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IPA News

Texas lawmakers limit opioid prescriptions for acute pain patients

Texas lawmakers last month gave final approval to a bill that will limit opioid prescriptions for acute pain to a 10-day supply, one of several measures passed this session aimed at tackling the state’s opioid overdose crisis.

House Bill 2174 now goes to Gov. Greg Abbott’s desk to be signed into law. He has until June 16 to do so or otherwise veto it.

The legislation, authored by Rep. John Zerwas, R-Katy, also requires that all opioid prescriptions be sent to pharmacies electronically to cut down on the number of fraudulent written prescriptions.

Zerwas said the two measures would help address prescription opioid misuse in Texas. He said the less time people are on the medication, the less likely they are to become addicted. The legislation also seeks to reduce the amount of leftover medication, which could be taken by someone else or diverted for illegal use, he said.

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Purdue Pharma to pay $270 million to settle historic Oklahoma opioid lawsuit

(CNN)Purdue Pharma has agreed to pay $270 million to settle a historic lawsuit brought by the Oklahoma attorney general, who accused the OxyContin maker of aggressively marketing the opioid painkiller and fueling a drug epidemic that left thousands dead in the state.

The settlement comes after Purdue fought the attorney general in court, seeking to delay the start of the trial, which is scheduled for May 28.
“It is a new day in Oklahoma, and for the nation, in our battle against addiction and the opioid epidemic,” Attorney General Mike Hunter said Tuesday in Tulsa.
Hunter said that $102.5 million of the settlement would be used to help establish a national addiction treatment and research center at Oklahoma State University, with additional payments of $15 million each year for the next five years beginning in 2020. The company will also provide $20 million of addiction treatment and opioid rescue medications to the center over the same five-year time frame.
A remaining $12.5 million from the settlement will be used directly to help cities and counties with the opioid crisis.

READ FULL STORY HERE

Updated 5:30 PM ET, Tue March 26, 2019

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Obesity Shown to Affect SCS Pain Outcomes

A study from the Cleveland Clinic reported a 20% better pain response to spinal cord stimulation therapy among patients categorized as underweight/normal than morbidly obese.

Investigators used self-reported data from 181 patients treated with spinal cord stimulation (SCS) implants to determine the relationship between body mass index (BMI) and pain relief (Spine J 2019;[3]:476-486). Categorized into four groups, the researchers found a 2% reduction in efficacy for every BMI unit.

The investigators measured pain on an 11-point numerical rating scale before and at six and 12 months after SCS implantation. Using multivariable regression analysis and adjusting for confounding factors such as opioid utilization, they found an inverse relationship between post-SCS outcomes and BMI.

“It could be that being overweight is associated with other degenerative conditions, such as osteoarthritis, that can exacerbate pain in ways that are not amenable to SCS treatment, or that other medical conditions that are more common in people with higher BMI lead to a loss of pain relief over time,” said Joshua M. Rosenow, MD, FAANS, FACS, the director of functional neurosurgery and epilepsy surgery at Northwestern Medicine, in Chicago.

Full Story Read Here: https://www.painmedicinenews.com/Primary-Care/Article/05-19/Obesity-Shown-to-Affect-SCS-Pain-Outcomes/54895

 

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Study Shows Smoking Reduces Efficacy of SCS

San Francisco—Researchers at the Cleveland Clinic Foundation have uncovered yet another detrimental effect of smoking. Their retrospective analysis concluded that among pain patients implanted with a spinal cord stimulator, current smokers demonstrated significantly higher pain scores and opioid use than their counterparts who had smoked or never smoked.

“Spinal cord stimulation [SCS] is a great treatment option for patients with chronic spinal pain,” said Youssef Saweris, MD, a pain management fellow at the Cleveland-based institution. “Yet while spinal cord stimulation provides many patients with relief, we occasionally encounter failures.

“One of the common associations with chronic pain is with smoking,” Dr. Saweris continued. “In fact, the prevalence of smoking among adult patients with chronic pain is quite high, and it keeps increasing.”

Full Story, Read Here:  https://www.painmedicinenews.com/Interventional/Article/05-19/Study-Shows-Smoking-Reduces-Efficacy-of-SCS/54896

 

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May is Mental Health Awareness Month

May is Mental Health Awareness Month

“Chronic pain, anxiety and depression are all directly related, equally important and have to be addressed.  Chronic pain will never be under control without treating the anxiety and depression.   A multimodal approach is always best when treating both physical and mental health.  There are many different professionals who can help with depression to include psychiatrists, psychologists, counselors and social workers.   Patients should talk to the healthcare professional that they feel most comfortable with.

Individuals who take proactive steps toward managing their pain often find relief.  However, fighting chronic pain can be complicated by the debilitating effects of depression, pain, and anxiety.  But, there is hope and we encourage anyone suffering to reach out for help.”

  • Kristian Delgado, MD

Chronic Pain and Mental Health

Chronic pain affects every aspect of your life, including your mental health. Sometimes patients are so focused on alleviating their physical aches that they neglect to address the psychological effects of their chronic pain.

Ignoring the toll chronic pain has on the mind can be a major mistake. Your mental state can exacerbate your physical pain, making it even more difficult to manage.

In a 2006 study, 77% of people who suffered from chronic pain reported feeling depressed. Over 85% of chronic pain patients said that they had difficulty sleeping.

Let’s discuss some common psychological effects of chronic pain, and how to cope:


Depression

You can’t sleep, you can’t socialize, you can’t work — of course you would feel down. However, some people who endure chronic pain also experience major depressive disorder: symptoms include persistent feelings of sadness, loss of interest, inability to concentrate, sleep disturbances, appetite changes, self-isolation, low self-worth, and more.

Long-term pain can trigger a depressive episode, even for individuals who have never before been diagnosed with depression before. The insomnia caused by chronic pain (more on that below) wreaks havoc on your moods and prompts you to nap frequently instead of engaging with others. Pain issues also cause you to withdraw from activities, thus isolating yourself from your loved ones. Depression is shockingly common among individuals suffering from chronic pain.

 

Insomnia

While a symptom of many mental and physical disorders, insomnia is also a separate diagnosis in its own right. You need quality sleep to function. Even though getting a good night’s sleep is sometimes inconvenient and often difficult in today’s hectic world, adults still require seven to nine hours of sleep every night.

Chronic pain makes sleeping difficult. This can be due in part to the pain itself, as well as any medication side effects you may need to cope with the pain. Insomnia adversely impacts every aspect of your life: concentration, digestion, memory, fitness, relationships, etc. Worse, insomnia can exacerbate psychological disorders like depression or anxiety.

 

Anxiety

You worry, and most of your worries are connected to your chronic pain: you worry about why you’re in pain, how you’ll pay your bills, when you’ll see your doctor, if you’ll keep your job. Your pain keeps you up at night, and you find yourself obsessing over what-if scenarios. You become fearful, wondering if the pain will ever go away or if it is actually a symptom of another serious illness.

People sometimes even second guess themselves, wondering if they are overreacting or if their pain is psychosomatic. For all these reasons and more, chronic pain can cause anxiety and even panic attacks.


Fatigue

Fatigue is different from simply being tired. Feeling tired can be fixed by resting; feeling fatigued can’t be relieved by resting and if anything, resting might worsen the feeling. Walking around the block feels like running a marathon. You are so focused on appearing “normal” that you mentally exhaust yourself.

Studies indicate that arthritis can physically increase fatigue; the body fights the inflammation by releasing chemicals, which can in turn cause fatigue.

 

Guilt

Feelings of guilt may stem from everyday occurrences, such as being unable to play with your toddler, or work for more than a few hours a day. While not a disorder by itself, feelings of guilt can overwhelm a person.

Chronic pain prevents you from participating in activities that most people take for granted like socializing, working and exercising. You might feel angry at yourself and blame yourself for no longer being able to engage with the world. Guilt is one of the most insidious mental side effects of chronic pain.


Tips for Coping with the Mental Effects of Chronic Pain

Educate yourself about your condition to reduce fear of the unknown.

Practice meditation.

Exercise (only as much as you are able, and with your pain medicine clinician’s permission!)

Consider seeing a mental health counselor for talk therapy.

Some people might need medication to treat insomnia, depression, or anxiety.

Practice mindfulness: focus on the here and now.

Do not fall into self-medication! Using substances might temporarily alleviate physical or emotional pain, but this is never a good long-term solution.

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Abrupt Discontinuation of Opioids Dangerous, FDA Warns

Reports of “serious harm” in patients dependent on opioid painkillers who suddenly stop taking the medication, or rapidly decrease the dose, have prompted a drug safety communication issued today by the US Food and Drug Administration (FDA).

Harms from abruptly stopping opioids or rapidly decreasing the dose include “serious withdrawal symptoms, uncontrolled pain, psychological distress, and suicide,” the FDA said.

While the FDA continues to track this “safety concern,” the agency is requiring changes to the prescribing label for these medicines that are intended for use in the outpatient setting. These changes are designed to promote safe tapering or discontinuing of opioids in patients who are physically dependent on the medication.

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Megan Brooks

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Another Lawmaker Overlooks Pain Management in Bill to Fight Opioid Crisis

“Dependence isn’t addiction, and that is continually left out of the discussion and the policies being made,” said disability advocate Maelee Johnson.

Hardly a day goes by when the discussion of opioids and their misuse is not on the front page of local or national newspapers. However, the flipside of the issue, pain management, is barely, if ever, centered in the conversation.

This came up most recently with Republican Sen. Rob Portman of Ohio, who seeks to advance a bill he previously introduced called the Comprehensive Addiction and Recovery Act 2.0, which would, among other things, establish a three-day limit for opioid prescriptions.

This lack of focus on disabled and chronically ill patients has inadvertently pitted doctors against their own patients, who are framed as going down the rabbit hole of dependency following a sprained ankle or routine dental surgery. But this overly simplistic framing erases people with long-term disabilities and chronic health conditions who are struggling to live their lives while being punished for using the best tools we have available to enable their full participation in society.

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 Rebecca Cokley

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Legitimate opioid use for pain management

People across the country who are dealing with serious acute and chronic pain issues are becoming increasingly alarmed and confused about whether their opioid prescriptions will remain available.

If you are someone who’s looking at a major surgery, such as spinal fusion or a total knee replacement and resulting acute pain; are dealing with chronic pain, from conditions such as Crohn’s disease or rheumatoid arthritis; or are in palliative care after battling cancer, you should know there’s a lot of misinformation out there.

Unfortunately, doctors, pharmacists and patients can fall victim to faulty reporting and make decisions based on what they believe are facts but are half-truths instead. That’s why we’re going to set out the current information, so you know — or can find out — where you really stand.

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IPA Imaging Earns ACR Accreditation

Killeen, Texas — IPA Imaging has been awarded a three-year term of accreditation in magnetic resonance imaging (MRI) as the result of a recent review by the American College of Radiology (ACR). MRI is a noninvasive medical test that utilizes magnetic fields to produce anatomical images of internal body parts to help physicians diagnose and treat medical conditions.

The ACR gold seal of accreditation represents the highest level of image quality and patient safety. It is awarded only to facilities meeting ACR Practice Parameters and Technical Standards after a peer-review evaluation by board-certified physicians and medical physicists who are experts in the field. Image quality, personnel qualifications, adequacy of facility equipment, quality control procedures and quality assurance programs are assessed. The findings are reported to the ACR Committee on Accreditation, which subsequently provides the practice with a comprehensive report that can be used for continuous practice improvement.

The ACR, founded in 1924, is a professional medical society dedicated to serving patients and society by empowering radiology professionals to advance the practice, science and professions of radiological care. The College serves more than 37,000 diagnostic/interventional radiologists, radiation oncologists, nuclear medicine physicians, and medical physicists with programs focusing on the practice of medical imaging and radiation oncology and the delivery of comprehensive health care services.

About IPA Imaging

Integrated Pain Associates is wholly committed to delivering care to our community and has been delivering innovative pain management solutions for over a decade. We have taken great measures in order to open up alternative avenues to you as your partner in healthcare. At IPA Imaging we believe that finances should never be a barrier to receiving healthcare and we are committed to providing access to the best quality and affordable diagnostic imaging services for our community.

IPA Imaging offers high quality, on site MRI at a lower, more affordable cost to patients. With high quality images read by the area’s top radiologist(s) and a highly trained staff we honor our commitment to clinical excellence and quality.  We are conveniently located in Killeen and offer same day appointments.

For those with high deductibles or no insurance, we are confident you will find that IPA Imaging is significantly more affordable. Our time-of-service cash pay saves you up to 50% or higher savings compared to other imaging providers.

By using our self-pay option, you get affordable, high-quality imaging services, avoiding the hassle of merely paying down your deductible while paying more out of your pocket.

Save those deductible payments for really big issues, and pay less up front with cash pay. Take advantage of our affordable pricing options. 

Remember, you have a choice of where you go for imaging services.

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Unintended consequences of opioid crackdown

The overdose problem – and a rise in suicides, another byproduct of the drug epidemic — is so pervasive it’s being blamed for a drop in U.S. life expectancy.

The crisis has led to a rush of public health and law enforcement initiatives at all levels of government. The federal government has vowed to cut prescription opioids by a third. More than 30 states have passed some type of legislation aimed at attacking the opioid epidemic.

“Defeating this epidemic will require the commitment of every state, local, and federal agency,” President Donald Trump said in a March speech in New Hampshire. “Failure is not an option. Addiction is not our future. We will liberate our country from this crisis.”

Read more here

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