Archives for March 2016

This Is Why an Implant Cannot Stop Heroin Addiction

A recent The Daily Beast article asks the question: Can an implant stop heroin addiction?

Heroin Addiction Implant

The short answer is that, no, an implant cannot stop heroin addiction. The buprenorphine implant the article cites is only used once someone has already developed an opioid addiction.

Therefore, the implant isn’t preventing heroin addiction, it’s only treating it.

Other Implant Uses

However, the buprenorphine implant may make treating opioid addiction more successful. It may make it easier for those who could benefit from buprenorphine treatment to receive it, and it might improve compliance and utilization. This would be a good thing.

Why You See The Pendulum of Addiction Fear Swinging Again

Addiction Fear

“The data about the ability of opioids to cause addiction haven’t changed. But that ‘old’ news can’t compete with the fire-breathing, vote-getting, be-seen-to-be-doing-something mentality of our political and regulatory folks,” said Charles F. von Guenten, MD, PhD, Editor-in-Chief of the Journal of Palliative Medicine.

I couldn’t have said it better. Of course, this is not the first time in U.S. history when opioids and the people for whom they have been intended have been castigated. Early in the 20th century, as many as 10% of the American population had become addicted or were physically dependent on opioids.

This is the Reason Mindfulness and Meditation Transcend Religion

Mindfulness is not a foreign religion or threat to anyone’s religion, despite what some people may assume. We should remember that Walking the Labyrinth is a traditional process by which believers in Christianity can meditate.

All religions have recognized the healing properties of meditation or mindfulness.

Each religion may use its own symbols or mannerisms to practice its style of meditation, but they all come from the same place and serve the same purpose. It is to merge the mind with the body and to provide insight and peace for the purpose of becoming centered.

What Is the Correlation Between Financial Stress and the Ability to Cope with Pain?

The authors of this Harvard Business Review article appropriately report an association between economic insecurity and the rise in painkiller consumption. Of course, a person’s painkiller consumption may increase for many reasons, but augmented pain due to stress certainly may be one reason.

The Experience of Pain

People consume painkillers primarily because of pain which is a bio/psych/social/spiritual disorder. The experience of pain is the sum of all of life’s experience. The combination of fear, anxiety, and stress will factor into that pain experience.

This is the Way We Learn: Through Family Connections

The Importance of Family Connections

This article discusses the needs of grandparents and why it is important to them that their grandchildren stay in touch. That reminds me of the movie, “The River Runs Through It,” and the impact the film had on several of my friends and me.

Before I saw the movie, I read the book by Norman McClean after a colleague, who was a cardiac surgeon, highly recommended it. I think my friend’s love of the book was in part due to its theme of flying fishing, as he was an avid fly fisherman.

Abuse-Deterrent Formulations Are Part of the Solution to Overdose Crisis

Curbing The Epidemic of Drug Overdoses

Dr. Robert Califf, the new commissioner of the Food and Drug Administration, is focusing his energy on curbing the epidemic of drug overdoses. He told a panel of FDA advisors last week that abuse-deterrent formulations (ADFs) may be part of the solution.

However, many speakers at that panel warned the FDA that it would be a mistake to rely on ADFs to solve the problem.

The advisors are correct. Abuse deterrent formulations (ADFs) are not a magical cure to the problem of opioid abuse.

The Reasons Caregivers are Heroes and Saints

Some religions call their holiest people saints. In secular speak, a saint is a person who is pure, honest, and beyond reproach, and who mostly devotes their life to benefit others. In our more common vernacular, we use the word “heroes” to describe those who sacrifice themselves for the good of others.

Saints and Heroes: A Personal Story

I have decided that my grandfather was either a saint or a hero. That epiphany came to me recently, long after he passed.

Is Death from Pain a Natural Death?

What is a natural death?

That’s partly a judgment call, and it reveals our prejudice against pain patients.

Pain treatment and cancer treatment are two colors of the same spectrum.

They both serve the same purpose, and yet they’re perceived very differently. Pain treatment with an opioid is unacceptable to many advocating against the use of opioids for non-cancer pain. Cancer treatment, on the other hand, is valiant — whether it works or not, whether it hastens death or not.

What Is the Icon for Chronic Pain?

The Icon For Cancer: The Jimmy Fund

Say what you will about Boston sports teams. One of them, the Boston Braves, helped launch “The Jimmy Fund.”

It all started in 1948. At that time, members of polite society rarely mentioned cancer. Fear, superstition, and ignorance caused people to whisper about cancer, steer clear of anyone who had been diagnosed with it, and even refer to it as the “c-word.”

This state of affairs, unfortunately, marginalized cancer patients and their needs. It also slowed down cancer research. Progress to find treatments was dismal, and there was a lack of awareness of how much could be accomplished if only people felt empathy for cancer patients.

Chronic Pain and the Death of a New York Times Journalist

The death of the New York Times journalist, Sarah Kershaw, reminds me painfully of too many conversations I had with my patients during the course of my career as a pain doctor, about whether or not they wanted to live.

During the 30 years of my practice, countless patients told me they had no hope for a life without severe disabling pain and would, therefore, prefer to die. I believed them.

CDC Report

The CDC reports there are 44 deaths per day that involve opioids, but there are more than 105 deaths per day from suicide. An undoubtedly significant (but uncertain) number of those suicides can be attributed to people with severe pain.