Information on chronic pain and addicton

Christopher Frandrup, M.D., DABPM, FIPP

Month: May 2016 (Page 1 of 2)

Poor sleep can worsen your mood and pain.

I have always promoted a good nights sleep for my patients to promote healing and pain relief.  Now there is an addition reason to avoid sleep deprivation.  It turns out a bad night can make you crabby.  Two recent studies in the Journal of Psychosomatic Research assessed a group of college students on emotional responses to positive and negative images.  The students were divided into two groups and were asked to completed a simulated work-shift.  One group had five hours sleep beforehand and the other group was kept awake for 24 hours.  Both groups showed diminished emotional response to positive imagery.  As the night wore on the response be even less.  Basically, they were less and less likely to be uplifted by positive images.   “The human brain is naturally more attentive to negative events,” says June J. Pilcher, study co-author and psychologist at Clemson University.  This gives us a tendency to over react to minor negative events, such as a traffic jam, especially when we are overly tired.

Do I need a new MRI?

I am often asked this question by my patients whenever they have a change in their pain condition. An MRI is an invaluable tool for clinicians but it is unfortuneately overused by many practitioners.  New onset spinal pain associated with weakness or incontinence certainly may need re-imaging, but for most cases of back and neck pain a repeat MRI may actually be harmful.

How could it be harmful?  I thought it just used high powered magnets and was completely safe.  The harm is not in obtaining the image, it is what else might be found on the image.  Often, new “problems” are found which lead to more workups and procedures, any of which could possibly harm you.  A vast majority of these new problems are benign (harmless) and are considered incidental findings.  So next time when your doctor says you don’t actually need a repeat scan, you will know the rationale behind their thinking.

Prince’s death triggered the FDA to mandate physician training.

Even though Prince will be only one of over 100,000 to die this year from prescription drug abuse this year he has brought public attention to the opioid epidemic facing America.  Additional physician training requirements have been proposed in the past by the FDA but were essentially made voluntary at the behest of the pharmaceutical companies.  However, the new FDA commissioner stated in a speech earlier this year he specifically addressed the opioid problem and the role of the FDA in combating the epidemic.  He also spoke at length about opioid specific physician education programs developed through the Risk Evaluation Mitigation Strategies (REMS) programs promoted by the FDA.  So far, 100,000 physicians have “voluntarily” participated in these programs.  Many of which were required by the states licensing them.  I too have completed some of these programs and I can attest to their length.  Sure enough, shortly after it was revealed Prince died of an opioid overdose, an FDA panel recommended mandatory REMS training for all physicians with DEA registrations.

DEA COLLECTS RECORD-SETTING AMOUNT OF MEDS AT LATEST NATIONAL R/X TAKE-BACK DAY

 

  FOR IMMEDIATE RELEASE

 Contact: DEA Public Affairs

Press Release

DEA COLLECTS RECORD-SETTING AMOUNT OF MEDS AT 

LATEST NATIONAL R/X TAKE-BACK DAY 

WASHINGTON, D.C. – Americans turned in more unused prescription drugs at the most recent DEA National Prescription Drug Take-Back Day than on any of the previous ten events since it began in 2010, demonstrating their understanding of the value of this service. 

 

Last weekend the DEA and over 4,200 of its state, local, and tribal law enforcement partners collected 893,498 pounds of unwanted medicines—about 447 tons—at almost 5,400 sites spread through all 50 states, beating its previous high of 390 tons in the spring of 2014 by 57 tons, or more than 114,000 pounds.  The top five states with the largest collections, in order, were Texas (almost 40 tons); California (32 tons); Wisconsin (31 tons); Illinois (24 tons); and Massachusetts (24 tons). 

 

The majority of prescription drug abusers report in surveys that they get their drugs from friends and family.  Americans understand that cleaning out old prescription drugs from medicine cabinets, kitchen drawers, and bedside tables reduces accidents, thefts, and the misuse and abuse of these medicines, including the opioid painkillers that accounted for 20,808 drug overdoses—78 a day—in 2014 (the most recent statistics from the Centers for Disease Control and Prevention).  Eight out of 10 new heroin users began by abusing prescription painkillers and moved to heroin when they could no longer obtain or afford those painkillers.

 

“These results show that more Americans than ever are taking the important step of cleaning out their medicine cabinets and making homes safe from potential prescription drug abuse or theft,” said DEA Acting Administrator Chuck Rosenberg.  “Unwanted, expired or unused prescription medications are often an unintended catalyst for addiction.  Take-Back events like these raise awareness of the opioid epidemic and offer the public a safe and anonymous way to help prevent substance abuse.”

Prince overdosed on Percocet

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As a Minnesota native I was devastated to learn of Prince’s death.  It turns out he suffered from a percocet addiction.  His addiction started innocently as a prescription from his doctor to treat his chronic hip pain.  In fact, he was scheduled to see an addictionologist the day he was discovered dead.

America is in the midst of an opioid epidemic.  According to the CDC, 40 Americans die every day from prescription opioid overdoses.  The number of opioids prescribed in this country has quadrupled in the past decade.   This problem is now out of control with both doctors and patients to blame.  Years ago, the Joint Commision made pain the “fifth vital sign” and many physicians blame them for starting the epidemic.  However, it is much more complicated.  Many factors including marketing by pharmaceutical companies, increased access to care, patient empowerment, and legal issues have contributed to the increased use of opioids in this country.  I used to prescribe large amounts of opioids a decade ago and personally contributed to this problem.  Although thousands have already died, we can still save thousands by reducing the number of opioid prescriptions and treating patient on opioids and those addicted to pain killers.

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