Chronic Opioid Pretreatment Potentiates the Sensitization of Fear Learning by Trauma

Despite the large comorbidity between PTSD and opioid use disorders, as well as the common treatment of physical injuries resulting from trauma with opioids, the ability of opioid treatments to subsequently modify PTSD-related behavior has not been well studied.  

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Frequency of Cannabis and Illicit Opioid Use Among People Who Use Drugs and Report Chronic Pain: A Longitudinal Analysis

Ecological research suggests that increased access to cannabis may facilitate reductions in opioid use and harms, and medical cannabis patients describe the substitution of opioids with cannabis for pain management. Howe...
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Trends in Gabapentin and Baclofen Exposures Reported to U.S. Poison Centers

Prescriptions for nonopioid pharmacological therapies such as gabapentin and baclofen have been increasing. While gabapentin and baclofen are less likely than opioids to result in fatal overdose, they are each associated with dependence, misuse and adverse effects.

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A New Link Between Migraines, Opioid Overuse May Be Key to Treating Pain

Researchers at the University of Illinois at Chicago and colleagues discovered that a peptide — small chains of amino acids that can regulate many behaviors and brain signaling pathways — links together migraine pain and...
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Fighting Opioids with an Unlikely Supplemental Painkiller: Anti-Itch Medicine

  A West Virginia University researcher is investigating whether an anti-itch medication that targets a specific part of our nerve cells can make morphine—which targets a different part—more effective.

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DEA Announces Additional Regulatory Steps to Address Opioid Epidemic

The Drug Enforcement Administration announced proposed regulations to improve DEA's ability to oversee the production of dangerous drugs at the height of the national opioid crisis. This proposed regulation would further...
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Innovative Addiction Treatments Hold Promise for Stemming the Opioid Crisis

In a report published in Psychological Science in the Public Interest , scientists in health behavior, neuroscience, pain management, and addiction describe advances in brain science that can explain an individual's vuln...
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Anxiety Among Patient Factors Linked to More Opioid Use After Surgery

New research from Michigan Medicine could help clinicians identify which patients are more likely to continue to use opioids after surgery recovery.

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Trump Administration Announces $1.8 Billion in Funding to States to Continue Combating Opioid Crisis

The U.S. Department of Health and Human Services (HHS) announced more than $1.8 billion in funding to states to continue the Trump administration's efforts to combat the opioid crisis by expanding access to treatment and supporting near real-time data on the drug overdose crisis.

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Mortality After Discontinuation of Primary Care–Based Chronic Opioid Therapy for Pain: A Retrospective Cohort Study

 Despite known risks of using chronic opioid therapy (COT) for pain, the risks of discontinuation of COT are largely uncharacterized. The objective of this study was to evaluate mortality, prescription opioid use, and primary care utilization of patients discontinued from COT, compared with patients maintained on opioids.

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6 Key Steps that States Should Take Now to End the Opioid Epidemic

The AMA has released a national policy road map based on in-depth analysis of the response to the opioid epidemic by four states: Colorado, Mississippi, North Carolina and Pennsylvania. The report , " National Roadmap on...
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Mixing Marijuana with Opioids May Not Be Good for Mental Health

AAPM Secretary W. Michael Hooten, MD comments on a new study on opioid and cannabis co-use, pointing out that the study shows us "that individuals with chronic pain who use opioids and cannabis concurrently are more likely to have mental health problems and other substance use issues, and that is very important." Dr. Hooten was not an author in the study.

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How To Teach Future Doctors About Pain in the Midst of the Opioid Crisis

AAPM member Beth B. Hogans, MD PhD comments in this NPR interview about the four-day course she helped create at Johns Hopkins for medical students about pain and pain management at the start of their medical education. 

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New Route to Designing Safer Pain Medications Discovered

A team at Scripps Research in Florida has discovered a biological system that manages cells' response to opioid drug exposure. The unexpected discovery offers new ideas for improving the safety of the one of the most eff...
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Oregon Panel Drops Effort to Cut Opioids and Cover Chronic Pain

An Oregon committee has abandoned a controversial proposal that would have expanded treatment options for chronic pain patients under the Oregon Health Plan, but would have forced many to reduce dosages or discontinue prescription opioids. 

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FDA Announces Public Meeting to Discuss Safety and Utility of Higher-Dose Opioid Analgesics

FDA is seeking public input on the clinical utility and safety concerns associated with the higher range of opioid analgesic dosing (both in terms of higher strength products and higher daily doses) in the outpatient set...
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AAPM Foundation Convenes Opioid Reduction Consensus Panel

Pain management experts and patient advocates met this past week to begin developing clear evidence-informed guidance for healthcare clinicians on the reduction or elimination of opioids, when appropriate, for ...
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FDA Identifies Harm Reported From Sudden Discontinuation of Opioid Pain Medicines

The U.S. Food and Drug Administration (FDA) has received reports of serious harm in patients who are physically dependent on opioid pain medicines suddenly having these medicines discontinued or the dose rapidly decreased. These include serious withdrawal symptoms, uncontrolled pain, psychological distress, and suicide. 

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2019 AAPM Meeting Highlights from Medscape

Read articles about the latest pain research present at AAPM35 in Denver, March 6-10, 2019.

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Trends and Patterns of Geographic Variation in Opioid Prescribing Practices by State, United States, 2006-2017

Importance : Risk of opioid use disorder, overdose, and death from prescription opioids increases as dosage, duration, and use of extended-release and long-acting formulations increase. States are well suited to respond ...
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Opiates Prescribing for Knee Arthroscopies and ACL Reconstruction (NCT03876743)

The purpose of the study is to determine if opiates are required to achieve adequate analgesia after knee arthroscopy and ACL reconstruction in outpatient surgery.  The investigators hypothesize that patients are fr...
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Managing Twin Crises in Chronic Pain and Prescription Opioids

AAPM Past President Sean Mackey, MD PhD, co-authored a BMJ editorial on how the national pain strategies are part of the solution in managing this twin crises. 

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Assessment of the FDA Risk Evaluation and Mitigation Strategy for Transmucosal Immediate-Release Fentanyl Products

 Did the US Food and Drug Administration's (FDA's) Transmucosal Immediate-Release Fentanyl (TIRF) Risk Evaluation and Mitigation Strategy (REMS) meet its goal of preventing inappropriate use of TIRF products, such a...
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Opioid Use in the Family May Influence Adolescents’ Opioid Risk after Surgery

The presence of one or more family members using long-term opioids before a procedure was associated with a higher likelihood that adolescents prescribed opioids for the first time would do the same, according to the fin...
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Statement from FDA Commissioner Scott Gottlieb, MD, on the Agency’s 2019 Policy and Regulatory Agenda for Continued Action to Forcefully Address the Tragic Epidemic of Opioid Abuse

"The opioid crisis is one of the largest and most complex public health tragedies that our nation has ever faced. It remains the biggest public health crisis facing the FDA. The toll of addiction, in lost lives and broke...
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U.S. Opioid Deaths Jump Fourfold in 20 Years; Epidemic Shifts to Eastern States

The opioid epidemic is no longer concentrated among whites in Appalachian and Midwestern states, according to a new study from Stanford, Harvard and the University of Toronto.

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Peer-Support, Healing Hands Offers New Options to Patients with Chronic Pain on Prescription Opioids

A program providing group support, acupuncture, mindfulness, massage and gentle exercise may offer safe, extra relief to patients on prescription opioids, according to a study led by researchers at UC San Francisco. Full...
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Interdisciplinary Pain Management Approach May Reduce Opioid and Benzodiazepine Use in Chronic Pain Patients

A four-week interdisciplinary pain management program for worker's compensation patients with chronic pain significantly reduced their opioid and benzodiazepine use, according to a new study.

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HEAL Initiative: Coordinating Center to Support NIDA Preventing Opioid Use Disorder in Older Adolescents and Young Adults (Ages 16–30) Initiative

As part of the NIH Helping to End Addictions Long-term (HEAL) initiative to speed development and implementation of scientific solutions to the national public health opioid crisis, NIDA is seeking cooperative agreement ...
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Smokers Are At High Risk for Low Back Pain, Hospitalization, and Opioid Use

Smokers are at high risk for low back pain, and also have higher rates of healthcare utilization and opioid use, and physicians should ask these patients about other comorbidities that may make their pain treatment more ...
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Two Decades of Data Reveal Overall Increase in Pain, Opioid Use Among U.S. Adults

Recent NIH study provides new insights concerning pain trends and opioid use for pain management.

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AAPM Represented at Senate HELP Committee Hearing

AAPM Opioid Advisory Committee member Halena Gazelka, MD, testified as a witness at a February 12 U.S. Senate hearing on Pain Management in the Opioid Crisis before the HELP Committee. View video of the hearing and Dr. G...
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Opioid Policy: The Devil and the Deep Blue Sea

AAPM Member and MedPage Today Pain Points blog contributor Heath McAnally, MD MSPH, comments on his decision to sign on to a letter published in Pain Medicine decrying forced opioid tapering.

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Use of Prescription Opioids and Initiation of Fatal 2-Vehicle Crashes

The prevalence of prescription opioids detected in fatally injured drivers has increased markedly in the past 2 decades in the United States. It is unclear whether driver use of prescription opioids plays a role in fatal...
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Prevention of Prescription Opioid Misuse and Projected Overdose Deaths in the United States

What is the projected effect of lowering incident nonmedical prescription opioid use on the future trajectory of the opioid overdose crisis in the United States?

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Randomized Study of Electronic Health Record Defaults and Comparison Feedback to Effectively Decrease Opioid Prescription Pill Burden (NCT03825549)

In this study, the investigators will evaluate the effect of a health system initiative aiming to change clinician opioid prescribing behaviors using two behavioral economic interventions - default options and social com...
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Penn’s ‘Enhanced Recovery’ Protocol Reduces Opioid Use in Spinal Surgery Patients

A new study published in the Journal of Neurosurgery: Spine showed that when an ERAS protocol was employed—which optimizes patients' surgical care before, during, and after surgery, including patient education, post-oper...
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Training the Prescriber: An Institutional Effort to Reduce the Amount of Opioids Prescribed Following Lumbar Surgery

A new study shows that an educational program on opiate use and misuse, the role of the orthopedic prescriber, multimodal analgesia, and state laws regarding opioid prescription could change prescriber behavior and resul...
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Parents Worried About Risks, But Still Think Opioids Are Best for Kids’ Pain Relief, Nationwide Survey Shows

A new survey shows that parents remain conflicted about opioids: while more than half express concern their child may be at risk for opioid addiction, nearly two-thirds believe opioids are more effective at managing thei...
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Chronic Pain Patients: The Baby with the Bathwater?

AAPM longtime member David Nagel, MD , spoke to the New Hampshire Medical Society about unintended consequence of the battle against the opioid epidemic, and the negative impact on chronic pain patients. Full story .

Association of Pharmaceutical Industry Marketing of Opioid Products with Mortality From Opioid-Related Overdoses

This study identifies the association between direct-to-physician marketing of opioid products by pharmaceutical companies and mortality from prescription opioid overdoses across US counties. Read the abstract . 
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Phosphorylation-Deficient G-Protein-Biased μ-Opioid Receptors Improve Analgesia and Diminish Tolerance but Worsen Opioid Side Effects

Findings identify carboxyl-terminal multisite phosphorylation as key step that drives acute μ-opioid receptor desensitization and long-term tolerance. Read the abstract . 
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Statement from FDA Commissioner Scott Gottlieb, MD, on Unprecedented New Efforts to Support Development of Over-the-Counter Naloxone to Help Reduce Opioid Overdose Deaths

To encourage drug companies to enter the OTC market and increase access to naloxone, the FDA took an unprecedented step of developing a model Drug Facts label (DFL) with easy-to-understand pictograms on how to use the dr...
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Rapidly Taking Patients off Opioids Might Not Be a Good Idea, Experts Say

Forcing patients off opioid painkillers could sometimes do more harm than good, international medical experts warn in an open letter published in Pain Medicine to health authorities. Full story . Read the letter .
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NCATS Announces HEAL Design Challenges to Inspire Innovative Opioid Crisis Solutions

  The National Center for Advancing Translational Sciences (NCATS) at the National Institutes of Health (NIH) invites innovators to submit novel design solutions for its ASPIRE (A Specialized Platform for Innovative...
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Randomized Trial of Telephonic Pain Self-Management to Promote Opioid Tapering (NCT03743402)

In the Pain Self-Management Training for Opioid Taper (PSMOT) study, the effectiveness of a multicomponent intervention will be tested, compared with usual care, on opioid dose and pain outcomes among patients on high do...
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Pain Abstracts

Association of Opioid Prescribing with Opioid Consumption after Surgery in Michigan. Read the abstract . Knee Pain as a Predictor of Structural Progression Over 4 Years: Data from the Osteoarthritis Initiative, a Prospec...
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West Virginia University First Site to Launch Clinical Trial Utilizing Non-Opioid Micropellet Implant for Chronic Pain

As part of an ongoing commitment to battle opioid addiction, the Rockefeller Neuroscience Institute at West Virginia University marked a major milestone, enrolling the first patient in a randomized clinical trial that wi...
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Pain Medicine Physician Perspective Represented in AMA House of Delegates

Pain medicine was represented at the recent American Medical Association House of Delegates Interim meeting by delegate Robert Wailes, MD , and alternate delegate Donna Bloodworth, MD . Among topics discussed, delegates ...
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The National Science and Technology Council (NSTC) Seeks Public Comment

The NSTC is seeking public comment on the Draft Report of the Fast Track Action Committee (FTAC) on Health Science and Technology Response to the Opioid Crisis. Comments are requested by December 5. Full story .
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