Friday, February 27, 2015

Topic: Predictors of Suicidal Ideation in Chronic Pain Patients

Topic: Predictors of Suicidal Ideation in Chronic Pain Patients

Predictors of Suicidal Ideation in Chronic Pain Patients


This blog post relates to an article entitled Predictors of Suicidal Ideation in Chronic Pain Patients: An Exploratory Study that Dr. Manon Choinière, Dr. Warren Nielson and I have recently published in The Clinical Journal of Pain [4]. (To read this same blog post in French please click here).

Suicide has always been a very sensitive topic to touch upon, whether it be about “suicidal ideations” (SI), “suicide attempts” (SA) or — god forbid — suicide completion. According to the World Health Organization, death by suicide is one of the leading causes of mortality rate every year (16 per 100, 000 individuals) [6]. The worldwide lifetime prevalence for passive (without plan) and active (with a plan) SI, and SA have been estimated to be 9.2%, 3.1% and 2.7% respectively [3]. In many cases, there is a progression from passive suicidal thoughts to more active thoughts, which may be followed by SAs and in some unfortunate cases, death.

Please click on this link to view more:

Topic: All About Opioids and Opioid-Induced Constipation (OIC)

Topic: All About Opioids and Opioid-Induced Constipation (OIC)

All About Opioids and Opioid-Induced Constipation (OIC)

Treatment options for OIC

Although opioids are very effective for treating and managing pain, their use frequently results in opioid-induced constipation (OIC). Treatment options for OIC may be as simple as changing diet or as complicated as requiring several medicines and laxatives.

How can changing lifestyle factors treat OIC?

Changing lifestyle factors is usually the first recommendation that physicians make for the prevention or treatment of constipation. This includes:

Increasing dietary fiber

Increasing fluid intake

Increasing exercise or physical activity

Increasing time and privacy for toileting

Changes in lifestyle, however, may not be possible for many patients. In addition, these changes may be ineffective in treating OIC. If there is a concurrent underlying disease or medicine that is causing constipation, the disease may need to be treated separately or another treatment regimen may have to be considered.

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Topic: How does the weather affect your pain or pain syndrome(s)?

Topic: How does the weather affect your pain or pain syndrome(s)?

How does the weather affect your pain or pain syndrome(s)? Please share with us daily so that you can see, read and comment on how the weather affects your pain and those around you! You may be surprised to see that you are not alone in this area also!

Please click on this link to view more:

Wednesday, February 25, 2015

Topic: Risk Evaluation and Mitigation Strategy (REMS)

Topic: Risk Evaluation and Mitigation Strategy (REMS)

Risk Evaluation and Mitigation Strategy (REMS)

A Risk Evaluation and Mitigation Strategy (REMS) is a strategy to manage known or potential serious risks associated with a drug product and is required by the Food and Drug Administration (FDA) to ensure that the benefits of a drug outweigh its risks.

The FDA has required a REMS for extended-release and long-acting (ER/LA) opioid analgesics.

Under the conditions specified in this REMS, prescribers of ER/LA opioid analgesics are strongly encouraged to do all of the following:

Train (Educate Yourself) - Complete a REMS-compliant education program offered by an accredited provider of continuing education (CE) for your discipline

To read more please click this link:

Saturday, February 21, 2015

Topic: Pain Care Advocacy in an Era of Opioid Abuse Part 1

Topic: Pain Care Advocacy in an Era of Opioid Abuse Part 1

Pain Care Advocacy in an Era of Opioid Abuse (Part 1)

By Jennifer Van Pelt, MA Social Work Today Vol. 12 No. 5 P. 16

Pain medication abuse is affecting individuals with legitimate needs to manage chronic pain. Learn how social workers can advocate for them.

Prescription drugs now rank second after marijuana as the drug of choice for substance abuse, surpassing cocaine, heroin, and other illegal street drugs. Media headlines, celebrity doctors, and popular TV shows regularly denounce the “painkiller epidemic,” “prescription drug trade,” and “war on prescription painkillers.” Lost in these negative media messages, however, is the fact that the majority of these abusers were not prescribed opioids themselves but rather buy or steal them from others who were prescribed opioids for a medical condition (Manchikanti, Fellows, Ailinani, & Pampati, 2010).

Prescription pain medication addiction has been referred to as a public health crisis in the media. Statistics from the National Institute on Drug Abuse (NIDA) indicate that prescription drug abuse has increased dramatically, and opioid pain medications are now abused by more than 5 million Americans, making this drug class more likely to be abused than prescription antidepressants, sedatives, or stimulants. According to NIDA statistics, 15,600 deaths in 2009 were attributable to prescription pain medications.

But for individuals who legitimately require and benefit from opioids, the undertreatment of chronic long-term pain is a problem unrecognized even by those in healthcare due to the focus on opioid abuse. “The media generally does not report the issues around opioid use with accuracy, neutrality, and critical thinking. The tide has shifted from demonizing pain medication to demonizing people with pain, continuing the suffering of millions with untreated or undertreated pain,” says Yvette Colón, PhD, MSW, a psychosocial specialist at The MetaCancer Foundation.

Opioids typically have been more accepted in cancer care, especially for pain in the terminally ill, and prior to the 1990s they were rarely prescribed for chronic noncancer pain, even when pain was severe and long-term. After some cancer pain research studies showed that most patients did not experience addiction issues and the American Academy of Pain Medicine and the American Pain Society endorsed opioid use for chronic noncancer pain, opioids began to be more commonly prescribed (Schug, Zech, Grond, Jung, Meuser, & Stobbe, 1992; Manchikanti et al., 2010; Fauber, 2012). (See sidebar on page 20 for more information.)

“Unfortunately, this research coincided with increased rates of prescription pain medication abuse and media attention to it,” says Deborah Barrett, PhD, MSW, LCSW, a clinical associate professor at the University of North Carolina at Chapel Hill School of Social Work, a private practice psychotherapist, and the author of Paintracking: Your Personal Guide to Living Well With Chronic Pain. Barrett sees the issue from both the social worker and the patient perspective: She has lived with the chronic pain of fibromyalgia for almost 20 years.

To read more please click here:

Friday, February 20, 2015

Topic: The Connection Between Chronic Pain and Suicide

Spine injuries can lead to chronic pain, which in turn may cause feelings of depression, anxiety and hopelessness.
Sadly, some people who experience these debilitating emotions admit their desire to end their own lives.

 Where to turn if you are considering suicide
If you are considering committing suicide, please visit the "Suicide Help" page on the nonprofit website

The professionals at the site instruct suicidal people to "call 1-800-273-TALK in the U.S. or visit Befrienders Worldwide to find a helpline in your country. Or talk to someone you trust, and let them know how bad things are."

Basic facts about suicide and pain
To learn more about the relationship between suicide and pain, I contacted Jill M. Harkavy-Friedman, PhD, Vice President of Research at the American Foundation for Suicide Prevention, to ask her what research shows us about the connection between the two.

To read more please click on this link:

Crohn's Disease and Diet

Crohn's Disease and Diet

Crohn's disease is a condition defined by chronic inflammation and irritation of the digestive tract, and, according to the Crohn's and Colitis Foundation of America (CCFA), an estimated 700,000 Americans suffer from inflammatory bowel disease (IBD). There is no known cause, but the condition is known to run in families. In addition, one's immune system and environment appear to play a role in the development of Crohn's.

 What Happens with Crohn's Disease?

The exact process that causes the inflammation and irritation is unknown, but there has been some insight into the disease. Crohn's disease often affects the lower part of the small intestine, but can manifest anywhere from the mouth to the anus. The immune system also plays a role in this condition.

To Read More, please click this link:

Thursday, February 19, 2015

Topic: Overview of Fibromyalgia (FMS), Chronic Fatigue Syndrome (CFS) & Central Sensitivity Syndrome (CSS)

Fibromyalgia Syndrome (FMS) is a progressively recognized chronic pain syndrome, which is characterized by it's constellation of musculoskeletal aches, pain and stiffness, soft tissue tenderness, general fatigue and sleep disturbances. The most common sites of pain include the neck, back, shoulders, pelvic girdle and hands, but any body part can be implicated. Fibromyalgia patients confront an array of symptoms of varying intensities that are fluxional over time such as; morning stiffness, headaches, irritable bowel syndrome, anxiety, cognitive disorders such as concentration, memory problems, attention deficit disorder, and anxiety. It is estimated that approximately 3-6% of the U.S. population has FM.
To read more please click this link:

Saturday, February 14, 2015

New Drug Called Subsys

Dr Patty's Chronic-Intractable Pain and You Main Site - New Drug Called Subsys

New Drug Called Subsys (fentanyl) Sublingual Spray

SUBSYS (fentanyl sublingual spray) is a potent opioid analgesic intended for sublingual mucosal administration.. Dennis Verdugo​ and I are supposed to go on this.  This reminds me of the fentanyl lollipop. The cost is $4000.00 and I don't see it happening!  To read more, please go to this link: