Category: NOVEMBER 2019

What I’m Required to Go Through to Get My Prescriptions for Chronic Pain 

Good, law-abiding people are suffering severely in the fallout from recent state and federal laws. These laws and prevailing societal views all begin with the false assumption that prescription pain pills are entirely to blame for rising heroin and fentanyl abuse rates. Chronic pain patients, including many elderly and disabled citizens, often feel treated like…

Prescription drug monitoring programs operational characteristics and fatal heroin poisoning

International Journal of Drug Policy Volume 74, December 2019, Pages 174-180 Author links open overlay panelSilvia S.MartinsaMagdalenaCerdádShow morehttps://doi.org/10.1016/j.drugpo.2019.10.001Get rights and content Abstract Background Prescription drug monitoring programs (PDMP), by reducing access to prescribed opioids (POs), may contribute to a policy environment in which some people with opioid dependence are at increased risk for transitioning from POs…

October 16, 2019 Sleep Disturbances May Affect Chronic Pain Outcomes Hannah DellabellaSleep disturbance may be associated with reduced improvements in pain interference and pain severity in patients with chronic pain, regardless of whether they are treated with opioids, according to results published in Pain Medicine.The study included 240 participants with chronic back pain or hip/knee osteoarthritis (OA) pain who were randomly assigned to receive opioid therapy or nonopioid medication therapy (n=120 in each group). The researchers used mixed models for repeated measures to determine the effect of baseline sleep disturbance scores on pain outcomes in the presence vs absence of an opioid therapy, and whether such disturbances could predict improvements in pain outcomes.Of the 238 participants who completed the study, 80 (34%) reported severe sleep disturbance at baseline.Testing for interaction of baseline sleep disturbance score by opioid treatment group did not yield any differences for Brief Pain Inventory (BPI) interference or severity, indicating that the level of baseline sleep disturbance may not have an effect on the impact of the presence vs absence of opioid therapy on pain outcomes.Related ArticlesChallenges in Developing Therapeutics for Addiction and PainLatent Profile Analysis May Help Identify Subgroups of Children With Chronic PainPerseverative Thinking May Partially Mediate the Association Between Pain Intensity and CatastrophizingBaseline sleep disturbance scores were found to predict reduced improvement in BPI interference (P =.0002). Every 10 points higher of baseline Patient-Reported Outcomes Measurement Information System sleep disturbance score were found to correlate with a 0.58-point reduction in BPI interference. Baseline sleep disturbance was also found to predict less improvement in BPI severity (P=.0164).Study limitations include the fact that it was not a prespecified analysis, that participants were Veterans Affairs patients who were primarily male, that sleep was not assessed at all time points, and that the study was not designed to investigate the sleep-pain relationship.“Evidence-based behavioral sleep treatments should be considered to optimize outcomes for patients with chronic pain,” noted the researchers.Follow @ClinicalPainAdvReferenceKoffel E, Kats AM, Kroenke K, et al. Sleep disturbance predicts less improvement in pain outcomes: secondary analysis of the SPACE randomized clinical trial [published online September 14, 2019]. Pain Med. doi:10.1093/pm/pnz221

Pain Management for Your Back

The best defense against back pain from ankylosing spondylitis (AS) is controlling your disease with a daily treatment plan. It will usually include medications your doctor recommends. When the pain is worse than normal and you’re having a flare, your doctor may have you try other drugs. But you can take steps on your own,…