PDMPs proven to be Ineffective

EDS and Chronic Pain News & Info

Study Finds Prescription Drug Monitoring Programs Ineffective at Curbing Overdoses – by Allison Inserro – May 2019

This is the kind of interesting information I find when I look at journals for the medical-business industry; this article is from the American Journal of Managed Care.

Prescription drug monitoring programs (PDMPs) are now in place in all 50 states and the District of Columbia in response to rising levels of overdoses involving opioids and synthetic opioids.

But a new study published in the Annals of Internal Medicine that sought to clarify the relationship between PDMPs and their effectiveness in attacking the nation’s drug problem found limited to no evidence that they actually work.

It couldn’t be any clearer. They keep applying solutions for prescribing problems, wasting time while more and more people die of overdoses.

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Non-Opioid Medication May Reduce Pain

EDS and Chronic Pain News & Info

Novel, ‘Non-Habit Forming’ Medication May Reduce Low Back PainNancy A. Melville – Apr 2019

A novel, “non-habit-forming” neurosteroidappears to be effective and well tolerated in the treatment of chronic low back pain, new research suggests.

In a double-blind, randomized controlled trial of almost 100 Iraq/Afghanistan-era veterans, those treated with a pharmaceutical-grade tablet formulation of pregnenolone showed “significant and meaningful reductions” in low back pain intensity ratings at 6 weeks compared with their peers who received matching placebo, investigators report.

I’m excited about this because pregnenolone is an over-the-counter supplement available to us all.

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Relieving the Supreme Court’s Pain…..

painpolicy

Revisiting the constitutional right to Palliative Care

Katherine Irene Pettus, PhD, a political theorist, was invited to write this commentary on April 18th.  She is currently writing a book on Palliative Care and Public Policy for SUNY Press to be published in 2013)

New state laws aimed at curbing opioid access in regions experiencing what the mainstream media calls the “prescription drug abuse epidemic” may run afoul of Supreme Court dicta on the right to pain relief.  It could well be time for palliative care and pain activists to strategize how to get the Court to revisit its dicta in “Glucksberg,” one of the two 1997 “physician assisted suicide” cases that generated a surprising side effect, a constitutional right to palliative care and pain relief.[1]

At the turn of the twentieth century, two cases challenging state laws in Washington and New York criminalizing physician assisted suicide made…

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Different Pain, Different Neural Circuits

EDS and Chronic Pain News & Info

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. 

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Genetic Switch Involved in Depression

EDS and Chronic Pain News & Info

Genetic Switch Involved in Depression | National Institutes of Health (NIH)–  by Helen Fields – Sept 2012

The activity of a single gene sets in motion some of the brain changes seen in depression, according to a new study. The finding suggests a promising target for potential therapies.

People with major depressive disorder, or major depression, have feelings of sadness, loss, anger or frustration that interfere with daily life for weeks or longer.

The symptoms of depression also include memory loss and trouble thinking.

Well, that certainly explains a lot! 

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Patients Vulnerable to Limits on Opioid Rx

EDS and Chronic Pain News & Info

Limits on Opioid Prescribing Leave Patients With Chronic Pain Vulnerable – from Jama – Rita Rubin, MAApril 29, 2019

Thomas Kline, MD, PhD, refers to 22 of his patients as “pain refugees.”

Stable for years taking opioid therapy for chronic pain, these patients sought out Kline—well-known for his advocacy on their behalf on Twitter and elsewhere—because their physicians had abruptly cut their dose or refused to refill a prescription.

They had appealed to multiple physicians for treatment with no success before contacting him, said Kline.

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Health Officials Reach Out To Pain Patients

Bingo!

EDS and Chronic Pain News & Info

Amid Opioid Prescriber Crackdown, Health Officials Reach Out To Pain Patients – Apr 2019

A pharmacist in Celina, Tenn., was one of 60 people indicted on charges of opioid-related crimes last week, in a multistate sting. John Polston was charged with 21 counts of filling medically unnecessary narcotic prescriptions.

Here’s the first hint that this article is only about people with addiction, while people with pain are forgotten: the article uses the word “narcotics” to describe our prescribed medicines, instead of “pain medication”, “opioids”, or even the all-encompassing “drugs”, which is the term favored by the CDC when counting overdoses.

I’m sure they are well aware that most people will assume they’re referring to opioids, and even more precisely (wrong), “prescription opioids”.

With so many more accurate and representative words to choose from, using the word “narcotics”…

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Raising Alarm on Oregon Force-Tapering Opioids

EDS and Chronic Pain News & Info

Pain and Addiction Leaders Raise Alarm on Oregon Force Tapering Opioid Proposal – by Sean Mackey, MD, PhDMar 2019

On Mar 14th, the Oregon HERC Task Force was going to vote to make a rule for Medicaid requiring all opioids to be tapered to zero except in a few very narrowly defined cases.

At the last minute on the morning of the vote, HERC said they were postponing the vote due to a conflict of interest they had “just learned about”. That’s a pretty flimsy excuse because the membership and the whole process of this group have been driven by conflicts of interest (of the alternative medicine community) and a vast ignorance of medicine, pharmacology, and reality.

The extreme nature of this proposal has reached a level of such preposterous cruelty that protest by medical professionals is now required to preserve some limits on the government’s practice of…

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Brain abnormalities are Consequence Not Cause of pain

EDS and Chronic Pain News & Info

Brain Gray Matter Decrease in Chronic Pain Is the Consequence and Not the Cause of Pain | Journal of NeuroscienceNov 2009

If you can reverse brain “damage” by effectively treating the patient’s chronic pain, it seems pretty clear that the chronic pain was the cause.

This means we don’t have to accept the idea that abnormalities in our brains are what’s causing our pain (which some have hinted at).

Recently, local morphologic alterations of the brain in areas ascribable to the transmission of pain were reported in patients suffering from chronic pain.

Although some authors discussed these findings as damage or loss of brain gray matter, one of the key questions is whether these structural alterations in the cerebral pain-transmitting network precede or succeed the chronicity of pain.  

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