PAINWeek 2014

Chronic pain can sometimes be too complex a challenge to easily fit into a strictly reductionist biomedical model of care. A “find it and fix it” reductionist model has produced many advances in diagnosis and therapy, Michael Saenger, MD, FACP, said to attendees at PAINWeek 2014, but it “may miss the complexity of the whole.”

Preoperative symptoms of self-loathing are just one of many factors that can predict prolonged opioid use after surgery, and supports a “self-medication hypothesis” in which patients with affective-cognitive distress find their mood enhanced with opioids, leading to reinforcement, said Jennifer Hah MD, MS, instructor in the Department of Anesthesiology, Perioperative, and Pain Medicine, at Stanford University, Stanford, California to attendees of PAINWeek 2014.

Complementary and alternative medicine (CAM) for chronic low back pain: “what works, how much, and for how long?” asked Michael S. Saenger, MD to attendees of PAINWeek 2014.

“IPM is a solid-choice solution to avoid escalation of controlled substances and assist in diagnosis and treatment of painful conditions,” said Hans C. Hansen, MD, FIPP, ABIPP, DABPM, and DABM, Executive Director of the North Carolina Society of Interventional Pain Physicians and Medical Director of The Pain Relief Centers in Conover, North Carolina, to PAINWeek attendees. “Interventional pain medicine is a very important part of pain control strategies.”

Extended-release combination oxycodone/naloxone is associated with a cardiovascular risk no higher than that seen for extended-release morphine or extended-release oxycodone among patients without histories of major cardiovascular events, according to a retrospective cohort study of patients in the United Kingdom, presented at PAINWeek 2014.

“There’s a great and urgent need to study cannabinoids in a manner similar to other medications so that these substances can be used as appropriately as possible,”Charles E. Argoff, MD, CPE, Professor of Neurology and Director of the Comprehensive Pain Center at the Albany Medical Center in Albany, New York reported at PAINWeek 2014. When in the United States do we actually allow a medication to be utilized without knowing what its benefits and safety profile might be?”

Fentanyl, methadone, and oxycodone were significantly more likely to be associated with androgen deficiency than hydrocodone; these odds ratios were large,” reported Andrea Rubinstein, MD, of Kaiser Permanente Medical Group in Santa Rosa, California, and Diane Carpenter, MPH, of Kaiser Permanente’s Division of Research in Oakland, California at PAINWeek 2014.

Increasing utilization of social media by patients to create health communities can offer insights to providers into patient concerns surrounding treatment. Data presented at PAINWeek 2014 showed than an analysis of message content from Twitter and other health-related online forums spotlighted patients’ “lack of knowledge about opioid-induced GI side effects and their attempts to minimize them whilst maintaining effective pain management regimens.”

Fixed-dose methylnaltrexone, a peripherally restricted mu-opioid receptor antagonist, demonstrated robust and durable efficacy in patients with opioid-induced constipation and advanced illness, Janet Bull, MD, and colleagues reported at PAINWeek 2014.