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Opioids and chronic pain

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https://www.readbyqxmd.com/read/28449262/predictive-mechanisms-linking-brain-opioids-to-chronic-pain-vulnerability-and-resilience
#1
REVIEW
Anthony Kenneth Peter Jones, Christopher Andrew Brown
Chronic pain is a major global healthcare problem that is currently inadequately treated. In addition, the current use of opioids for treatment has reached far beyond the paucity of evidence for long-term benefits relative to risks. Benefit-risk models for opioid and non-opioid treatments would benefit from a rational, mechanism-based understanding of neuroplastic and neurochemical contributions to chronic pain. Here we evaluate the findings and limitations of representative research investigating brain neuroplasticity and neurochemistry in chronic pain...
April 27, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28447542/assessing-outcomes-of-educational-videos-in-group-visits-for-patients-with-chronic-pain-at-an-academic-primary-care-clinic
#2
Carrie Vogler, Stacy Sattovia, Laura Y Salazar, Tiffany I Leung, Albert Botchway
OBJECTIVES: This study evaluates the impact of pain education group visits on patients with chronic non-cancer pain (CNCP). The primary outcome of the study was to evaluate patients' functional status and secondary outcomes included knowledge, behavior, and satisfaction, before and after participation in the pain education group visits. METHODS: Locally produced patient educational videos on chronic non-cancer pain were delivered during patient group visits led by a healthcare provider...
April 27, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28446883/in-vitro-and-in-vivo-profile-of-ppl-101-and-ppl-103-mixed-opioid-partial-agonist-analgesics-with-low-abuse-potential
#3
Taline V Khroyan, Andrea Cippitelli, Nicholas Toll, John A Lawson, William Crossman, Willma E Polgar, Lawrence Toll
Opiates are still the most effective and widely used treatments for acute and chronic pain. However, the problems associated with morphine and other standard opioid analgesics severely limit their effectiveness in the clinic. PPL-101 and PPL-103 derived from morphine and morphinan ring systems contain a chiral N-substituent, which confers it with a unique combination of high-binding affinities and partial agonist activities at mu, delta, and kappa opioid receptors, leading to unique in vivo pharmacology compared to other conventional opioids...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28446522/improving-opioid-safety-practices-in-primary-care-protocol-for-the-development-and-evaluation-of-a-multifaceted-theory-informed-pilot-intervention-for-healthcare-providers
#4
Pamela Leece, Daniel Z Buchman, Michael Hamilton, Caitlyn Timmings, Yalnee Shantharam, Julia Moore, Andrea D Furlan
INTRODUCTION: In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. METHODS AND ANALYSIS: Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians...
April 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/28445930/opioids-modulators-of-angiogenesis-in-wound-healing-and-cancer
#5
REVIEW
Martina Ondrovics, Andrea Hoelbl-Kovacic, Daniela Alexandra Fux
Opioids are potent drugs that are widely used to control wound or cancer pain. Increasing evidence suggest that opioids mediate clinically relevant effects that go beyond their classical role as analgesics. Of note, opioids appear to modulate angiogenesis - a process that is critical in wound healing and cancer progression. In this review, we focus on pro- and anti-angiogenic facets of opioids that arise from the activation of individual opioid receptors and the usage of individual concentrations or application routes...
April 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28443503/kratom-and-future-treatment-for-the-opiods-addiction-and-chroic-pain-periculo-beneficium
#6
Ismaliza Ismail, Suzaily Wahab, Hatta Sidi, Srijit Das, Loo Jiann Lin, Rosdinom Razali
Kratom (Mitragynaspeciosa), a natural existing plant found in South-East Asia, is tradi-tionally used as an herb to help to elevate a person's energy and also to treat numerous medical ailments. Other than the analgesic property, kratom has been used as an agent to overcome opioid withdrawal as it contains natural alkaloids, i.e. mitragynine, 7-hydroxymitragynine, and MGM-9, which has agonist affinity on the opioid receptors, including mu (μ) and kappa (κ). The role of neural reward pathway linked to μ-opioid receptors and both dopaminergic and GABA-ergic interneurons that express μ-opioid receptors were deliberated...
April 25, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28442956/a-comparison-between-intravenous-lidocaine-and-ketamine-on-acute-and-chronic-pain-after-open-nephrectomy-a-prospective-double-blind-randomized-placebo-controlled-study
#7
Ali Jendoubi, Imed Ben Naceur, Abderrazak Bouzouita, Mehdi Trifa, Salma Ghedira, Mohamed Chebil, Mohamed Houissa
BACKGROUND: Recently, there has been increasing interest in the use of analgesic adjuncts such as intravenous (IV) ketamine and lidocaine. OBJECTIVES: To compare the effects of perioperative IV lidocaine and ketamine on morphine requirements, pain scores, quality of recovery, and chronic pain after open nephrectomy. STUDY DESIGN: A prospective, randomized, placebo-controlled, double-blind trial. SETTINGS: The study was conducted in Charles Nicolle University Hospital of Tunis...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28441313/clinical-evidence-for-spinal-cord-stimulation-for-failed-back-surgery-syndrome-fbss-systematic-review
#8
Leonardo Kapural, Erika Peterson, David A Provenzano, Peter Staats
STUDY DESIGN: A systematic review OBJECTIVE.: A systematic literature review of the clinical data from prospective studies was undertaken to assess the efficacy of spinal cord stimulation (SCS) in the treatment of FBSS in adults. SUMMARY OF BACKGROUND DATA: For patients with unrelenting back pain due to mechanical instability of the spine, degenerative disc disease, spinal injury, or deformity, spinal surgery is a well-accepted treatment option; however, even after surgical intervention, many patients continue to experience chronic back pain that can be notoriously difficult to treat...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28438822/efficacy-and-safety-of-topical-sevoflurane-in-the-treatment-of-chronic-skin-ulcers
#9
F Dámaso Fernández-Ginés, Manuel Cortiñas-Sáenz, Héctor Mateo-Carrasco, Ana Navajas-Gómez de Aranda, Estrella Navarro-Muñoz, Rocío Rodríguez-Carmona, Carmen Fernández-Sánchez, Francisco Sierra-García, José Antonio Morales-Molina
PURPOSE: Results of efficacy and safety assessments of topical sevoflurane use in patients with long-term treatment-refractory vascular ulcers are reported. METHODS: Patients were randomly assigned to receive sevoflurane instillations (1 mL per cm(2) of ulcer area 1-4 times daily) plus standard wound care (ulcer cleaning, debridement, and dressing changes) or standard care only. Topical sevoflurane was initiated during hospitalization, with self- or nurse-administered instillations continued after discharge...
May 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28436710/ischemic-ulcer-pain-is-both-nociceptive-and-neuropathic-pain-based-on-a-discriminant-function-analysis-using-the-mcgill-pain-questionnaire
#10
Takamichi Kogure, Masahiko Sumitani, Hiroaki Abe, Jun Hozumi, Reo Inoue, Kazuhito Mietani, Kazuo Kawahara, Yoshitsugu Yamada
The McGill Pain Questionnaire (MPQ) is composed of 78 words reflecting the mechanisms underlying chronic pain conditions. Ischemic ulcer pain is generally regarded as a nociceptive and inflammatory pain condition. However, it is sometimes refractory to nonsteroidal anti-inflammatory drug (NSAID) and opioid treatment. We categorized ischemic pain into nociceptive/inflammatory pain (NocP) or neuropathic pain (NeP), on the basis of patients' descriptions of their pain using the MPQ. We investigated pain characteristics of 365 patients with NeP and 124 with NocP using the 78 words of the MPQ...
April 24, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28435316/subanesthetic-ketamine-for-pain-management-in-hospitalized-children-adolescents-and-young-adults-a-single-center-cohort-study
#11
Kathy A Sheehy, Caroline Lippold, Amy L Rice, Raissa Nobrega, Julia C Finkel, Zenaide Mn Quezado
BACKGROUND: Subanesthetic doses of ketamine, an N-methyl-d-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults. PURPOSE: We examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#12
Billy Sin, Diana Gritsenko, Grace Tam, Kimberly Koop, Eva Mok
Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28429337/from-acute-to-chronic-pain-tapentadol-in-the-progressive-stages-of-this-disease-entity
#13
F Coluzzi, D Fornasari, J Pergolizzi, P Romualdi
OBJECTIVE: Chronic pain is now recognized as a neural disease, which results from a maladaptive functional and structural transformation process occurring over time. In its chronic phase, pain is not just a symptom but also a disease entity. Therefore, pain must be properly addressed, as many patients still report unsatisfactory pain control despite on-going treatment. The selection of the therapy - taking into account the pathophysiological mechanisms of pain - and the right timing can result in a successful analgesic outcome...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28426545/sex-differences-in-prescription-opioid-use
#14
Mirsada Serdarevic, Catherine W Striley, Linda B Cottler
PURPOSE OF REVIEW: Recent literature focused on prescription opioids has neglected sex differences in use. Here, we evaluated the recent literature (since 2015) examining sex differences in prescription opioid use. RECENT FINDINGS: Between 2015 and 2016, our review found only eight articles addressing sex differences in prescription opioid use mostly opioid misuse in North America among individuals with chronic pain. Risk factors included depression, pain, and polydrug use...
April 19, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28424989/t-lymphocyte-derived-enkephalins-reduce-th1-th17-colitis-and-associated-pain-in-mice
#15
Lilian Basso, Laure Garnier, Arnaud Bessac, Jérôme Boué, Catherine Blanpied, Nicolas Cenac, Sophie Laffont, Gilles Dietrich
BACKGROUND: Endogenous opioids, including enkephalins, are fundamental regulators of pain. In inflammatory conditions, the local release of opioids by leukocytes at the inflammatory site inhibits nociceptor firing, thereby inducing analgesia. Accordingly, in chronic intestinal Th1/Th17-associated inflammation, enkephalins released by colitogenic CD4(+) T lymphocytes relieve inflammation-induced visceral pain. The present study aims to investigate whether mucosal T-cell-derived enkephalins also exhibit a potent anti-inflammatory activity as described for exogenous opioid drugs in Th1/Th17-associated colitis...
April 19, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28419637/self-reported-prevalence-description-and-management-of-pain-in-adults-with-haemophilia-methods-demographics-and-results-from-the-pain-functional-impairment-and-quality-of-life-p-fiq-study
#16
M Witkop, A Neff, T W Buckner, M Wang, K Batt, C M Kessler, D Quon, L Boggio, M Recht, K Baumann, R Z Gut, D L Cooper, C L Kempton
INTRODUCTION: Haemophilia is characterized by frequent haemarthrosis, leading to acute/chronic joint pain. AIM: To assess self-reported prevalence, description and management of pain in adult males with mild-to-severe haemophilia and history of joint pain/bleeding. METHODS: Participants completed a pain survey and five patient-reported outcome instruments assessing pain, functional impairment and health-related quality of life (HRQoL). RESULTS: Of 381 participants enrolled, median age was 34 years; 77% had haemophilia A, 71% had severe disease and 65% were overweight/obese...
April 16, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28413937/alexithymia-and-depression-in-the-recovery-of-chronic-pain-patients-a-follow-up-study
#17
Anita S Saariaho, Tom H Saariaho, Aino K Mattila, Pasi Ohtonen, Matti I Joukamaa, Max Karukivi
BACKGROUND: Childhood adversities and emotional dysregulation are connected with chronic pain, alexithymia, and depression. Longitudinal studies exploring the impact of their co-occurrence on the pain situation are rare. AIMS: The influence of alexithymia, depression, baseline pain situation, and treatment options on the course of chronic pain in a clinical sample was studied. METHODS: The baseline data was collected from chronic pain patients (n = 154) before their first pain clinic visit, and the follow-up data after 1 year by self-report questionnaires...
May 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28410920/potential-drug-interaction-with-opioid-agonist-in-the-setting-of-chronic-low-dose-opioid-antagonist-use
#18
James B Leonard, Vidya Nair, Christopher J Diaz, Jonathan B Penoyar, Penelope A Goode
Low dose naltrexone (LDN) has been evaluated in several small studies for the treatment of inflammatory conditions. It is thought to work through modulation of inflammatory mediators and upregulation of endogenous opioid receptors. This may hypersensitize patients to exogenous opioids. Drug-drug interaction screening tools built into electronic health records and other services identify the interaction as risk of opioid withdrawal rather than hypersensitivity. We present a case of a drug-drug interaction in a patient who was receiving LDN treatment of multiple sclerosis...
April 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28410599/the-role-of-vitamin-c-in-the-treatment-of-pain-new-insights
#19
REVIEW
Anitra C Carr, Cate McCall
The vitamin C deficiency disease scurvy is characterised by musculoskeletal pain and recent epidemiological evidence has indicated an association between suboptimal vitamin C status and spinal pain. Furthermore, accumulating evidence indicates that vitamin C administration can exhibit analgesic properties in some clinical conditions. The prevalence of hypovitaminosis C and vitamin C deficiency is high in various patient groups, such as surgical/trauma, infectious diseases and cancer patients. A number of recent clinical studies have shown that vitamin C administration to patients with chronic regional pain syndrome decreases their symptoms...
April 14, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28409588/chronic-pain-management-and-opioid-misuse-guidance-for-family-physicians
#20
David T O'Gurek, Robert Rich
No abstract text is available yet for this article.
April 1, 2017: American Family Physician
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