A study of people who die from opioid overdoses found just over 60 percent suffer from chronic pain, HealthDay reports. Many also struggle with anxiety or depression, the researchers report in the American Journal of Psychiatry. The study included medical records of more than 13,000 adults who died from an opioid overdose between 2001 and 2007. “The frequent occurrence of treated chronic pain and mental health conditions among overdose decedents underscores the importance of offering substance use treatment services in clinics that treat patients with chronic pain and mental health problems,” said lead investigator Dr. Mark Olfson of Columbia University Medical Center.

A study of patients who went to the emergency room suffering from acute pain found those given a combination of ibuprofen and acetaminophen reported as much pain relief as those who were given opioids. The 416 patients in the study had acute pain in their shoulders, arms, hips or legs, the Los Angeles Times reports. About 20 percent of the patients had a bone fracture, the researchers wrote in the Journal of the American Medical Association. Other patients had injuries such as a sprained ankle or dislocated shoulder. Patients were assigned to one of four groups. One group received a combination ibuprofen/acetaminophen tablet (containing the medications found in Advil and Tylenol. The other groups received a drug containing a prescription opioid, such as Percocet (a combination of oxycodone and acetaminophen), Vicodin (hydrocodone and acetaminophen) or Tylenol No. 3 (codeine and acetaminophen). Patients were asked to rate their pain when they arrived...

Pharmaceutical companies are working to develop less addictive pain drugs, according to the Associated Press. Companies are researching drugs that target specific pathways and types of pain, instead of acting broadly in the brain. One example of this type of drug is Enbrel, which treats a key feature of rheumatoid arthritis. Other drugs being tested would prevent the need for opioids. One numbs a wound for several days and reduces inflammation, thereby decreasing pain after surgery. The hope is these drugs will lessen the chance of developing chronic pain that might require opioids. Researchers are also looking for new sources for pain medicines, including drugs from silk, hot chili peppers and the venom of snakes and snails. They are also testing existing seizure and depression medicines for their ability to treat pain.

Researchers at Stanford University are studying a pre-surgical online program that is designed to help patients better manage pain and reduce the use of opioid painkillers after surgery. The program, called “My Surgical Success,” helps patients develop a personalized pain-management plan to control the anxiety associated with anticipating surgical pain. The program teaches patients to dampen the pain processing in their nervous system, so they have more control over how much pain is impacting them and how much medicine they need to manage their post-surgical pain. “For many people, pain resolves after surgery, but there is a subset of patients for whom pain does not resolve,” says study lead researcher Beth Darnall, Ph.D., Clinical Associate Professor in the Division of Pain Medicine at Stanford University. “We need to figure out how to best meet their needs so they’re not taking opioids forever and are able to get back to meaningful activities...

A new study finds people with moderate to severe pain have a 41 percent higher risk of opioid addiction, compared to those without pain. Columbia University researchers surveyed more than 34,000 Americans, HealthDay reports. Males and younger adults were at increased risk for opioid abuse, the researchers report in the American Journal of Psychiatry. “In evaluating patients who present with pain, physicians should also be attentive to addiction risk factors such as age, sex and personal or family history of drug abuse,” study senior author Mark Olfson, MD, MPH said in a news release. “If opioids are prescribed, it is important for clinicians to monitor their patients carefully for warning signs of opioid addiction.”

As the Obama Administration and public health officials push for a reduction in prescription opioids, they are facing some resistance from both patients and doctors, experts tell The New York Times. Insurance coverage for alternative treatments is inconsistent, the article notes. The plans may not cover all treatments, or they may impose strict limits on coverage. Alternative pain treatments include acupuncture, yoga, chiropractic and osteopathic manipulation, massage, meditation and cognitive behavioral therapy. Medicaid does cover physical therapy for patients who gained coverage under the Affordable Care Act, but the level of coverage varies by state. Matt Salo, Executive Director of the National Association of Medicaid Directors, says benefits for alternative treatments are often the first to be eliminated when budgets are cut, because they are considered optional. A complicating factor is the widely varying amounts of evidence about the effectiveness of these treatments. Many patients resist nondrug treatments for pain, because...

The nation’s largest medical society is recommending that pain be removed as a “fifth vital sign” in professional medical standards – a move critics say will make it even more difficult for pain sufferers to have their pain properly diagnosed and treated. Delegates at the annual meeting of the American Medical Association in Chicago also passed several other resolutions aimed at reducing opioid prescribing and increasing access to addiction treatment. The AMA represents over 200,000 physicians in the U.S. and is very influential in setting public health policy. The AMA’s new president said physicians played a key role in starting the so-called opioid epidemic by overprescribing pain medication, and now must do their part to end it. “We have taken ownership of that, and physicians have taken ownership of being part of the solution,” AMA president Andrew Gurman, MD, told Modern Healthcare.The AMA’s main “solution” to the opioid problem is to...

Patients suffering from chronic pain say they are finding it more difficult to get prescriptions for opioid painkillers, The Boston Globe reports. Federal and state regulations to reduce access to opioids have made doctors and pharmacists more reluctant to prescribe and dispense the drugs. Chronic pain patients say they are frequently required to prove they are not addicted to opioids, the article notes. An estimated 100 million adults in the United States are thought to suffer from chronic pain. In many cases, the pain is caused by injury, disease or nervous system problems. There are a number of non-opioid treatments available, including anti-seizure drugs, antidepressants, devices such as spinal stimulators, physical therapy and meditation. While these treatments rarely stop the pain, patients often use a variety of these options to help them cope with it. Some patients see opioids as critical in helping them deal with their pain. Claire Sampson, Co-Chairwoman...

Long-acting opioids are associated with a significantly increased risk of death when compared with alternative medications for moderate-to-severe chronic pain, according to a Vanderbilt study released in the Journal of the American Medical Assocation (JAMA). Not only did long-acting opioids increase the risk of unintentional overdose deaths, but they were also shown to increase mortality from cardiorespiratory events and other causes. The story appeared in Vanderbilt University’s Research News @ Vanderbilt. Lead author Wayne Ray, Ph.D., and colleagues with the Vanderbilt Department of Health Policy studied Tennessee Medicaid patients between 1999-2012 with chronic pain, primarily back and other musculoskeletal pain, who did not have cancer or other serious illnesses. Researchers compared those starting a long-acting opioid to those taking an alternative medication for moderate-to-severe pain. Alternative medications included both anticonvulsants — typically prescribed to prevent seizure activity in the brain, treat bipolar disorder or neuropathic pain — and low doses of...

A New Jersey hospital emergency department has been treating pain with alternative regimens, in an attempt to reduce opioid use. The treatments include non-narcotic infusions and injections, ultrasound guided nerve blocks, laughing gas, and “energy healing,” according to The New York Times. St. Joseph’s Regional Medical Center’s emergency department in Paterson, New Jersey, is one of the nation’s busiest, treating approximately 170,000 patients a year. Since January, it has been treating patients with common types of acute pain—such as migraines, fractures, kidney stones and sciatica—with alternative treatments. Almost 75 percent of patients seek emergency treatment because of pain. Emergency department personnel and patients have long thought that opioids are the quickest, most effective response to pain. “St. Joe’s is on the leading edge,” said Dr. Lewis S. Nelson, a professor of emergency medicine at New York University School of Medicine, a member of a panel that recently recommended opioid prescribing guidelines...