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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.
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Latest Pain-Topics News/Research UPDATES

FDA Committee Nixes Opioid-REMS Plan
A special U.S. FDA Advisory Committee recently considered the agency’s proposed Risk Evaluation and Mitigation Strategy (REMS) intended to stem the tide of problems associated with extended-release opioid pain relievers. By a large majority, the committee turned down the FDA’s sensible plans, saying a broader approach and more rigorous restrictions are needed; however, the wisdom of the Committee’s decision at this time might be questioned. See discussion>
Vitamin D & Pain: Latest Research Updates, Perspectives
Vitamin D is no longer considered a vitamin, but rather a hormone that may have remarkably beneficial functions well beyond those of regulating calcium absorption and bone health, including the relief of pain for many patients. This long blogpost provides an UPDATE on recently published research as well as some contrary perspectives and perplexing new guidelines on vitamin D.
Lean more>
Other Recent Pain-Topics UPDATES of Interest...

> Treat RA Early, Aggressively, Researchers Say
> Does the Weather Really Affect Pain?
> CAM Popular for Back Pain Relief, Survey
> Glucosamine of No Help for Chronic Low Back Pain?
> Dietary Supplements for Arthritis Pain Examined
> Action Needed to Prevent GI Problems with NSAIDs
> Chronic Pain Surveys Portray a World of Hurt
See Table of Contents for ALL Updates>
Stay Updated on UPDATES, Register for e-Notifications>
View & Subscribe to UPDATES RSS Feed>
Opioid Rx & Safety
PCSS Guidance on Methadone and Drug Interactions
From: Physician Clinical Support System for Methadone (PCSS-M); Elinore F. McCance-Katz, MD, PhD; July 2010.
This paper is based on an updated examination of medical literature and is more current but less comprhensive than the earlier paper from Pain Treatment Topics on the same topic. Access both papers here>
Understanding Opioid Metabolism
Review describes the basics of opioid analgesic metabolism and the factors influencing it. See details>
Managing Opioid Emergencies
Opioid emergencies are rarely sudden events; they are usually foretold by signs-symptoms of overmedication, which can be reversed. See details>
New Pain-Treatment GUIDELINES

VA/DoD Guideline for the Management of
Opioid Therapy for Chronic Pain
From: U.S. Department of Veterans Affairs and the Dept. of Defense (VA/DoD); 2010.
These updated guidelines for use in ambulatory settings discuss all levels of pain management from assessment to patient education, with an emphasis on the proper and safe prescribing of long-term opioid therapy. A treatment algorithm guides the clinician through assessment, treatment goals, trial therapy, evaluation, maintenance therapy, and treatment challenges.
Access the document here>
EULAR Recommendations for the Management of RA with DMARDS
From: European League Against Rheumatism (EULAR); 2010
Experts within the European community of rheumatologists have established 15 recommendations for the management of rheumatoid arthritis (RA) with biological and synthetic DMARDs and glucocorticoids. Includes an algorithm showing 3 phases of treatment aimed at achieving clinical remission.
See details>
Results – 2010 Pain-Topics.org Ratings Survey
To the 212 persons who responded during June to our Pain-Topics.org Website Rating Survey, including 74 who took the time to make personal comments — Thank You. The overall site rating was a phenomenal 4.41 out of a possible 5, and 91% of you said you’d recommend Pain-Topics.org to others. For those who are interested, a complete and detailed
report of
survey
results is available. Click here for PDF>
Latest Continuing Education Postings

Comprehensive Assessment of Fibromyalgia and Overlapping Conditions
From: MedscapeCME Rheumatology; 2010.
This activity reviews key presenting features of fibromyalgia as well as recently-proposed changes in the diagnostic criteria developed by the American College of Rheumatology (ACR). Recommendations for an initial work-up include tests and assessment techniques that help to exclude alternative or comorbid disease; and, screening instruments to assess mood, sleep disturbances, and quality of life are suggested.
See details and access here>
Resources for Patients
Update – What to Do With Leftover Medications?
Improper disposal of unused prescription drugs raises concerns from both environmental and societal perspectives. A particular problem is that the improper disposal of opioid pain relievers has led to their diversion and misuse. New guidance from the FDA recommends the disposal of almost all opioid medicines via flushing down the toilet. See details>
Clinical Concepts: Pain Therapies Update - 2010
ACPA Consumer Guide to Pain Medication & Treatment
From: American Chronic Pain Association (ACPA), 2010.
Document provides current information on pharmacotherapies as well as their potential side effects, and other treatments for pain. Iit is perhaps the most concise and complete document of its kind, which also makes it an excellent reference for all healthcare providers. See details>
Pain & Disability Assessment Tools to Note
Our listing of Pain & Disability Assessment Tools is one of the most frequently visited features. We continually work to make this the most comprehensive offering available anywhere.
Tools for Assessing Neuropathic Pain
By: Giorgio Cruccu, Andrea Truini; PLoS Medicine; 2009.
See details & access this article>
Diagnosing FMS Without Counting Tender Points
New approaches have been developed for use in daily practice to establish a diagnosis of fibromyalgia syndrome (FMS) and to measure its severity without the need to count tender points. Such diagnostic criteria also can be used to detect fibromyalgia as a comorbidity in other clinical illnesses, and may be easier for some practitioners to use than traditional ACR criteria. See discussion in the UPDATES weblog>
SPECIAL ANNOUNCEMENTS 
Buprenorphine Analgesic Patch Approved
Purdue Pharma L.P. has announced that the U.S. Food and Drug Administration (FDA) approved its Butrans™ (buprenorphine) transdermal system for the management of moderate to severe chronic pain. Buprenorphine, previously approved only in parenteral form for analgesia in the U.S., is a unique opioid offering potential benefits for patients needing long-term around-the-clock analgesia. See details in our Newsroom>
Plan Now for Continuing Ed This Fall...
AAPM Conference September 21-24, 2010
Registration for the AAPM (American Academy of Pain Management) 21st Annual Clinical Meeting in Las Vegas, NV, is now available online. This is the only educational conference that truly addresses multimodal and integrative approaches for pain management and attracts healthcare professionals representing diverse disciplines. It is a genuinely unique learning and networking opportunity. See details in the Newsroom>
PAINWeek September 8-11, 2010
The goal and vision of PAINWeek 2010 in Las Vegas, NV, is to disseminate knowledge and tools to frontline clinicians who are faced with treating the majority of patients in pain. PAINWeek offers 100+ hours of continuing education. See details in the Newsroom>
AATOD Conference 2010 -- October 23-27 -- Chicago
American Association for the Treatment of Opioid Dependence (AATOD) conferences attract an eclectic mix of healthcare providers, international stakeholder organizations, government regulators, and patient advocates. A vital focus is on the critical role of medication assisted treatment for opioid dependence and the evidence-based science behind it. This is of special importance for the pain field, as many persons coming into addiction treatment today are dependent on opioid analgesics.
See details in Newsroom>
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MERCO Provides Pain Management Resources Online
Purdue Pharma L.P. has launched their Medical Education Resource Catalog Online (MERCO), a web-based resource providing healthcare professionals with access to free educational materials to help improve the care of people with pain. See details in the Newsroom>
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Become a Pain-Topics.org Supporter
Pain Treatment Topics provides non-commercial information and education on the causes and effective management of pain. To do this, we rely on support in the form of annual educational grants and, through these, we are able to provide all offerings absolutely free and without restriction to site visitors. Learn how your organization can participate in helping to support this website. See information>
Thank you, for visiting, and we hope to see you here often.
Stewart B. Leavitt, MA, PhD, Executive Director
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