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The mission of Pain Treatment Topics is to serve as a noncommercial resource for healthcare professionals & their patients, providing open access to clinical news, information, research, and education for a better understanding of evidence-based pain-management practices. Commercial advertising is not accepted.
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NOV-DEC 2008 News/Research UPDATES
 In this latest edition >>
> Accidental Opioid Overdose in Children Increasing
> Methadone Cardiotoxicity Questioned
> Opioids for Chronic Nonmalignant Pain Improve QoL
> Factors Affecting Analgesic Adherence Evaluated
> Musculoskeletal Pain Influences Death Risk
> Depression, Anxiety Add to Chronic Pain Morbidity
> Patient-Controlled Analgesia Errors Assessed
> Better Pain Control, Communication Needed by Hospitals
> One in Ten Americans Suffers Arthritis Pain
> Despite Treatment, 1 in 3 Patients Still Suffer Chronic Pain
> Recent Drug or Device Approvals, Announcements, and Warnings
And, much more... See News/Research Updates...>
NEW EDITION — e-Briefing Newsletter
This latest edition features our 2008 Research Roundup. The 19-page newsletter is available for free download as a PDF document, formatted for on-screen reading or printing.

- Can Pain Medicine Research Be Trusted?
- Opioid-Analgesic Abuse/Addiction Uncertain
- Special Reports
> Aches? Pains? Extra Vitamin D May Help
> Safety Stressed in Methadone Guidance
- Current Comments
> Do Opioid Analgesics Sometimes Make Pain Worse?
> Discharging Patients for Opioid-Analgesic Abuse/Addiction?
> Telltale Signs Identify Patients with Uncontrolled Pain
> Sexual Dysfunction – Common with Opioid Analgesics
Go to e-Briefing...>
Events Calendar Updated
During December, more than 20 events were added to our listings, extending to year 2015. This is the most extensive compilation anywhere of events (conferences, seminars, etc.) related to pain management, and most of these also offer continuing education credits.
Go to the Events Section...>
Book Focuses on Safe Opioid Prescribing
Responsible Opioid Prescribing: A Physician’s Guide
By: Scott M. Fishman, MD (from Federation of State Medical Boards).
This brief and authoritative book, commissioned by the Federation of State Medical Boards (FSMB), offers effective strategies for reducing the risk of addiction, abuse, and diversion of opioids that are prescribed for pain. It translates the FSMB “Model Policy for the Use of Controlled Substances for the Treatment of Pain” into practical steps for opioid-risk reduction and improved patient care. See Review & Ordering Info…>
Non-Opioid Therapies Expanded
More than 12 additions were made to this section, which focuses on the variety of non-opioid therapies -- both pharmacologic and non-pharmacologic -- from an evidence-based, clinical perspective. Including…
> Acupuncture for Pain Management
> Non-Narcotic Options for Pain Relief in Chronic
Neuropathic Conditions
> Antidepressants for Non-Specific Low Back Pain
> Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Pain
> Exercise for Treating Fibromyalgia Syndrome
> Effectiveness of Massage Therapy for Chronic, Non-Malignant Pain
> And, others…
Look for the Icon at the Tab Section Page…>
Newly Posted Pain-Treatment GUIDELINES
There are now 88 pain-management Practice Guidelines listed at Pain-Topics.org, along with descriptions and URL links for accessing the documents. This is the most complete listing anywhere on the Internet, and the most recently-posted guidelines include…
Cancer Pain Algorithm
From: University of Texas MD Anderson Cancer Center. See Details…>
Guideline on the Treatment of Carpal Tunnel Syndrome
From: American Academy of Orthopaedic Surgeons (AAOS). See Details…>
Diagnosis and Treatment of Trigeminal Neuralgia
From: American Academy of Neurology (AAN) and European Federation of Neurological Societies (EFNS). See Details…>
Diagnosis/Management of Migraine, Tension-Type, Cluster, and Medication-Overuse Headache
From: British Association for the Study of Headache. See Details…>
NEW in Clinical Concepts
ACPA Medications & Chronic Pain Supplement 2008
From: American Chronic Pain Association, 2008.
This 50+ page supplement is revised annually to provide current information on drugs as well as their potential side effects. Written initially for patients, it is perhaps the most concise and comprehensive document of its kind, which also makes it an excellent reference for all healthcare providers. The manuscript has many links to additional Internet resources.
See Details...>
Which Analgesics Work Best? What Do They Cost?
Selecting an appropriate analgesic can be difficult, especially when cost is a concern. The Consumers Union, publisher of Consumer Reports, offers guidance via their education project, Consumer Reports Best Buy Drugs™. Reports for each of 4 drug classes -- Opioids, Anticonvulsants, Triptans, NSAIDs -- offer valuable information for healthcare providers and their patients. This includes analgesic-selection considerations, efficacy, dosing, safety issues, and relative costs for each drug in the class. See Details...>
Current Comments - Opioid Concerns
The OIH Paradox: Can Opioids Make Pain Worse?
By: Peggy Compton, RN, PhD, Pain Treatment Topics, August 2008.
 This evidence-based review examines how ongoing opioid therapy for chronic pain can paradoxically worsen the pain in some patients, a phenomenon called Opioid-Induced Hyperalgesia or OIH. The differential diagnosis of OIH from other conditions – worsening disease, opioid tolerance, withdrawal, pseudoaddiction, or addiction – is described and strategies for avoiding or managing OIH, if it occurs, are recommended. See Article...>
Help for Controlling Opioid Rx Risks…
Properly validated and applied assessment tools can sometimes be useful for evaluating current or potential risks of drug abuse, misuse, addiction, or diversion associated with prescribed opioid analgesia. These recent offerings describe clinical assessment tools for all healthcare providers treating patients with pain.
Clinical Tools for Assessing Opioid Risks
From: PainEdu.org. See Details…>
Monitoring Opioid Adherence in Chronic Pain Patients:
Tools, Techniques, and Utility
By: L. Manchikanti, MD, et al. Pain Physician; 2008. See Details…>
A Clinical Guide to Urine Drug Testing:
Augmenting Pain Management and Enhancing Patient Care
By: Catherine A.Hammett-Stabler, PhD and Lynn R.Webster, MD. From: University of Medicine & Dentistry of New Jersey, Center for Continuing & Outreach Education; 2008. See Details…>
A Practical Guide for Prescribing Controlled Substances
By: Nathaniel Katz, MD, MS, et al. From: PainBalance.org, 2007.
See Details...>
Recently Posted PATIENT RESOURCES...
Neuropathic Facial Pain and TN (Trigeminal Neuralgia)
From: Trigeminal Neuralgia Association. A Pain Treatment Topics affiliate organization. This web page provides a description of TN and other less common nerve disorders that cause facial pain. See Details…>
Practical Management of Whiplash
From: British Columbia Medical Association. This handout addresses patient uncertainties about different types of whiplash, diagnosis, treatment, and the recovery process. It also discusses the need for neck-specific exercises, suggests precautions, and describes 5 exercises in detail (including pictorial instructions). See Details…>
TMJ (Temporomandibular Joint) Disorder
From: National Institute of Dental and Craniofacial Research. This booklet describes TMJ disorder, its causes, and related conditions. Diagnosis and the symptoms of TMJ are discussed along with treatment -- from conservative measures and self-care to surgery. See Details…>
Rheumatic Conditions Fact Sheets
From: American College of Rheumatology (ACR). There are 40 fact sheets on rheumatic conditions, including: back and neck pain, tendonitis/bursitis, fibromyalgia, the various types of arthritis, and many others. See Details…>
SPECIAL ANNOUNCEMENTS 
Blog/Website on Palliative Medicine Recommended
Pallimed is an excellent blog/website started in 2005 and run by 3 professionals in the hospice and palliative care field: Drew Rosielle, MD, Christian Sinclair, MD, Thomas Quinn, APRN, CHPN. They offer thoughtful and practice-oriented reviews of current palliative medicine, hospice, and end-of-life research from major journals and other sources. They also highlight important events and other news regarding end-of-life care. Much of the content deals with pain management issues. Be sure to sign up for the e-mailed updates.
See Pallimed Review…>
Pain Medicine News: Special Edition Worth Viewing
A Special Edition of Pain Medicine News, available online, features a compendium of 8 recently published educational reviews. Topics include an overview of analgesic agents, methadone analgesia, opioids for postoperative pain, treatments for diabetic peripheral neuropathy, fibromyalgia, and more. See Description and Link in Newsroom…>
NEW FDA Web Page Focuses on Drug Safety Info
Healthcare professionals and consumers can now go to a single page on the FDA website to find a wide variety of safety information about prescription drugs. The page, titled “Postmarket Drug Safety Information for Patients and Providers,” serves as a linked index to major features at the FDA’s extensive Center for Drug Evaluation and Research (CDER).
See Description and Link in Newsroom…>
December 2008 Europad Journal Posted
This latest edition of the Journal of Heroin Addiction & Related Clinical Problems from Europad has 6 articles of interest to practitioners concerned with opioid addiction. Featured articles focus on buprenorphine versus methadone maintenance treatment, injuries associated with opioid abuse, opioid therapy effects on immune function, and more. The entire journal is available for free download. Go to the Journal…>
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Thank you, for visiting, and we hope to see you here often.
Stewart B. Leavitt, MA, PhD; Publisher & Editor-in-Chief
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