Tag Archives: chronic pain

Study Indicates Opioids Worsen Pain Over Time

pain pillsA new study conducted by researchers at the University of Colorado, shows that prescription painkillers do very little in terms of helping with chronic or acute pain. Instead, the temporary masking of the pain that they do provide can actually lengthen or worsen the problem. This breakthrough comes at a very important time for the United States, a country that reportedly consumes 80% of all painkillers in the world.

Researchers administered painkillers to rats and found that after only five days on the medication, the rats suffered from chronic pain that lasted months. Researchers noted that the pain signals were coming from the spinal cord. Normally, the glial cells in the spinal cord are responsible for clearing out infection-causing microorganisms. However, when pain medication is administered, the cells are put on high alert and increase their activity, causing a buildup of glial cells in the spinal cord. This buildup stimulates the nerves and chronic pain is experienced for longer periods of time.

“We are showing for the first time that even a brief exposure to opioids can have long-term negative effects on pain. We found the treatment was contributing to the problem,” explained Peter Grace, researcher and faculty member in the Department of Psychology and Neuroscience at the University of Colorado-Boulder.

In order to take the research further, the study would need to be conducted on humans. However, researchers are excited about the progress. And for many, the findings answer the question of why people are reliant on prescription painkillers for so long. Understanding that painkillers are not only just temporarily covering up the problem, but also making it worse, explains why patients have to take such high doses for extended amounts of time to feel relief. Many are also convinced that they will continue to have pain if they stop taking the drugs, whether their original condition is still present or not.

This breakthrough study is likely to lead to further research into the effectiveness of opiate painkillers. The ineffectiveness, paired with the high rate of addiction may finally convince the medical community to stop blanket opiate prescriptions for pain, and instead seek more non-narcotic solutions and treatments.

Doctors Focus on Reducing Painkiller Use in Chronic Pain Patients

chronic painA recent study of patients taking prescription narcotics for chronic pain conditions focused on reducing the amount of drugs they were using. The research team, headed by Dr. Beth Darnall, was able to successfully cut down the amount of medication being taken without increasing the intensity of their pain.

Dr. Darnall is a Clinical Associate Professor in the Division of Pain Medicine at Stanford University. She is the author of the book Less Pain, Fewer Pills and is focused on the psychology of pain. Her work is important not just for the help of individual patients to reduce their symptoms, but it can also hold the key to helping to eliminate some of the opioid dependency in our country that starts with chronic pain.

Typically, patients believe that if they take less medication that they will experience more pain, but this research has thus far shown positive results. “A lot of people falsely assume that if you taper off opioids your pain will spike, your depression and anxiety will increase and you will fall apart,” said Dr. Darnall. “They think opioids are holding them together. Our data suggests otherwise.”

The psychology of pain shows that people have different reactions to their pain and can help control their symptoms based o their mindset. Dr. Darnall works with patients to “harness the power of their mind-body connection to reduce suffering, pain and need for medications.”

With overdose deaths reaching new heights around the country, there has been considerable focus of late on reducing the influence and damage that opioids can cause. The CDC recently issued new prescribing recommendations, which included finding non-opioid treatments for mild to moderate chronic pain.

Helping to cut the overall number of pain pills being taken can have a dramatic effect on improving the quality of life for potentially millions of people as well as help save thousands more from addiction.

U.S. Pledges More Than $20 Million to Study Ways to Ease Soldiers’ Pain

The United States Government recently announced that it will launch research efforts focused on finding alternative ways for members of the military to manage their chronic pain. Thirteen projects will explore alternative therapy options for pain-related conditions as well as post-traumatic stress disorder, drug abuse and sleep problems, to hopefully lessen the use of narcotic painkillers.

In a government news release, Dr. Josephine Briggs, Director of the United States National Center for Complementary and Alternative Medicine, said that pain is the most common reason for Americans to turn to complementary and integrative health practices. She added, “We believe this research will provide much-needed information that will help our military and their family members, and ultimately anyone suffering from chronic pain and related conditions.”

The 13 research projects will be conducted at the Veterans Affairs medical centers and academic institutions across the country, and will cost close to $22 million over the next five years.

Nearly 100 million adult Americans have chronic pain, and the problem disproportionately affects members of our military, both current and former, according to a 2011 Institute of Medicine study. In the June issue of the journal JAMA Internal Medicine, a report said the rate of chronic pain is 44 percent among members of the U.S. military after combat deployment, compared with just 26 percent in the general population. The report said the rate of use of powerful and potentially addictive narcotic painkillers is 15 percent among U.S. military members after deployment, compared with only 4 percent in the general population.

National Institute on Drug Abuse Director Dr. Nora Volkow said prescription opioids are a key tool in managing pain, but doctors prescribing the narcotics more and the increased availability of the drugs may be contributing to the growing misuse of the drugs. “This body of research will add to the growing arsenal of pain management options to give relief while minimizing the potential for abuse, especially for those bravely serving our nation in the armed forces,” Volkow said.

Prescription Narcotics Shown to be Ineffective for Long-Term Pain Relief

Painkillers were originally manufactured and prescribed to handle chronic pain. For patients who did not have illnesses such as cancer but did have chronic back pain or other joint pain, patients with muscle pain or chronic headaches, painkillers were often prescribed to address this pain and allow them to live a normal life. However, painkillers do not do a good job of addressing the pain on an extended period of time, as many patients report increased sensitivity to pain and a need for more of the drugs.

So if painkillers really do not work why are they being prescribed? For some, doctors are just not informed about the risks associated with taking painkillers. Many doctors consider that addiction is a rare side effect, nothing to take too seriously because it is so unlikely to happen. However, this is just simply not true. More and more people are becoming dependent on and addicted to narcotic painkillers after being prescribed the medication from their doctor. There are studies that indicate that over half of the patients who take prescription painkillers for more than three months are still taking the pills five years later. This shows that long-term use means the patient will likely become addicted.

Another reason why prescription narcotics are being given out so much is because patients request them. When a person visits a doctor for a chronic pain problem they often assume they are going to leave the office with a prescription for an opioid like oxycodone or hydrocodone. Doctors often do not want to disappoint them and fulfill the patients requests for some form of immediate relief, which can be understandable. The point isn’t to blame doctors, but just to show there are multiple contributing factors to the problem.

In order to avoid further addictions to painkillers, doctors need to familiarize themselves with the potential for addiction. Other alternatives to chronic pain treatment should be considered either before or along with the prescribing of drugs that have a high potential for abuse. Many people find success in handling their chronic pain by consulting with a physical therapist, exercising more and changing their diet, among several other avenues. These healthier alternatives allow the person to live a life free from addiction while still being able to manage their pain.

Treating Chronic Pain and Addiction Among Veterans

housevaA recent article from the American Psychiatric Association (APA) urges better cooperation between states and Veterans Affairs (VA) health centers regarding prescription drug monitoring among Veterans, especially for opioids and benzodiazepines. It cites the necessity to ensure quality treatment and alleviation of pain while being more aware of addiction problems for the purpose of prevention and rehabilitation.

Last Fall, a statement was provided to the House Veterans Affairs’ Subcommittee on Health hearing, “Between Peril and Promise: Facing the Dangers of VA’s Skyrocketing Use of Prescription Painkiller’s to Treat Veterans” by APA CEO and Medical Director Saul Levin, M.D., M.P.A. Dr. Levin recommended more specialty training for physicians within the VA system for the diagnosis and treatment of co-occurring disorders as well as opioid addiction.

The APA produced a series of webinars focused on the use of treatments for opioid dependence and on the safe use of opioids in the treatment of chronic pain. The free webinars were available for psychiatrists, physicians of other specialties, other prescribers, residents, and other interested clinicians. Example webinar topics included:

– The Use of Buprenorphine to Treat Co-occurring Pain and Opioid Dependence in a Primary Care Setting

– Learning the Evidence Behind Alternative/Complementary Chronic Pain Management – Emphasis on Chronic Low Back Pain

– Patterns of Opioid Use, Misuse, and Abuse in the Military, VA, and US Population

– Enhancing Access to PDMPs [Prescription Drug Monitoring Programs] Through Health Information Technology

– Identifying and Intervening With Problematic Medication Use Behaviors

– Assessing and Screening for Addiction in Chronic Pain Patients

– Psychological Management and Pharmacotherapy of Patients with Chronic Pain and Depression, Schizophrenia, and Post Traumatic Stress Disorder (PTSD)

The number of Veterans dealing with anxiety, PTSD, depression or any other disorder in conjunction with substance abuse is higher than ever. A large portion of the addiction problems are connected to prescription drugs, especially for those who are also combating chronic pain symptoms. A greater awareness and higher level of education and training on how to deal with the multi-layered problems will help to ensure better outcomes for the health of our Veterans.