Topic: What Are Opioids and Who Needs Them?

Topic: What Are Opioids and Who Needs Them?

Opioids work by changing the way pain is experienced and "felt." They literally block pain signals to and in the brain. They also have sedative effects which can improve rest and sleep.

If you have been diagnosed with chronic pain, you have several treatment options. Your first decision is whether to take any pain medicines at all. That decision almost always revolves around how severe your pain is, and whether you are able to work and live fairly normally with the pain. Since pain is an entirely subjective experience, only you and your doctor can reach this decision.



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Topic: Opiates Raise Atrial Fibrillation Risk; AFib Makes Heart Attacks More Likely

Topic: Opiates Raise Atrial Fibrillation Risk; AFib Makes Heart Attacks More Likely

Researchers say using opioids such as hydrocodone can increase your risk of developing an irregular heartbeat, and an irregular heartbeat can make you more likely to have the most common kind of heart attack.

If you have atrial fibrillation, your risk of suffering the most common type of heart attack goes up.



And if you take an opioid such as hydrocodone, you’re increasing your risk of developing an irregular heartbeat in the first place.



That’s the conclusion of two new studies released today.



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Topic: Doctor Defends Use of Urine Drug Tests

Topic: Doctor Defends Use of Urine Drug Tests

A prominent pain doctor is disputing reports that a widely used urine drug test often gives faulty results.



“They are reasonably reliable and highly cost effective for use in a pain management practice. I would strongly recommend the practitioners use this,” said Laxmaiah Manchikanti, MD, chairman and CEO of the American Society of Interventional Pain Physicians.

Dr. Manchikanti, who is medical director of a pain clinic in Paducah, Kentucky, was the lead author of a study published in the journal Pain Physician in 2011, which looked at the reliability of immunoassay “point-of-care” (POC) tests. The urine tests are inexpensive and give immediate results, and doctors often use them to monitor their patients for opioid or illicit drug use.



“The UDT (urine drug test) with immunoassay in an office setting is appropriate, convenient and cost effective. Compared with laboratory testing for opioids and illicit drugs, immunoassay office testing had high specificity and agreement,” Manchikanti's study found.

Pain News Network recently reported on the results of a second study conducted by Millennium Health, a San Diego-based drug testing laboratory, which found that POC tests were wrong about half the time – frequently giving false positive and false negatives results for drugs like marijuana and oxycodone. The Millennium study advocates the use of chromatography-mass-spectrometry – a more complex laboratory test that costs thousands of dollars – to confirm POC test results.

“Following the advice from companies in reference to numerous expensive tests and also income generating avenues will only lead to time in the slammer and will not improve patient care at all,” said Manchikanti.



“(The) Millennium study is performed by the company which makes a living by testing. The more samples that are sent to them, the better off they are. Further, they are not even a practical setting. From our practice we send approximately only 2% of the samples for confirmation testing. Even then, the patients can’t pay their bills.”



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Topic: Another Study Links Chronic Pain and Suicide

Another Study Links Chronic Pain and Suicide

Suicide is the 10th most common cause of death in the United States and a growing body of scientific literature suggests that chronic pain is associated with suicidal ideation, attempts, and mortality. However, there have been limited data on the extent to which specific pain conditions might be linked to suicides. New research suggests that back pain, migraine, and psychogenic pain may be of greatest concern.



In this new study, Mark A. Ilgen, PhD — of the U.S. Veterans Affairs (VA) Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, Michigan — and colleagues examined associations between clinical diagnoses of chronic noncancer pain conditions and suicide in a very large population of patients served by the VA Healthcare System (Ilgen et al. 2013). The researchers retrospectively identified 4,863,036 individuals who received services in fiscal year 2005 and were alive at the start of fiscal year 2006.



During a 3-year followup period (spanning fiscal years 2006-2008), there were 2,838 suicides in patients with pain conditions. The data were examined for associations between baseline clinical diagnoses of arthritis, back pain, migraine, neuropathy, headache or tension headache, fibromyalgia, and psychogenic pain and subsequent suicide death recorded in the National Death Index. At baseline, 92% of the patients were male and the vast majority (81%) were aged 50 years or older — more than a third (38%) were older than 70 years of age.



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Topic: How the War on Rx-Drugs Victimizes Pain Patients

In a battle against prescription drug abuse and diversion, primarily involving opioid pain relievers, the U.S. Drug Enforcement Agency (DEA) has launched attacks on wholesalers and pharmacies within the legitimate supply chain. Questions are being raised about the foresight of such tactics, as healthcare providers are becoming leery of prescribing and severe shortages of these vital analgesics loom over the horizon. In the end, patients with pain may become collateral damage in this “War on Rx-Drugs.”



According to a recent report from Reuters news service [“U.S. War on Drugs Moves to Pharmacy from Jungle”; June 16, 2012, here], in response to ever-increasing concerns about the diversion of prescription pain relievers to illegitimate use, the DEA has beefed up its efforts at deterrence and is deploying many of the tactics it uses to combat illegal drugs, such as wire taps, undercover operations, and informants.



Such efforts have helped it dismantle many “pill mills” — bogus pain clinics writing thousands of questionable prescriptions — as well as rogue Internet pharmacies. However, the agency is now applying the same tactics to prosecute the legitimate pharmaceutical supply chain, including wholesalers and pharmacies that must follow strict record-keeping and security rules to prevent drug diversion.



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Patients are becoming collateral damage in US war on drugs

Patients are becoming collateral damage in US war on drugs

In October the U.S. Food and Drug Administration proposed tightening restrictions on access to certain low-potency narcotic pain medicines in an effort to stem the rising tide of prescription-drug abuse in the United States. The new rules would require patients to visit their doctors more often to refill their prescriptions and prohibit pharmacists from filling prescriptions over the phone.

The recommended changes may seem innocuous to many Americans, who are accustomed to getting just one side of the story on prescription-drug use. In fact, they are part of a disturbing trend that threatens to disrupt access to life-sustaining medication for millions of law-abiding citizens while having minimal impact on levels of drug abuse and addiction.

The move by the FDA to reclassify low-level hydrocodone preparations like Vicodin as Schedule II narcotics — the same category currently assigned to stronger pain medications, including fentanyl and morphine — follows several years of unilateral action by the states to erect new roadblocks to pain management. Advanced under the guise of protecting the health of Americans, these restrictions represent a heedless expansion of the war on drugs at the expense of the privacy and well-being of innocent patients.

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When Prosecution Replaces Prescription

When Prosecution Replaces Prescription

By Lynn Webster, MD
POSTED: JUNE 11, 2014


Chances are that most of us know someone with disabling chronic pain. Spotting these people is not very easy. If she is in pain, for instance, you can bet she won’t share it with anyone. The stigma associated with chronic pain often produces a sense of shame and, therefore, desire for concealment.

Imagine this same scenario but on a national scale, with the only difference being that instead of some people withholding problems, society is withholding the solutions.

Such is the plight of Americans who suffer from some type of chronic, persistent pain—a group of people that the Institute of Medicine estimates to number more than 100 million. Many of these people find relief from non-opioid treatment, but there are countless others whose pain is so severe that opioid therapy is the only option that provides enough relief for them to live functional lives. Because of this, it is critical for opioids to remain an available option to those who suffer agonizing pain. It also means that we must take the necessary steps to ensure that these medications are not abused or inappropriately prescribed.

Today, in the United States, prescription drug abuse and opioid-related deaths are a full-fledged epidemic. Drug overdoses have tripled since 1990, and prescription drugs are a driving factor. More than 12 million people reported using prescription painkillers (i.e., opioids) without consent of a prescribing physician in 2010, and opioid-related emergency room visits have skyrocketed in recent years.

To combat these tragic realities, the federal government has moved aggressively to regulate, restrict and monitor the use of painkillers. Even so, the prescription drug abuse and overdose epidemic persists. Now, in the face of increasing pressure to do more, we’ve turned to a new tactic: the prosecution of doctors who treat patients using painkillers.

Please Read More at Dr. Patty's Chronic-Intractable Pain and You Sites, Inc.

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Coping with chronic pain

Coping with chronic pain


Chronic pain is physically and psychologically stressful and its constant discomfort can lead to anger and frustration with yourself and your loved ones. By definition, chronic pain is pain that lasts longer than six months and affects how a person lives their daily life. While physicians can provide treatment for the physical dimensions of chronic pain, psychologists are uniquely trained to help you manage the mental and emotional aspects of this often debilitating condition.


Several medical treatments may be used to alleviate chronic pain, including over-the-counter or prescription medication, physical therapy and less utilized treatments, such as surgery. However, these options are only a few of the pieces necessary to solve the puzzle of chronic pain. Mental and emotional wellness is equally important — psychological techniques and therapy help build resilience and teach the necessary skills for management of chronic pain.


Please Read More at Dr. Patty's Chronic-Intractable Pain and You Sites, Inc.

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TEARLESS PAIN~

NOTICE:

Care-giving: Insights for Caregivers

Care-giving: Insights for Caregivers

Ask Questions

To give your loved one the best care, you have to understand her needs. Set aside time to talk. Find out how she feels and what she wants you to do for her.

Don't argue or insist your own opinion is best. Offer ideas, but listen to what she has to say. Show that you've heard by repeating back key points, like, "I understand that you want to do more for yourself."

Create a Schedule

When you care for someone at home, days can feel long and unfocused. Give him structure by making a schedule. Set times for meals, personal care, household chores, exercise, activities, and relaxation. Also set sleep and wake times to make sure both of you get enough rest.

When you make the schedule, think about your loved one's needs. Consider how he organized his day before you got involved.

Read the entire article at Dr. Patty's Chronic-Intractable Pain and You Site

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Topic: 9 Pain Pill Mistakes Prescription or over-the-counter, pain pill mistakes common

9 Pain Pill Mistakes Prescription or over-the-counter, pain pill mistakes common



It's been a hard day, and Joe's back is killing him. His wife has some Percocet left over from a trip to the dentist, and there's that big bottle of Tylenol under the sink, so Joe grabs a couple of each and washes them down with a slug of beer. Luckily for Joe, he's a fictional character invented for this article. But there are a lot of real-life Joes out there making big mistakes with over-the-counter and prescription pain pills. Can you spot Joe's mistakes? Joe didn't make every mistake in the book. But he made quite a few.

Here's WebMD's list of common pain pill mistakes, compiled with the help of pharmacist Kristen A. Binaso, spokeswoman for the American Pharmacists Association; and pain specialist Eric R. Haynes, MD, founder of Comprehensive Pain Management Partners in Trinity, FL.

Pain Medications Mistake No.1: If 1 Is Good, 2 Must Be Better To Read More, please click this link: 

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When to Go to the Emergency Room for a Headache or Migraine

When to Go to the Emergency Room for a Headache or Migraine

Headache is one of the most common reasons for an emergency room visit. Some people go due chronic headache or Migraine problems that do not go away with treatment, and in other cases, headache is a symptom of another medical problem.

The best reason for an ER visit is for unusual symptoms that are new to you. You may seek attention to make sure there is no chance of another problem such as aneurysm or meningitis. A severe headache that starts very suddenly (within a second or two) can mean another disorder such as stroke. New symptoms such as a fever, weakness, vision loss or double vision, or confusion are some of most concerning symptoms. If you have a new symptom and serious, life-threatening medical problems such as liver, heart or kidney disease, are pregnant, or have a disorder which affects your immune system such as HIV infection, an ER visit may be more essential.

Read More At:

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Topic: Ask Dr. Patty

Ask Dr. Patty (Member's of the main website http://www.chronicintractablepainandyou.net)

If you have any questions that you would like to ask Dr. Patty, please click on the reply button and ask away!

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Topic: Dr. Patty is trying the new medication called Subsys (Member's Only Section)

Dr. Patty is trying the new medication called Subsys  (Member's Only Section).

I am going to start a new medication called Subsys. As many of you know by the post that I wrote here: http://www.chronicintractablepainandyou.net/new-drug-called-subsys, my insurance did approve the new drug for me.  It took a lot of time but it came through.  Dennis will be on it as well.  The pain doc found a 3rd party payer that will absorb his cost for a year (if the medication works).  I will keep you all updated as to how it is working.  More information about Subsys, will be in this section.



Please click here to follow her progress:  http://www.chronicintractablepainandyou.net/apps/forums/topics/show/13149865-dr-patty-is-trying-the-new-medication-called-subsys-member-s-only-section-

Topic: Meditation can reduce chronic neck pain, study shows

Topic: Meditation can reduce chronic neck pain, study shows



Meditation might be an effective treatment for reducing chronic neck pain, according to research reported in The Journal of Pain.

Chronic neck pain can lead to serious comorbidities like depression. Patients with chronic neck pain frequently experience distress. Meditation has been increasingly used as a supportive treatment for individuals with chronic pain.

Previous research has shown that chronic pain is associated with distress and that meditation has stress relieving benefits. German researchers compared the effects of meditation on pain, perceived stress and psychological well being. They hypothesized that an eight-week meditation program will decrease pain more effectively than a standardized exercise program and that pain relief will coincide with stress reduction. To read more click this link: http://www.chronicintractablepainandyou.net/apps/forums/topics/show/13143410-meditation-can-reduce-chronic-neck-pain-study-shows

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

DECEMBER 17, 2013 BY BIM

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.



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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!



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