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Recent News and Articles on the Keywords: chronic pain + narcotic drugs + pain  Related to the article below (Last Update: 7/8/2008)

Officials urge action on painkiller abuse
Las Vegas Sun, NV -
He said he was most concerned about patients who take too many narcotics to alleviate pain. ?These pills aren?t the answer and can lead to more trouble,? he ...

Las Vegas Sun
The painful truth about painkillers
Las Vegas Sun, NV - Jul 6, 2008
?There?sa lot of money in the drug industry and they push really hard,? one pain doctor said. No one can say with certainty why so many narcotic painkillers ...
Rising use of painkillers taking deadly toll Las Vegas Sun
all 3 news articles »
Mayville man faces narcotics charge
The Reporter, WI -
Pillsbury was taken into custody as the result of a May 6 traffic stop in Mayville after officers discovered tablets of pain medication hidden inside the ...
Guest columnist: Chronic-pain sufferers deserve treatment with dignity
Battle Creek Enquirer, MI - Jun 22, 2008
I have been treated like a drug addict. Like I was lying about my pain to get prescription narcotics that I was going to sell on the street. ...

Irish Independent
Celebrity health: Steve Tyler
Irish Independent, Ireland - Jul 7, 2008
When someone in pain takes a drug they do not usually develop the dependence relationship that is a factor of 'normal' drug addiction. ...
Thomas D. Elias: No good reason for medipot decision counter to ...
The Union of Grass Valley, CA - Jul 7, 2008
The ruling also opens up other problems for patients who use legal narcotics like morphine for pain. They, too, could fail a drug test, get fired and have ...

TopNews
Electronic device zaps migraine pain, study says
CTV.ca, Canada - Jun 26, 2008
"Since almost all migraine drugs have some side effects, and patients are prone to addiction from narcotics, or developing headaches from frequent use of ...
Migraine zapping device shows promise, study finds CBC.ca
Electronic Device May Zap Away Migraines Boston Channel.com
all 250 news articles »
Dr. Gott: Son abuses prescription drugs
Monterey County Herald, CA - Jul 6, 2008
Dear Reader: Oxycontin is a habit-forming narcotic similar to morphine that can be prescribed in liquid or pill form for the treatment of severe pain. ...
Medical Board Disciplines
KTRE, TX - Jul 7, 2008
The order is based on Dr. Sessions prescribing controlled substances for pain to a foot surgery patient over an extended period of time without sufficient ...

Washington Post
Steven Tyler Says He Needed to Kick Pain and Sleep Drugs
People Magazine - Jun 27, 2008
... pain and sleep medication. "To have your feet done, to have your leg done, you have to be on narcotics," Tyler, 60, told the Associated Press on Friday. ...
Tyler admits narcotics addiction Ireland Online
Friend's email address *Multiple addresses must be separated by commas MTV.com
Steven Tyler Admits Pill Addiction Artistdirect.com
LiveDaily.com - KBS Radio
all 348 news articles »
Source: Google News

Grading the severity of chronic pain. -
M Von Korff, J Ormel, FJ Keefe, SF Dworkin - Pain, 1992 - ncbi.nlm.nih.gov
... Behavior/drug effects; Chronic Disease; Depression ... Middle Aged; Models, Biological;
Narcotics/therapeutic use; Pain ... Pain/drug therapy; Pain/psychology; Pain Measurement ...

Opioid therapy for chronic nonmalignant pain: a review of the critical issues -
RK Portenoy - Journal of Pain and Symptom Management, 1996 - Elsevier
... The potential for physical dependence and iatrogenic addiction is a major issue
in the use of opioid drugs for the management of chronic nonmalignant pain. ...

[CITATION] PATTERNS OF NARCOTIC DRUG USE IN A CANCER PAIN CLINIC*
RM Kanner, KM Foley - Annals of the New York Academy of Sciences, 1981 - Blackwell Synergy
... The treatment of pain caused by chronic disease presents several serious ... Relief of
moderate to severe pain often requires narcotic analgesics, yet ...

Lack of analgesic effect of opioids on neuropathic and idiopathic forms of pain. -
S Arner, BA Meyerson - Pain, 1988 - ncbi.nlm.nih.gov
... continued, or discontinued, use of narcotic medication in ... study illustrate the
misconception of chronic pain as an ... in responsiveness to analgesic drugs as well ...

[CITATION] The reliability of a linear analogue for evaluating pain
SI REVILL, JO ROBINSON, M ROSEN, MIJ HOGG - Anaesthesia, 1976 - Blackwell Synergy
... The effect of narcotic drugs on pain has been measured by interviewing patients
before and after the administration of the drug.? They have been instructed ...

Amitriptyline. A review of its pharmacological properties and therapeutic use in chronic pain states … -
HM Bryson, MI Wilde - Drugs Aging, 1996 - ncbi.nlm.nih.gov
... Analgesics, Non-Narcotic/therapeutic use*; Animals; ... Chronic Disease; Diabetic
Neuropathies/drug therapy; ... therapy; Neuralgia/etiology; Pain/drug therapy*. Substances ...

… Toward Pain and the Use of Opioid Analgesics: Results of a Survey from the Texas Cancer Pain … -
M Score, P Attribute - South Med J, 2000 - medscape.com
... 10.3, 52.7. Prescribing narcotics for patients with chronic pain is likely to
trigger a drug enforcement agency investigation. 26.4, 59.4. ...

Drug utilization patterns in chronic pain patients.
JA Turner, DA Calsyn, WE Fordyce, LB Ready - Pain, 1982 - ncbi.nlm.nih.gov
... examined differences between chronic pain patients who ... significantly more pain-related
hospitalizations and ... Narcotic-sedative patients spent significantly more ...

Prescription Opiate Abuse in Chronic Pain Patients: Clinical Criteria, Incidence, and Predictors. -
C Chabal, MK Erjavec, L Jacobson, A Mariano, E … - The Clinical Journal of Pain, 1997 - clinicalpain.com
... The Drug Abuse Screening Test. ... Chabal C, Jacobson L, Mariano A, Chaney E. The
psychosocial effects of chronic narcotic use in pain patients (Abstract). ...

Non-NSAID pharmacologic treatment options for the management of chronic pain. -
TJ Schnitzer - Am J Med, 1998 - ncbi.nlm.nih.gov
... management, nonsteroidal anti-inflammatory drugs (NSAIDs) are ... which commonly experiences
chronic pain, such as ... Several non-NSAID, non-narcotic therapies are ...

Source: Google Scholar
 
 

Narcotic drugs effective for severe, chronic pain in elderly

 
 
Researchers at University of California San Francisco ( UCSF ) have compared younger versus older patients' desires / needs to escalate the dose of opioid pain medications they take -- a class of drugs including Morphine, Methadone and Oxycodone.

Opioids have long been used for unremitting pain caused by nerve damage, arthritis and other diseases, but clinicians and patients often worry that use of the drugs will lead to patient requests for ever-increasing doses.
Extended opioid use at high doses can alter immune and hormonal function and increase pain sensitivity.

The new findings show that patients 60 or older faced a much lower risk of opioid " dose escalation " than did younger patients.
Older patients also received long-term pain relief from the opioids whereas younger patients showed no long-term benefit.

The discovery about opioid tolerance and age was uncovered from a study of patient records, and confirmed in animal studies.

" We have found that older patients, often discouraged from using opioids for pain management, actually gain significant long-term relief with minimal risk of excessive dose escalation or toxicity, " said Pamela Palmer, director of the UCSF Pain Management Center.

In addition, long-term use of opioids at moderate levels does not pose an increased risk for cardiac or kidney damage or gastric ulcers, as some Cox-2 inhibitors do -- a risk of greater concern for older patients than younger ones, Palmer said. Sedation and constipation are the main opioid side effects, but these can be managed by modifying the selection of the opioid, the dosage and proper bowel medications.

Researchers examined the medical records of 206 patients who had been treated for two years for severe, non-cancer-related pain, either from nerve damage ( neuropathic pain ) or from arthritis, fibromyalgia and related conditions that cause what is known as nociceptive pain.

Patients were divided into younger ( less than 50 years old ) and older ( over 60 ) age groups.

The records showed that both groups started with similar doses of Morphine-like drugs and both took about 14 to 15 months to reach their peak dose. But the average peak dose of the younger group was more than twice that of the older group.
In many cases, peak doses for younger patients were well over half a gram per day of morphine or related opioid.

Younger patients with nociceptive pain escalated the drug dosage at a " tremendous rate " for more than a year, the researchers report. Yet they did not achieve any long-term pain relief from these high doses according to standard self-assessment scores.
In contrast, the older patients, with less than half the dose escalation, reported significant relief from pain, the scientists found.

The researchers speculate that the difference between the older and younger patients may be the result of molecular changes in neurons that occur with aging, and they cite this as a particularly important area for future research. They also recognize the importance of a prospective study rather than a retrospective one, and they are planning a follow-up study.

In an animal study, the scientists sought to confirm the age-related difference in tolerance to opioid drugs.
They note that no study had systematically evaluated how quickly rats develop tolerance to opioid pain medication as a function of age.
Rats aged three weeks, three months, six months and a year were given twice-daily injections of Morphine proportional to their weight, and pain-relief was assessed in a standard procedure of applying heat to the rat's tail and measuring how quickly the animal flicked its tail away from the heat source.

The researchers found that the youngest rats experienced drug tolerance more than five times sooner than the oldest rats.
Six-month-old and three-month-old rats showed a 250 percent and a 150 percent increase in time to tolerance compared with the three-week-old rats, they reported. The findings are consistent with the human studies in which older patients continue to experience benefit from a given opioid dosage while younger patients need to escalate the dosage.

Why the older patients found long-lasting pain relief at lower doses is not certain, Palmer says. But the results suggest that use of opioids for pain relief in both the young and the old should be reconsidered.

For older patients, opioids appear to be a safe, effective medication to treat long-lasting, serious pain without the increased risks posed by Cox-2 inhibitors and other anti-inflammatory drugs, Palmer concludes. On the other hand, younger people should be cautious of using daily opioids to treat chronic pain.

" Younger people are more vulnerable to opioid tolerance and ever-escalating doses, and they are at much lower risk than older patients for heart attack and gastrointestinal bleeding linked to anti-inflammatory drugs," she said.
Younger patients might be better candidates for the newer non-steroidal anti-inflammatories and poorer candidates for opioids, while older patients might benefit more from opioids but are at greater risk for serious side effects from anti-inflammatory drugs, Palmer says.

Source: UCSF, 2005
 
 
 
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