recent survey of nearly 2,000 pain patients, over two-thirds said their opioid medication has either been reduced or stopped by their doctor since the CDC’s opioid prescribing guidelines were released.

…a sign they are being rigidly adopted and implemented by physicians, regardless of the impact on patients. 

Myth #1: The CDC prescribing guidelines are mandatory

False. The guidelines are voluntary and intended only for primary care physicians, yet they are being widely implemented by many prescribers, including pain management specialists and even some oncologists. Here is what the guidelines actually say:   Continue reading

Scrambler Therapy Found Promising

Scrambler Therapy Found Promising in Pilot Study – Pain Medicine News – Aug 2016

Various forms of neuropathic pain were significantly reduced by applying scrambler therapy, according to the results of a pilot study presented at the 2016 annual scientific meeting of the American Pain Society.

“With my years of experience in pain management, I realize there is no magic bullet,” said principal investigator Ricardo Cruciani, MD, PhD, professor and chair in the Department of Neurology

Scrambler therapy (also known as Calmare Pain Therapy Treatment [Calmare Therapeutics]) is noninvasive, using electrostimulation to block the transmission of pain signals to nerve fibers.   Continue reading

PROP Ends Affiliation with Phoenix House

PROP Ends Affiliation with Phoenix HousePain News Network –  Aug 2016 By Pat Anson

Physicians for Responsible Opioid Prescribing (PROP), an influential and politically connected advocacy group that seeks to reduce opioid prescribing, is no longer directly affiliated with Phoenix House, which runs a nationwide chain of addiction treatment centers.

The Steve Rummler Hope Foundation is now the “fiscal sponsor” of PROP, which will allow PROP to collect tax deductible donations under the foundation’s 501 (c) (3) non-profit status.

IRS regulations allow non-profits to form partnerships with like-minded organizations, allowing other groups to essentially piggyback off their non-profit status and collect donations.   Continue reading

The Opioid Crisis: Nociception, Pain and Suffering

The Opioid Crisis: Nociception, Pain, and Suffering – Jun 2016 – By Martin Samuels, MD

This article offers an excellent explanation of how pain works and how opioids function just like our own endogenous opioids.

In order to understand the concept of pain and its relationship to the current opioid crisis, it is prudent to review the neurology of pain an why it exists.  

Several concepts are important to integrate.

Nociception: 

Nociception is the capacity to sense a potentially tissue damaging (noxious) stimulus.    

To illustrate this one should place a forefinger in a glass of ice water and determine how long passes until an unpleasant sensation arises.   Continue reading