Tramadol: The Opioid Crisis for the Rest of the World - WSJ
GAROUA, Cameroon —Not long ago, a Dutch neurobiologist announced a surprising discovery: A root used by rural West African healers to treat pain contains an apparently natural version of a man-made opioid.The root from northern Cameroon had such high levels of a painkiller called tramadol that mice given an extract and placed on a hot plate didn't feel their feet burning at first.A year later, German rivals came up with a different explanation for the unusual plant. Inexpensive, imported tramadol is so heavily abused in northern Cameroon that it seeps from human and animal waste into the groundwater and soil, whe...
Source: Psychology of Pain - October 20, 2016 Category: Anesthesiology Source Type: blogs

The shocking pain of American men - The Washington Post
Once upon a time, nearly every man in America worked. In 1948, the labor-force participation rate was a staggering 96.7 percent among men in their prime working years.That statistic has been steadily declining ever since. Today, about 11.5 percent of men between the ages of 24-54 are neither employed nor looking for a job. Economists say that these people are"out of the labor force" — and they don't figure into statistics like the unemployment rate.This demographic trend has been the subject of much noise and consternation lately. Nicholas Eberstadt, a demographer at the conservative American Enterprise...
Source: Psychology of Pain - October 13, 2016 Category: Anesthesiology Source Type: blogs

How naked mole rats conquered pain —and what it could mean for us | Science | AAAS
This study points us to important areas … that might be targeted to reduce this type of pain."Naked mole rats are just plain weird. They live almost totally underground in coloniesstructured like honey bee hives, with hundreds of workers servicing a single queen and her few consorts. To survive, they dig kilometers of tunnels in search of large underground tubers for food. It's such a tough life that —to conserve energy—this member of the rodent family gave up regulating its temperature, and they are able to thrive in a low-oxygen, high–carbon dioxide environment that would suffocate or be...
Source: Psychology of Pain - October 12, 2016 Category: Anesthesiology Source Type: blogs

Lancet Global Burden of Disease Highlights Back Pain - The Atlantic
The newest iteration of the Global Burden of Disease study, which tracks the prevalence of deaths and diseases worldwide, contains some good news: On average people are living about a decade longer than they were in 1980. But there's a catch: Health hasn't improved as fast as life expectancy overall, which means that for many, those long, final years are spent hobbled by illness and disability.The nature of our old-age ailments has changed in recent years. The study, published this week in The Lancet and conducted by the Institute for Health Metrics and Evaluation at the University of Washington, uses a metric call...
Source: Psychology of Pain - October 8, 2016 Category: Anesthesiology Source Type: blogs

Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse - National Academy of Sciences
An ad hoc committee will develop a report to inform the U.S. Food and Drug Administration (FDA) as to the state of the science regarding prescription opioid abuse and misuse, including prevention, management, and intervention, and to provide an update from the 2011 Institute of Medicine (IOM) report Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, including a further characterization of the evolving role that opioid analgesics play in pain management. The report additionally will make recommendations on the options available to FDA to address the prescription opioid overdos...
Source: Psychology of Pain - September 19, 2016 Category: Anesthesiology Source Type: blogs

All Pain Is Not Equal - RELIEF: PAIN RESEARCH NEWS, INSIGHTS AND IDEAS
Thirty-one-year-old Less Henderson recently returned from a week-long hospital stay after her lung collapsed due to endometriosis, a reproductive disease in which the lining of the uterus grows in other parts of the body, causing pain. Though endometriosis usually only affects the pelvic area, in rare cases like Henderson's it can spread further, causing serious and potentially fatal complications.While Henderson's collapsed lung was addressed quickly and she is now on the mend, she has not always been as fortunate in the health care she's received. Henderson —who is both black and working class—struggled for y...
Source: Psychology of Pain - September 10, 2016 Category: Anesthesiology Source Type: blogs

National Pain Strategy - NIH
The objectives of the National Pain Strategy aim to decrease the prevalence of pain across its continuum from acute to high-impact chronic pain and its associated morbidity and disability across the lifespan. The intent is to reduce the burden of pain for individuals, their families, and society as a whole.More ...https://iprcc.nih.gov/docs/HHSNational_Pain_Strategy.pdf (Source: Psychology of Pain)
Source: Psychology of Pain - September 3, 2016 Category: Anesthesiology Source Type: blogs

NIH Pain Consortium - Pain Information Brochures
The National Institutes of Health consists of many different institutes and centers. The following is an index to various NIH publications about pain symptoms, conditions and treatments.https://painconsortium.nih.gov/News_Other_Resources/pain_index.html (Source: Psychology of Pain)
Source: Psychology of Pain - September 3, 2016 Category: Anesthesiology Source Type: blogs

The Interagency Pain Research Coordinating Committee (IPRCC)
is a Federal advisory committee created by the Department of Health and Human Services to enhance pain research efforts and promote collaboration across the government, with the ultimate goals of advancing the fundamental understanding of pain and improving pain-related treatment strategies.https://iprcc.nih.gov/index.htm (Source: Psychology of Pain)
Source: Psychology of Pain - September 3, 2016 Category: Anesthesiology Source Type: blogs

About the Pain Special Interest Group | NCCIH
The PAIN Special Interest Group (PAIN SIG) is comprised of investigators from a number of different institutes and centers at the NIH that are interested in the neurobiological mechanisms underlying pain. Our group is moderated by Drs. Yarimar Carrasquillo, Alex Chesler, and Lauren Chesler and includes students, postdocs, postbacs, staff, investigators, and clinicians. Research areas of interest span from molecular and cellular studies in model systems to clinical studies in both healthy individuals and pain patients. Our goal is to provide a forum where researchers from different backgrounds can openly exchange their idea...
Source: Psychology of Pain - September 3, 2016 Category: Anesthesiology Source Type: blogs

Review Examines Clinical Trial Evidence on Complementary Approaches for Five Painful Conditions | NCCIH
A review of evidence from clinical trials shows that a variety of complementary health approaches —including acupuncture, yoga, tai chi, massage therapy, and relaxation techniques—hold promise for helping to manage pain. The review, conducted by the National Center for Complementary and Integrative Health, was published in the journal Mayo Clinic Proceedings.Painful conditions are the most common reasons why American adults use complementary health approaches, on which they spend more than $30 billion yearly. About 40 million American adults experience severe pain in any given year, and they spend mor...
Source: Psychology of Pain - September 3, 2016 Category: Anesthesiology Source Type: blogs

In Search Of An Opioid That Offers Help Without The Risks : Shots - Health News : NPR
Once people realized that opioid drugs could cause addiction and deadly overdoses, they tried to use newer forms of opioids to treat the addiction to its parent. Morphine, about 10 times the strength of opium, was used to curb opium cravings in the early 19th century. Codeine, too, was touted as a nonaddictive drug for pain relief, as was heroin.Those attempts were doomed to failure because all opioid drugs interact with the brain in the same way. They dock to a specific neural receptor, the mu-opioid receptor, which controls the effects of pleasure, pain relief and need.Now scientists are trying to create opioid painkille...
Source: Psychology of Pain - August 20, 2016 Category: Anesthesiology Source Type: blogs

The Connoisseur of Pain - The New York Times
Within minutes of our first meeting, and more or less in response to my saying good morning, Justin Schmidt began lamenting our culture's lack of insect-based rites of passage. He told me about the Sater é-Mawé people in northwestern Brazil, who hold a ceremony in which young men slip their hands into large mitts filled with bullet ants, whose stings are so agonizing they can cause temporary paralysis; when initiates pass the test, they're one step closer to becoming full members of society. Schmidt believes we could learn something from this. By trade, he is an entomologist, an expert on the Hymeno...
Source: Psychology of Pain - August 20, 2016 Category: Anesthesiology Source Type: blogs

NYTimes: Minorities Suffer From Unequal Pain Treatment
Roslyn Lewis was at work at a dollar store here in Tuscaloosa, pushing a heavy cart of dog food, when something popped in her back: an explosion of pain. At the emergency room the next day, doctors gave her Motrin and sent her home.Her employer paid for a nerve block that helped temporarily, numbing her lower back, but she could not afford more injections or physical therapy. A decade later, the pain radiates to her right knee and remains largely unaddressed, so deep and searing that on a recent day she sat stiffly on her couch, her curtains drawn, for hours.The experience of African-Americans, like Ms. Lewis, and other mi...
Source: Psychology of Pain - August 9, 2016 Category: Anesthesiology Source Type: blogs

NYTimes: Naloxone Eases Pain of Heroin Epidemic, but Not Without Consequences
PORTLAND, Me. — A woman in her 30s was sitting in a car in a parking lot here last month, shooting up heroin, when she overdosed. Even after the men she was with injected her with naloxone, the drug that reverses opioid overdoses, she remained unconscious. They called 911. Firefighters arrived and administered oxygen to improve her breathing, but her skin had grown gray and her lips had turned blue. As she lay on the asphalt, the paramedics slipped a needle into her arm and injected another dose of naloxone. In a moment, her eyes popped open. Her pupils were pinpricks. She was woozy and disoriented, but eventually ...
Source: Psychology of Pain - July 27, 2016 Category: Anesthesiology Source Type: blogs

Financial Stress Hurts, Literally - Scientific American
Few things feel worse than not knowing when your next paycheck is coming. Economic insecurity has been shown to have a whole host of negative effects, including low self-esteem and impaired cognitive functioning. It turns out financial stress can also physically hurt, according to a paper published in February in Psychological Science. Eileen Chou, a public policy professor at the University of Virginia, and her collaborators began by analyzing a data set of 33,720 U.S. households and found that those with higher levels of unemployment were more likely to purchase over-the-counter painkillers. Then, using a series of exper...
Source: Psychology of Pain - July 20, 2016 Category: Anesthesiology Source Type: blogs

One striking chart shows why pharma companies are fighting legal marijuana - The Washington Post
There's a body of research showing that painkiller abuse and overdose are lower in states with medical marijuana laws. These studies have generally assumed that when medical marijuana is available, pain patients are increasingly choosing pot over powerful and deadly prescription narcotics. But that's always been just an assumption.Now a new study, released in the journal Health Affairs, validates these findings by providing clear evidence of a missing link in the causal chain running from medical marijuana to falling overdoses. Ashley and W. David Bradford, a daughter-father pair of researchers at ...
Source: Psychology of Pain - July 15, 2016 Category: Anesthesiology Source Type: blogs

Pfizer agrees to truth in opioid marketing - The Washington Post
Pfizer, the world's second- ­largest drug company, has agreed to a written code of conduct for the marketing of opioids that some officials hope will set a standard for manufacturers of narcotics and help curb the use of the addictive painkillers. Though Pfizer does not sell many opioids compared with other industry leaders, its action sets it apart from companies that have been accused of fueling an epidemic of opioid misuse through aggressive marketing of their products. Pfizer has agreed to disclose in its promotional material that narcotic painkillers carry serious risk of addiction — even when used pro...
Source: Psychology of Pain - July 7, 2016 Category: Anesthesiology Source Type: blogs

New Ways to Treat Pain Meet Resistance - The New York Times
A few months ago, Douglas Scott, a property manager in Jacksonville, Fla., was taking large doses of narcotic drugs, or opioids, to deal with the pain of back and spine injuries from two recent car accidents. The pills helped ease his pain, but they also caused him to withdraw from his wife, his two children and social life. "Finally, my wife said, 'You do something about this or we're going to have to make some changes around here,'" said Mr. Scott, 43. Today, Mr. Scott is no longer taking narcotics and feels better. Shortly after his wife's ultimatum, he entered a local clinic where patients ...
Source: Psychology of Pain - June 23, 2016 Category: Anesthesiology Source Type: blogs

Survey shows lots of people save leftover painkillers - Futurity
More than half of patients who get a prescription for opioid painkillers have leftover pills and keep them to use later, a practice that could potentially exacerbate the United States' epidemic of painkiller addiction and overdoses.Researchers reporting in JAMA Internal Medicine also found that nearly half of those surveyed reported receiving no information on how to safely store their medications to keep them from children who could accidentally ingest them or from someone looking to get high.One in five respondents said they had shared their medication with another person, many saying they gave them to someone ...
Source: Psychology of Pain - June 16, 2016 Category: Anesthesiology Source Type: blogs

An E.R. Kicks the Habit of Opioids for Pain - The New York Times
Brenda Pitts sat stiffly in an emergency room cubicle, her face contorted by pain. An old shoulder injury was radiating fresh agony down to her elbow and up through her neck. She couldn't turn her head. Her right arm had fallen slack. Fast relief was a pill away — Percocet, an opioid painkiller — but Dr. Alexis LaPietra did not want to prescribe it. The drug, she explained to Mrs. Pitts, 75, might make her constipated and foggy, and could be addictive. Would Mrs. Pitts be willing to try something different? Then the doctor massaged Mrs. Pitts's neck, seeking the locus of a muscle spasm, apologizing as...
Source: Psychology of Pain - June 12, 2016 Category: Anesthesiology Source Type: blogs

Why taking morphine, oxycodone can sometimes make pain worse | Science | AAAS
There's an unfortunate irony for people who rely on morphine, oxycodone, and other opioid painkillers: The drug that's supposed to offer you relief can actually make you more sensitive to pain over time. That effect, known as hyperalgesia, could render these medications gradually less effective for chronic pain, leading people to rely on higher and higher doses. A new study in rats—the first to look at the interaction between opioids and nerve injury for months after the pain-killing treatment was stopped—paints an especially grim picture. An opioid sets off a chain of immune signals in the spinal cord that amp...
Source: Psychology of Pain - May 31, 2016 Category: Anesthesiology Source Type: blogs

The Itch Lab — The California Sunday Magazine
The rash, which has spread from the crook of my elbow to the base of my wrist, is starting to sprout puffy, crimson welts. It's been three minutes since I rubbed a mound of coarse blond fibers onto my forearm, and what began as a mild prickling sensation has escalated into a throbbing itch. Diana Bautista doesn't seem concerned. "Will scratching make it worse?" I ask. She nods. "Yes, but it will feel really good while you're doing it." This unsanctioned self-experiment is taking place in the kitchenette of Bautista's University of California, Berkeley, lab. The source of my discomfort is...
Source: Psychology of Pain - May 28, 2016 Category: Anesthesiology Source Type: blogs

The Sting of the Tarantula Hawk: Instantaneous, Excruciating Pain - Undark
Stung by a tarantula hawk? The advice I give in speaking engagements is to lie down and scream. The pain is so debilitating and excruciating that the victim is at risk of further injury by tripping in a hole or over an object in the path and then falling onto a cactus or into a barbed-wire fence. Such is the sting pain that almost nobody can maintain normal coordination or cognitive control to prevent accidental injury. Screaming is satisfying and helps reduce attention to the pain of the sting. Few, if any, people would be stung willingly by a tarantula hawk. I know of no examples of such bravery in the name of knowledge,...
Source: Psychology of Pain - May 19, 2016 Category: Anesthesiology Source Type: blogs

Treating Pain Without Feeding Addiction at ‘Ground Zero’ for Opioids - The New York Times
BRIDGEPORT, W.Va. — The doctors wanted to talk about illness, but the patients — often miners, waitresses, tree cutters and others whose jobs were punishingly physical — wanted to talk only about how much they hurt. They kept pleading for opioids like Vicodin and Percocet, the potent drugs that can help chronic pain, but have fueled an epidemic of addiction and deadly overdoses. "We needed to talk about congestive heart failure or diabetes or out-of-control hypertension," said Dr. Sarah Chouinard, the chief medical officer at Community Care of West Virginia, which runs primary care clinics acro...
Source: Psychology of Pain - May 12, 2016 Category: Anesthesiology Source Type: blogs

Research Grants - Migraine Research Foundation
The Migraine Research Foundation (MRF) and the Association of Migraine Disorders (AMD) announce the opening of a joint Request for Proposals for migraine research grants. MRF is committed to discovering the causes, improving the treatments, and finding a cure, and AMD stimulates increased research specifically in the area of migraine disorders. We are looking for projects that will help sufferers by advancing our ability to understand and treat migraine. As a result, we provide seed money grants for transformational projects that will lead to better treatment and quality of life for sufferers of migraine and migraine disor...
Source: Psychology of Pain - May 11, 2016 Category: Anesthesiology Source Type: blogs

What Does Genetics Tell Us About Chronic Pain? - Relief: Pain Research News, Insights And Ideas
When the pain comes, Alina Delp retreats to air conditioning as soon as possible. What begins to feel like a mild sunburn will, if left unattended, turn into a raging, burning pain. "It's this turbulent, violent sensation that feels electric and stinging," Delp says, describing the pain at its worst. "I've run out of the building screaming like a lunatic before because it's been so bad." Delp has erythromelalgia, a rare condition in which a person's body (typically the feet and the hands, though Delp experiences pain all over) reacts to mild warmth as though it is on fire. Mild exertio...
Source: Psychology of Pain - May 10, 2016 Category: Anesthesiology Source Type: blogs

' You want a description of hell?' OxyContin's 12-hour problem - Los Angeles Times
The drugmaker Purdue Pharma launched OxyContin two decades ago with a bold marketing claim: One dose relieves pain for 12 hours, more than twice as long as generic medications. Patients would no longer have to wake up in the middle of the night to take their pills, Purdue told doctors. One OxyContin tablet in the morning and one before bed would provide & quot;smooth and sustained pain control all day and all night. & quot; On the strength of that promise, OxyContin became America & #39;s bestselling painkiller, and Purdue reaped $31 billion in revenue. But OxyContin & #39;s stunning success masked a fun...
Source: Psychology of Pain - May 10, 2016 Category: Anesthesiology Source Type: blogs

'You want a description of hell?' OxyContin's 12-hour problem - Los Angeles Times
The drugmaker Purdue Pharma launched OxyContin two decades ago with a bold marketing claim: One dose relieves pain for 12 hours, more than twice as long as generic medications. Patients would no longer have to wake up in the middle of the night to take their pills, Purdue told doctors. One OxyContin tablet in the morning and one before bed would provide "smooth and sustained pain control all day and all night." On the strength of that promise, OxyContin became America's bestselling painkiller, and Purdue reaped $31 billion in revenue. But OxyContin's stunning success masked a fundamental problem: The d...
Source: Psychology of Pain - May 10, 2016 Category: Anesthesiology Source Type: blogs

Scientists Have Been Using a Flawed Method to Diagnose Pain  - Gizmodo
For many years, neuroscientists believed they had identified a specific pattern of brain activity acting as a kind of & quot;signature & quot; for pain in the brain. Recently this so-called & quot;pain matrix & quot; has been called into question, and a new study by British researchers may have shattered the myth once and for all. The pain matrix is actually a cluster of regions in the brain that prior imaging studies indicated are involved in processing pain perception, including the posterior insula and the anterior cingulate cortex. This has been so broadly accepted that the signature pattern has been u...
Source: Psychology of Pain - May 10, 2016 Category: Anesthesiology Source Type: blogs

Scientists Have Been Using a Flawed Method to Diagnose Pain - Gizmodo
For many years, neuroscientists believed they had identified a specific pattern of brain activity acting as a kind of "signature" for pain in the brain. Recently this so-called "pain matrix" has been called into question, and a new study by British researchers may have shattered the myth once and for all. The pain matrix is actually a cluster of regions in the brain that prior imaging studies indicated are involved in processing pain perception, including the posterior insula and the anterior cingulate cortex. This has been so broadly accepted that the signature pattern has been used to declare that em...
Source: Psychology of Pain - May 10, 2016 Category: Anesthesiology Source Type: blogs

Mind over back pain - Harvard Health Blog
To the surprise of doctors and patients alike, accumulating research suggests that most chronic back pain isn't actually the result of illness or injury. Study after study indicates instead that back pain is very often caused by our thoughts, feelings, and resulting behaviors. And an exciting new study now demonstrates that treatments aimed at our beliefs and attitudes can really help.When our back hurts, it's only natural to assume that we've suffered an injury or have a disease. After all, most pain works this way. When we cut our finger, we see blood and feel pain. When our throat hurts, it's usually because of an infec...
Source: Psychology of Pain - May 4, 2016 Category: Anesthesiology Source Type: blogs

F.D.A. Again Reviews Mandatory Training for Painkiller Prescribers - The New York Times
A pain management specialist, Dr. Nathaniel Katz, was stunned in 2012 when the Food and Drug Administration rejected a recommendation from an expert panel that had urged mandatory training for doctors who prescribed powerful painkillers like OxyContin. That panel had concluded that the training might help stem the epidemic of overdose deaths involving prescription narcotics, or opioids. At first, Dr. Katz, who had been on the panel, thought that drug makers had pressured the F.D.A. to kill the proposal. Then an agency official told him that another group had fought the recommendation: the American Medical Association, the...
Source: Psychology of Pain - May 3, 2016 Category: Anesthesiology Source Type: blogs

Unlike sex and violence, childbirth is rarely depicted in literary fiction - Slate
Are there any taboo subjects left in literature? Graphic violence and sex in any of its endless variations have become mainstream. Even excretion is now explicit: Think of the unforgettable scene of Joey searching for a ring in his own shit in Jonathan Franzen's Freedom. But read almost any novel in which childbirth, one of the most universal of human events, takes place, and you will find that the actual act has been deleted. An author as celebrated for her visceral and detailed accounts of female experience as Elena Ferrante offers the following as a description, in full, of the birth of the narrator's first ch...
Source: Psychology of Pain - May 3, 2016 Category: Anesthesiology Source Type: blogs

Mindfulness Effective for Chronic Low Back Pain in Clinical Trial | Pain Research Forum
Government officials, physicians, and the public are increasingly aware of a need to move away from using opiate drugs to treat chronic pain. More and more, doctors are searching for ways to help patients manage pain with non-pharmacological interventions. In line with this trend, new findings now support the use of mindfulness to treat chronic low back pain. In a clinical trial published March 22 in the Journal of the American Medical Association (JAMA), subjects who underwent mindfulness training for eight weeks were more likely to report improvements in pain, lasting up to a year, compared to people who received whatev...
Source: Psychology of Pain - May 2, 2016 Category: Anesthesiology Source Type: blogs

Botulinum Toxin Guidelines Overhauled | Medpage Today
VANCOUVER -- Guidelines for the use of botulinum toxin in various neurological disorders are getting an update, with the best evidence supporting the use of some formulations in spasticity and chronic migraine, researchers reported here. All three botulinum toxin type A formulations are supported by level A evidence for use in upper limb spasticity, and onabotulinumtoxinA (Botox) received a level A recommendation in chronic migraine, although the magnitude of the benefit is small, according to David Simpson, MD, of Icahn School of Medicine at Mount Sinai in New York, and colleagues. The new guidance, which is the first s...
Source: Psychology of Pain - April 19, 2016 Category: Anesthesiology Source Type: blogs

The Pain Gap: Why Doctors Offer Less Relief to Black Patients - The Daily Beast
A new University of Virginia study suggests that many medical students and residents are racially biased in their pain assessment, and that their attitudes about race and pain correlate with falsely-held beliefs about supposed biological differences—like black people having thicker skin, or less sensitive nerve endings than white people—more generally.The study highlights how a confluence of mistaken attitudes—about race, about biology, and about pain—can flourish in one of the worst possible places: medical schools where the future gatekeepers of relief are trained. And it illuminates wha...
Source: Psychology of Pain - April 11, 2016 Category: Anesthesiology Source Type: blogs

The perils of being manly - The Washington Post
A few years ago, I found myself in the emergency room. I had hurt my ankle playing basketball, and the pain was unbearable. I remember sitting there, waiting for someone to see me, thinking to myself that it must be broken, or fractured, or something similarly severe. "I'm going touch your ankle in a few places," the doctor said shortly after I was brought in. "I want you to describe the pain on a scale from 1 to 10." He pressed down onto various parts of my foot, each one more painful than the last. And yet, the numbers I uttered barely nudged, moving up from 5 to 5.5, and then from 5.5 to 6. I n...
Source: Psychology of Pain - March 29, 2016 Category: Anesthesiology Source Type: blogs

National Pain Strategy - The Interagency Pain Research Coordinating Committee
This report identifies the key steps we can take to improve how we prevent, assess and treat pain in this country."In 2011, in recognition of the public health problem of pain in America, the Institute of Medicine called for a coordinated, national effort of public and private organizations to transform how the nation understands and approaches pain management and prevention. In response, HHS tasked the Interagency Pain Research Coordinating Committee (IPRCC), a group of representatives from  the Department of Defense, Department of Veterans Affairs, Agency for Healthcare Research and Quality, Centers f...
Source: Psychology of Pain - March 23, 2016 Category: Anesthesiology Source Type: blogs

NYTimes: Patients in Pain, and a Doctor Who Must Limit Drugs
Susan Kubicka-Welander, a short-order cook, went to her pain checkup appointment straight from the lunch-rush shift. "We were really busy," she told Dr. Robert L. Wergin, trying to smile through deeply etched lines of exhaustion. "Thursdays, it's Philly cheesesteaks." Her back ached from a compression fracture; a shattered elbow was still mending; her left-hip sciatica was screaming louder than usual. She takes a lot of medication for chronic pain, but today it was just not enough. Yet rather than increasing her dose, Dr. Wergin was tapering her down. "Susan, we've got to get you to five ...
Source: Psychology of Pain - March 17, 2016 Category: Anesthesiology Source Type: blogs

CDC warns doctors about the dangers of prescribing opioid painkillers - The Washington Post
With no end to the nation's opioid crisis in sight, the federal government on Tuesday issued final recommendations that urge doctors to use more caution and consider alternatives before they prescribe highly addictive narcotic painkillers.This first national guidance on the subject is nonbinding, and doctors cannot be punished for failing to comply. But the head of the Centers for Disease Control and Prevention, which issued the guidelines, said the effort was critical to bringing about "a culture shift for patients and doctors.""We are waking up as a society to the fact that these are da...
Source: Psychology of Pain - March 16, 2016 Category: Anesthesiology Source Type: blogs

I ’m a doctor. I worry every time I prescribe painkillers to a patient. - Vox
& quot;Please, I need my Oxycodone! & quot; my patient, M, pleaded with me. My eyes met his. I observed every fleeting facial expression, hoping to gauge his intentions. The discussion about whether to continue to prescribe this medication was one I & #39;d had too many times with too many patients over the past few months. & quot;My arthritis is always worst in the winter, & quot; he said, rubbing his lower back. It was a snowy afternoon in clinic, and M and I were in the midst of a debate. Oxycodone is an opioid medication, and, like other painkillers such as Oxycontin, Percocet, and Vicodin, it ca...
Source: Psychology of Pain - March 16, 2016 Category: Anesthesiology Source Type: blogs

I’m a doctor. I worry every time I prescribe painkillers to a patient. - Vox
"Please, I need my Oxycodone!" my patient, M, pleaded with me. My eyes met his. I observed every fleeting facial expression, hoping to gauge his intentions. The discussion about whether to continue to prescribe this medication was one I'd had too many times with too many patients over the past few months. "My arthritis is always worst in the winter," he said, rubbing his lower back. It was a snowy afternoon in clinic, and M and I were in the midst of a debate. Oxycodone is an opioid medication, and, like other painkillers such as Oxycontin, Percocet, and Vicodin, it carries a significant risk of ...
Source: Psychology of Pain - March 16, 2016 Category: Anesthesiology Source Type: blogs

He couldn’t eat, drink or work. And doctors couldn’t explain his searing pain. - The Washington Post
Kim Pace was afraid he was dying. In six months he had lost more than 30 pounds because a terrible stabbing sensation on the left side of his face made eating or drinking too painful. Brushing his teeth was out of the question and even the slightest touch triggered waves of agony and a shocklike pain he imagined was comparable to electrocution. Painkillers, even morphine, brought little relief. Unable to work and on medical leave from his job as a financial consultant for a bank, Pace, then 59, had spent the first half of 2012 bouncing among specialists in his home state of Pennsylvania, searching for help from doctors w...
Source: Psychology of Pain - March 16, 2016 Category: Anesthesiology Source Type: blogs

'Dry eye' linked to chronic pain syndromes - Medical Xpress
Physician-researchers with Bascom Palmer Eye Institute, part of UHealth—the University of Miami Health System, have found a link between "dry eye" and chronic pain syndromes—a finding that suggests that a new paradigm is needed for diagnosis and treatment to improve patient outcomes. "Our study indicates that some patients with dry eye have corneal somatosensory pathway dysfunction and would be better described as having neuropathic ocular pain," said Anat Galor, M.D., M.S.P.H., a cornea and uveitis specialist and associate professor of clinical ophthalmology at Bascom Palmer Eye Institute ...
Source: Psychology of Pain - February 27, 2016 Category: Anesthesiology Source Type: blogs

The Problem With Treating Pain in America | TIME
Chronic pain affects an estimated 100 million Americans, and between 5 to 8 million use opioids for long-term pain management. Data shows the number of prescriptions written for opioids as well opioid overdose deaths have skyrocketed in recent years, highlighting a growing addiction problem in the U.S. In response, the National Institutes of Health (NIH) released a report on Monday citing major gaps in the way American clinicians are treating pain. In September, the NIH held a workshop to review chronic pain treatment with a panel of seven experts and more than 20 speakers. The NIH also reviewed relevant research on how ...
Source: Psychology of Pain - January 18, 2015 Category: Psychiatrists and Psychologists Source Type: blogs

Panel cites need for individualized, patient-centered approach to treat and monitor chronic pain - NIH
An independent panel convened by the National Institutes of Health concluded that individualized, patient-centered care is needed to treat and monitor the estimated 100 million Americans living with chronic pain. To achieve this aim, the panel recommends more research and development around the evidence-based, multidisciplinary approaches needed to balance patient perspectives, desired outcomes, and safety."Persons living with chronic pain have often been grouped into a single category, and treatment approaches have been generalized with little evidence to support this practice," said Dr. David B. Reuben, panel c...
Source: Psychology of Pain - January 17, 2015 Category: Psychiatrists and Psychologists Source Type: blogs

A Meditation on Pain | Longreads Blog
It's happening, says the woman I love to someone in the other room. The someone is most likely her sister, and I hear the shuffle of clogs on the ruined carpet, the swish and swirl of her turquoise dress. I feel the shadow of her body in the doorway. I hear her breathing, tiny bursts of air through the nose and mouth. I feel and hear everything, but I am not a body. And because I am no longer a body, I do not register sound or voice. I do not register anything. Even my presence on the scratchy carpet. I do not know that I have been lying in the lap of the woman I love as she soothes my sweat-drenched hair, as she whispers ...
Source: Psychology of Pain - January 17, 2015 Category: Psychiatrists and Psychologists Source Type: blogs

Chronic Pain Associated with Activation of Brain's Glial Cells - Scientific American
Patients with chronic pain show signs of glial activation in brain centers that modulate pain, according to results from a PET-MRI study. "Glia appears to be involved in the pathophysiology of chronic pain, and therefore we should consider developing therapeutic approaches targeting glia," Dr. Marco L. Loggia from Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, told Reuters Health by email. "Glial activation is accompanied by many cellular responses, which include the production and release of substances (such as so-called 'pro-inflammatory cytokines') that can s...
Source: Psychology of Pain - January 16, 2015 Category: Psychiatrists and Psychologists Source Type: blogs

Brain signature of emotion-linked pain is uncovered - health - 14 January 2015 - New Scientist
You're not imagining the pain. But your brain might be behind it, nonetheless. For the first time, it is possible to distinguish between brain activity associated with pain from a physical cause, such as an injury, and that associated with pain linked to your state of mind. A fifth of the world's population is thought to experience some kind of chronic pain – that which has lasted longer than three months. If the pain has no clear cause, people can find themselves fobbed off by doctors who they feel don't believe them, or given ineffective or addictive painkillers. But a study led by Tor Wager at the Un...
Source: Psychology of Pain - January 16, 2015 Category: Psychiatrists and Psychologists Source Type: blogs