Tag Archives: research

Women More Adept Than Men At Discerning Pain

Women May Be More Adept Than Men At Discerning Pain : Shots – Health News : NPR – August 26, 2019 – Patti Neighmond  – Twitter

I like this article because it has links to reputable sources, like PubMed abstracts from the NIH. Unfortunately, it starts out with the usual trope:

The pathway to opioid abuse for women often starts with a prescription from the doctor’s office. [wrong, wrong, wrong…]

This is an outdated and completely incorrect myth of anti-opioid propaganda. The CDC data clearly shows that pain patients taking prescribed (for them) opioids account for only a minuscule number of the opioid overdoses, as I have posted previously:  Continue reading

Different Pain, Different Neural Circuits

Responses to External Threats and Sustained Pain Travel Via Different Neural Circuits – Practical Pain Management – By Kerri Wachter with Qiufu Ma, PhD – Jan 2019

New study outcomes in mice suggest that common pain measurement tools may be inadequate.

Different neural pathways appear to underlie

  • reflexive responses to external threats and
  • coping responses to sustained pain

I’m surprised this hasn’t been obvious to researchers because it’s certainly clear to pain patients. The experience of acute pain, like stubbing your toe, is wildly different than that of long-term pain, like failed back surgery, so it seems obvious to me that different aspects of our nervous system are involved.  Continue reading

Blunting pain’s emotional component

Blunting pain’s emotional component | Newswise: News for Journalists – Mar 2019

Chronic pain involves more than just hurting. People suffering from pain often experience sadness, depression, and lethargy.

These days, I’m almost surprised they’re not claiming that people are causing their own pain when they experience “sadness, depression, and lethargy”.

That’s one reason opioids can be so addictive — they not only dampen the pain but also make people feel euphoric. [not!]

Wrong. Those of us using opioids for serious pain do not experience this euphoria; see Opioids + Pain != Euphoria for an explanation why this doesn’t happen.    Continue reading

Even Moderate Pain Associated With Suicide Risk

Moderate, Severe Chronic Pain May Be Associated With Suicide Risk in Veterans – Clinical Pain AdvisorBrandon May – Mar 2019

Pain intensity may represent a reliable indicator of suicide risk in veterans, according to a study published in the Journal of Pain.

The data of veterans who used Veterans Health Administration pain specialty services (index visit) between 2012 and 2014 were analyzed (n=221,817);

Medical records and suicide surveillance sources were used to identify suicide attempts in the year following the initiation of pain services.    Continue reading

Novel Opioid Receptor Agonist Found Effective[?]

Novel Opioid Receptor Agonist Found Effective for Chronic Low Back Pain – Clinical Pain Advisorby Amit Akirov, MD – Aug 2019

The main appeal of this very mild opioid pain reliever is that it enters the nervous system very slowly compared to current opioids, which supposedly makes it less addictive.

NKTR-181 was found to be a safe, effective, and well tolerated treatment over the long term in patients with moderate to severe chronic low back pain (CLBP), according to results from a phase 3 trial published in Pain Medicine.

NKTR-181, a novel μ-opioid receptor agonist, has several advantages compared with conventional opioid drugs, including

  • a slower entry into the central nervous system,
  • delayed receptor binding, and [why would a delay of pain relief be desireable?]
  • long duration of effect.

Continue reading

The complexity of opioid receptor function

Untangling the complexity of opioid receptor function – by Rita J. Valentino & Nora D. Volkow – Sept 2018for science nerds

This is a technical article explaining the differences between different opioid receptors, which turn out to have further layers of complexity. Finding the molecular paths or signals that create and/or transmit pain signals, researchers hope to find new ways to interrupt that process to alleviate pain.

Evidence that opioid receptors form and can function as heteromers suggests another layer of complexity and another route for manipulating opioid receptor function

Mu opioid receptor agonists are among the most powerful analgesic medications but also among the most addictive.   Continue reading

Mortality After Discontinuation of Opioid Therapy for Pain

Mortality After Discontinuation of Primary Care-Based Chronic Opioid Therapy for Pain: a Retrospective Cohort Study. – PubMed – NCBI – J Gen Intern Med. – Aug 2019

BACKGROUND:

Despite known risks of using chronic opioid therapy (COT) for pain, the risks of discontinuation of COT are largely uncharacterized.

These “risks of discontinuation of COT” are not “largely uncharacterized” but rather completely unstudied.

Pain patients being tapered are being used as guinea pigs because those who are restricting opioids have no idea what the results might be.  Continue reading

Critical Appraisal of Clinical Research

Critical Appraisal of Clinical Research – Free full-text /PMC5483707/J Clin Diagn Res. May 2017

This article is a primer on how to read research studies: what to look for and what to question.

Evidence-based practice is the integration of individual clinical expertise with the best available external clinical evidence from systematic research and patient’s values and expectations into the decision making process for patient care.

It is a fundamental skill to be able to identify and appraise the best available evidence in order to integrate it with your own clinical experience and patients values.      Continue reading

Less research is needed

Less research is needed | Speaking of Medicine | Plos BlogsPosted June 2012 by Trisha Greenhalgh

The most over-used and under-analyzed statement in the academic vocabulary is surely “more research is needed”. 

This has been bothering me for a while too. I’ll read through an endless extremely detailed study only to find the conclusion is that “more research is needed”. I thought the current study *was* more research, but those last words place all the findings in doubt and show the researchers have no confidence in their results.

These four words, occasionally justified when they appear as the last sentence in a Masters dissertation, are as often to be found as the coda for a mega-trial that consumed the lion’s share of a national research budget, or that of a Cochrane review which began with dozens or even hundreds of primary studies and progressively excluded most of them on the grounds that they were “methodologically flawed”.   Continue reading

Most heroin addicts didn’t start with Rx pain pills

The White House drug czar is wrong: Most heroin addicts didn’t start with prescribed pain pills by Phillip Smith / Independent Media Institute July 3, 2019

As part of its campaign to stem opioid addiction and overdoses, the White House Office of National Drug Control Policy (ONDCP — the drug czar’s office) has launched an education campaign called The Truth About Opioids, but some of the material it is presenting has more than a whiff of spin to it — and could imperil the ability of pain patients to get the relief they need.

The website declares in big, bold letters that “80% of heroin users started with a prescription painkillerThe graphic suggests that heroin users were prescribed opioids, developed a habit, and then went on to junk, with the further implication that a way to reduce heroin addiction is to tighten and reduce the prescribing of opioids.

Now even the “Drug Czar” is promoting the erroneous media story about the “innocent victims” and doubling down on the hype spread by anti-opioid activists.  Continue reading