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Wearable Tech Emerging For Chronic Pain Relief

The opioid crisis has revealed another real ongoing problem: a lot of people have chronic pain. For example, Lady Gaga recently revealed that she suffers from fibromyalgia, a chronic pain condition that the Centers for Disease Control and Prevention (CDC) says afflicts 4 million people (or 2% of the adult population). This number may actually be an underestimate because determining the real number of people that have fibromyalgia can be a pain.

Fibromyalgia is frequently underdiagnosed or misdiagnosed. Many people, including doctors, are not fully aware of the condition. People may try to maintain a “Poker Face” when afflicted with the symptoms of fibromyalgia, such as pain and stiffness throughout their body, fatigue, depression, anxiety, difficulties sleeping, memory problems, and headaches. Or they may attribute the symptoms to something else. Also, until the FM/a Test was approved by the U.S. Federal Drug Administration (FDA) in 2012, no simple test for fibromyalgia was available.

The Netflix documentary ‘Gaga: Five Foot Two‘ revealed Lady Gag’s struggles with fibromyalgia. Here Lady Gaga is pictured during the premiere during the film’s premiere at the 2017 Toronto International Film Festival.

While fibromyalgia is certainly not the only reason someone may be started on opioids, a publication in the Journal of Clinical Rheumatology discussed how fibromyalgia has contributed to the increase in opioid medication prescriptions since 2004. Opioid medications, if you haven’t heard, can be quite addictive and lead to the use of other drugs like heroin. Therefore, there is an urgent need for more alternatives to opioid medications to help manage chronic pain.

Enter the wearable movement. While some wearables may seem unnecessary (e.g., the No More Woof headset supposedly translates dog barks into English so that you can know when your dog is saying “what an idiot”), wearable technology for pain relief is an intriguing emerging area.

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It may sound a bit like a late-night infomercial or something from a mystical healer: wear this band around your leg to decrease the pain throughout your whole body. But there is real scientific reasoning behind devices such as NeuroMetrix’s Quell that received U.S. Food and Drug Administration approval for over-the-counter use in July 2014.

The Quell device is a band that looks a bit like a blood pressure cuff that you wear around your upper calf. The device does not utilize any medications but instead generates electric signals that stimulate your body to produce naturally occurring substances (endogenous opioids) that can then inhibit nerve signals that lead to feeling pain. In other words, the device helps activate your body’s natural system for regulating pain.

Shai N. Gozani, M.D., Ph.D., Founder and CEO of NeuroMetrix, Inc. explained that “fibromyalgia is believed to result from problems with the central nervous system. There is no injury per se in the peripheral nerves. The balance between positive and negative signals regulating the pain neurons may be off. The nerve signals that inhibit pain signals may be decreased. The Quell device can help boost this part of the system.”

Of course, you don’t just put on the band and presto your pain disappears. As Dr. Gozani related, you typically have to wear the device for a week or two before noticing the reduction in pain. Typically, people will wear the band for 6 to 8 hours a day. The device periodically cycles on and off and can also collect information on your activity and pain levels to help you adjust the device and manage your pain. The device offers the option of tapping into the Quell Health Cloud, which stores data on the usage, sleep, pain levels, and activity for many different users and thus can provide analysis that can in turn help with pain management.

Neurometrix reported that Quell contributed $3.0M out of NeuroMetrix’s $4.3M in revenue in the second quarter of 2017 and that they shipped their 100,000th Quell device in July 2017. Quell device shipments in the second quarter of this year were almost ten times what they were in the second quarter two years prior.

There are certainly many advantages of replacing medications with wearables. For example, addiction is less of an issue (e.g., wearing many bands all over your body probably won’t help). Finding and using ways to stimulate and modulate your body’s pain regulating mechanisms is certainly not a new approach to pain control. This is the basis of transcutaneous electrical nerve stimulation (TENS) and some physical therapy and alternative medicine approaches such as needling.

But developing wearables so that you can go about your daily activities while receiving non-medication pain treatments is new and opens up a whole new avenue of potential ways to manage pain. Furthermore, having such devices interface with digital platforms could help better track pain management, combine treatments, generate data to provide scientific insights, and interface with other types of wearables. Who knows, someday maybe your dog can help you more with your pain management.

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10/29/2023
Tom Petty’s Cause of Death: Accidental Overdose Medication Opioid Chronic Pain

After months of speculation, a medical examiner has ruled that Tom Petty died of an accidental overdose, according to a statement from the Los Angeles County Medical Examiner. The Hall of Fame musician had taken several pain medications, including Fentanyl, oxycodone, and generic Xanax. Other medications included generic Restoril (a sleep aid) and generic Celexa (which treats depression).

The Heartbreakers, Bruce Springsteen, Stevie Nicks, and more pay tribute to a genius craftsman who never stopped believing in the power of rock & roll

The coroner’s office listed Petty’s official cause of death as “multisystem organ failure due to resuscitated cardiopulmonary arrest due to mixed drug toxicity,” noting the singer suffered from coronary artery atherosclerosis and emphysema.

Petty had been prescribed the drugs to treat emphysema, knee issues, and a fractured hip, his family said in a statement accompanying the results. Petty’s coronary artery disease had been a persistent problem throughout his final tour.

“Despite this painful injury, he insisted on keeping his commitment to his fans and he toured for 53 dates with a fractured hip and, as he did, it worsened to a more serious injury,” Petty’s wife Dana and daughter Adria wrote in the statement. “On the day he died, he was informed his hip had graduated to a full-on break and it is our feeling that the pain was simply unbearable and was the cause for his overuse of medication.”

Petty was found unconscious and not breathing at his Malibu home on October 2nd. He was rushed to a hospital where he was placed on life support. Although he had a pulse, doctors found no brain activity when he arrived and the decision was made to pull life support. He died hours later.

The singer had recently completed a 40th-anniversary tour with his band, the Heartbreakers. It was intended to be his “last trip around the country,” though he told Rolling Stone he wasn’t going to stop playing. “I need something to do, or I tend to be a nuisance around the house,” he said.

Petty said he’d experimented with cocaine over the years (“[It] was never a good look,” he told Men’s Journal) and drinking (“I didn’t like the taste or the buzz,” he said). But it was in the late Nineties, when he was in his late 40s and two decades after he’d become a superstar, that he developed an addiction to heroin after a bitter divorce from his first wife. “Tried to go cold turkey, and that wouldn’t work,” he said in author Warren Zanes’ book Petty: The Biography. “It’s an ugly fucking thing.” He sought out treatment for his addiction and remarried in 2001.

“Using heroin went against my grain,” Petty said in the book. “I didn’t want to be enslaved to anything. So I was always trying to figure out how to do less, and then that wouldn’t work. Tried to go cold turkey, and that wouldn’t work. It’s an ugly fucking thing.”

Since his death, several artists have paid tribute to Petty onstage. Country artist Jason Aldean dedicated some of his time as the musical guest on Saturday Night Live to sing “I Won’t Back Down.” Bob Dylan performed Petty’s “Learning to Fly” at a concert in Broomfield, Colorado. And Dave Matthews, Emmylou Harris, and others sang “Refugee” at a benefit show in Seattle. Petty’s Greatest Hits album subsequently made it to the Number Two spot on the Billboard chart after his death.

He was laid to rest on October 16th at a private service in Pacific Palisades, California.

Petty’s family said they hope the musician’s death leads to a broader understanding of the opioid crisis. “As a family, we recognize this report may spark a further discussion on the opioid crisis and we feel that it is a healthy and necessary discussion and we hope in some way this report can save lives,” they wrote. “Many people who overdose begin with a legitimate injury or simply do not understand the potency and deadly nature of these medications.”

Full Statement from Dana and Adria Petty

Our family sat together this morning with the medical examiner – coroner’s office and we were informed of their final analysis that Tom Petty passed away due to an accidental drug overdose as a result of taking a variety of medications.

Unfortunately, Tom’s body suffered from many serious ailments including emphysema, knee problems, and most significantly a fractured hip.

Despite this painful injury he insisted on keeping his commitment to his fans and he toured for 53 dates with a fractured hip and, as he did, it worsened to a more serious injury.

On the day he died he was informed his hip had graduated to a full-on break and it is our feeling that the pain was simply unbearable and was the cause for his overuse of medication.

We knew before the report was shared with us that he was prescribed various pain medications for a multitude of issues including fentanyl patches and we feel confident that this was, as the coroner found, an unfortunate accident.

As a family, we recognize this report may spark a further discussion on the opioid crisis and we feel that it is a healthy and necessary discussion and we hope in some way this report can save lives. Many people who overdose begin with a legitimate injury or simply do not understand the potency and deadly nature of these medications.

On a positive note we now know for certain he went painlessly and beautifully exhausted after doing what he loved the most, for one last time, performing live with his unmatchable rock band for his loyal fans on the biggest tour of his 40 plus year career. He was extremely proud of that achievement in the days before he passed.

We continue to mourn with you and marvel at Tom Petty and the Heartbreaker’s incredible positive impact on music and the world. And we thank you all for your love and support over the last months.

Thank you also for respecting the memory of a man who was truly great during his time on this planet both publicly and privately.

We would be grateful if you could respect the privacy of the entire Heartbreaker family during this difficult time.

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10/23/2023
BLUE BADGE PARKING PERMITS TO BE ROLLED OUT TO PEOPLE WITH HIDDEN DISABILITIES, GOVERNMENT PROPOSES

People with hidden disabilities could soon be entitled to blue badge parking permits under Department for Transport (DfT) plans. The Government said the proposals would make it easier for people with conditions such as dementia, Fibromyalgia, Lupus, and autism to travel to work, socialize, and access shops and services.

It is hoped the move – which would be the biggest change to the blue badge scheme since it was introduced in 1970 – would help create parity in the treatment of physical and mental health.

The DfT said councils have different interpretations of existing rules with only some recognizing hidden disabilities.

The new policy is designed to provide “clear and consistent” guidelines. Around 2.4 million disabled people in England have a blue badge.

This enables them to park free of charge in pay and display bays and for up to three hours on yellow lines, while in London they exempt holders from having to pay the congestion charge.

Around three out of four blue badge holders say they would go out less often if they did not have one, according to the DfT.

Transport minister Jesse Norman said: “Blue badges give people with disabilities the freedom to get jobs, see friends or go to the shops with as much ease as possible.

“We want to try to extend this to people with invisible disabilities, so they can enjoy the freedom to get out and about, where and when they want.”

The changes being put to an eight-week public consultation also include blue badge assessments being carried out by a greater variety of healthcare professionals who can spot if mental health is causing mobility issues.

Sarah Lambert, head of policy at the National Autistic Society, welcomed the proposal and said amending parking permit access could be “a lifeline” for many autistic people, who often do not qualify under current regulations.

Autistic people can suffer anxiety from not being able to park in a predictable place close to their destination, and some can “experience too much information” from the environment around them on public transport, Ms. Lambert said.

“We hope the Government will make this important change and we look forward to working with them to make sure that autistic people and their families benefit.”

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10/22/2023
Chronic Pain Patient Abandoned by Doctor Dies

This will be the first Christmas that Tammi Hale spends without her husband Doug in over 30 years.

The 53-year old Vermont man, who suffered chronic pain from interstitial cystitis, committed suicide in October after his doctor abruptly cut him off from opioid pain medication.

“His primary care provider kept trying to wean him off his opioid therapy, which worked at higher doses,” says Tammi. “My husband ran out (of medication) early a few times, so the doctor cut him off completely one day. Six weeks later he took his life as no medical establishment would treat his chronic pain.”

We’re telling Doug Hale’s story, as we have those of other pain patients who’ve committed suicide because their deaths have been ignored or lost in the public debate over the nation’s so-called opioid epidemic. Patients who were safely taking high doses of opioids for years are suddenly being cut off or tapered to lower doses. Some are being abandoned by their doctors.

“I believe it will get worse with time. The docs are simply more interested in not risking their licenses than in treating chronic pain,” Tammi wrote to Pain News Network in a series of emails about her husband’s death.

Depression and suicidal thoughts are common for many people living with chronic pain and illness. According to a recent survey of over a thousand pain patients, nearly half have contemplated suicide.

But the problem appears to have grown worse as physicians comply with the “voluntary” prescribing guidelines released in March by the Centers for Disease Control and Prevention, which have been adopted as law in several states. Many doctors now fear prosecution and loss of their medical licenses if they overprescribe opioids. Some have chosen not to prescribe them at all.

While federal and state authorities track the number of drug overdose deaths, no one seems to be following the number of patients who are dying by suicide or from cascading medical problems caused by untreated chronic pain. Some in the pain community call this “passive genocide.” Tammi Hale compares it to the Holocaust.

“The Nazis eliminated the sick and the weak first, right? Makes you wonder,” she says. “I realize my comments are harsh, but I believe the public needs to be aware of the dangers any one of us could be facing with this silent epidemic.”

Doctor Insisted on Weaning

Doug Hale began facing a life with intractable chronic pain in 1999 after a surgery left him with interstitial cystitis, a painful inflammation of the bladder. According to his wife, Doug tried physical therapy, antidepressants, epidurals, nerve blocks, TENS, cognitive behavioral therapy, and several different medications before finally turning to opioids for pain relief. High doses of methadone and oxycodone for breakthrough pain were found to be effective.

But a few years ago, Doug’s primary care provider (PCP) started urging him to wean to a lower dose.

“The PCP insisted on weaning. Although Doug clearly had documented malabsorption issues, the PCP persisted on weaning. The pressure to wean was unbelievable,” says Tammi.

“It came to a head in May of 2016. The PCP gave Doug one month to wean completely from 120mg/day of methadone and 20 mg/day of oxy. We knew this was impossible.”

Tammi says Doug checked himself into a 7-day detox program, where he was weaned to 40 mg of methadone a day. The doctor agreed to prescribe that amount, but it was not enough to relieve Doug’s pain. He started taking extra doses.

“He ran out a week early in late August. The PCP abandoned Doug, stating ‘I’m not going to risk my license for you. The methadone clinic can deal with you.’”

But the methadone clinic refused to treat Doug because they saw him as a chronic pain patient, not as an addict. “Had he turned to street drugs they could have treated him, but because he didn’t break the rules they couldn’t help,” Tammi explained.

Doug tried to detox at home, which Tammi calls a “brutal” experience. On October 10th, after being turned down by other healthcare providers, Doug went to his former doctor one last time to beg for help and was refused. The doctor said again that he didn’t want to risk his license.

“Doug left the office still thrashing in pain and despondent,” Tammi recalls. “The next day, my dear, sweet thoughtful husband of 32 years; a father, son, brother, uncle, and friend, well-loved by many, dragged a chair to a remote spot in our back yard. A spot we could not see from the house, the road, or by the neighbors.

“He shot himself in the head to escape his pain. He made sure we could still live in our home and not be plagued by gruesome memories. I just wish the medical establishment had an ounce of the compassion that he did.”

“Can’t take the chronic pain anymore. No one except my wife has helped me. The doctors are mostly puppets trying to lower expenses.”— Doug Hale

“Can’t take the chronic pain anymore. No one except my wife has helped me,” Doug wrote in a suicide note. “The doctors are mostly puppets trying to lower expenses, and (do not accept) any responsibility. Besides people will die and doctors have seen it all. So why help me.”

Tammi says she has been comforted by an outpouring of love and support from her family, friends, and community. Doug’s suicide surprised many.

“Doug did make vague references about suicide during the summer due to the desperation and pain. He was just such a tough guy, he survived so much that my reaction, and others after the fact, was no. Not Doug. He’s like the bionic man. Too much of a warrior to give up,” said Tammi.

“At his memorial, so many people commented on what an inspiration he was to them. To graciously bear the path of pain and his never-give-up attitude made them reevaluate their own daily issues. I guess you could say his legacy was love and to never quit.”

Tammi consulted with a medical malpractice attorney after Doug’s death, who told her the chances of winning a lawsuit against the doctor were slim. The cost of legal action would have also been prohibitive, after so many years of dealing with Doug’s medical expenses.

Tammi and Doug may never get their day in court, but she is determined to share his story in the hope that patients, doctors, and regulators learn from it.

“My promise to him was to share with others. He was thrown away like a piece of trash, but his life and the life of all humans are precious. All patients deserve to be treated respectfully,” she wrote. “Hopefully some changes will come in time before the holocaust grows too much larger.”

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10/19/2023
Doctors Beginning to Speak Out about Pain Patients Denied Opioids

It’s a trickle at present, but the conversation around chronic pain between doctors and patients is no longer one way only.

Over the past few months, the constant messaging suggesting chronic pain patients are dying in dramatically increasing numbers because of opioid overdoses has been questioned.

Understand, the messaging was indeed clever. Chronic pain patients weren’t directly and specifically named, but the messaging caused listeners and readers to believe it was pain patients whose lives were being shattered, or even ended, due to opioids.

Then a few of us in media began to ask questions, and immediately the anti-opioid medication messaging began to falter. Patients suffering hideously from non-stop pain willingly spoke about the horrific conditions of their lives.

They voluntarily shared longtime doctors who had prescribed opioid medication which made their lives at least livable were under pressure to cut dosages dramatically, with the objective to end prescribing altogether.

There is pressure from supervisory medical bodies and governments. Ontario ended coverage of opioids on January 1, 2017, and now the elderly on fixed incomes, battling constant vicious pain, are required to pay for their not inexpensive medications out of pocket.

I interviewed the Federal Minister of Health at her request. Dr. Jane Philpott was ineffective in making the case against opioids for pain patients. In fact, she repeatedly told me my questions were “fantastic” and “excellent.” The only reason I asked the questions is that they reflected the need for relief from pain that can destroy the quality of life.

Last weekend, Dr. Lynn Webster of Salt Lake City, Utah, past president of the American Academy of Pain Medicine and co-producer of The Painful Truth documentary revealed the anti-opioid medication crusade was undertaken by U.S. insurance companies, which we’re finding opioid prescriptions expensive to cover.

Today I’ll be speaking with Dr. Stephen Nadeau, a scientist and neurologist with over 30 years in a U.S. tertiary care center treating patients with non-malignant pain. Dr. Nadeau heard my interview with the health minister and chronic pain patients and will share his own views on the subject.

Back with me today as well is Dawn Rae Downton, a national journalist and chronic pain patient who has a euthanasia plan in place in the event her opioid medication is arbitrarily stopped. Downton recently wrote a Globe and Mail column about her Fentanyl use.

Marvin Ross, who writes on health matters for Huffington Post Canada, has been challenging politicians and their anti-opioid agenda for some time.

If you’re a chronic pain patient, doctor, or even a politician who cares about the crushing weight of never-ending massive pain, listen today and then speak out.

Living pain-free is a human right. Pain patients should not be reduced to pleading for help and meeting arrogance and indifference as a reply.

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10/15/2023
Gabapentin Raises Risk of Opioid Overdose

Another study is raising questions about the safety of the anti-seizure drug gabapentin, especially when it’s taken with opioid pain medication.

According to research published online in PLOS Medicine, combining gabapentin with opioid painkillers is associated with a significantly higher risk of dying from an opioid overdose than opioid use alone.

“Clinicians should consider carefully whether to continue prescribing this combination of products and when deemed necessary, should closely monitor their patients and adjust opioid dose accordingly,” wrote lead author Tara Gomes, Ph.D., principal investigator for the Ontario Drug Policy Research Network and an assistant professor at the University of Toronto.

Gomes and her colleagues analyzed data from 1,256 people in Ontario, Canada who died from opioid-related causes, and compared them with a control group of 4,619 people who also used opioid medication, but did not die of an opioid-related cause.

Overall, 12.3% of the people who died and 6.8% in the control group were prescribed gabapentin in the prior 120 days. After adjusting for additional risk factors, the researchers estimated that the combination of gabapentin and opioids was associated with a 49% higher risk of dying from an opioid overdose.

Although gabapentin is an anticonvulsant originally developed as a treatment for epilepsy, it is now widely prescribed for neuropathy and other chronic pain conditions, sometimes in combination with opioids.

Until now, no previous study had examined the risks of using gabapentin and opioid medication simultaneously, even though both are known to cause respiratory depression that can lead to an overdose.

“Our study has important implications for public health, particularly given the high degree of co-prescription. Almost 10% of patients treated with an opioid in our study also used gabapentin, while nearly half of patients treated with gabapentin were co-prescribed opioids,” said Gomes.

“Gabapentin is frequently used as an adjunct to opioids for neuropathic pain syndromes, but physicians may not be aware of the potential for respiratory depression with this drug; thus, increased awareness among patients and clinicians about the potential for a life-threatening interaction between these drugs is essential.”

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The researchers believe pregabalin, an anticonvulsant that acts similarly to gabapentin, may also raise the risk of overdose when taken with opioids. But they were unable to test their theory because of the limited use of pregabalin during the study period.

Both pregabalin and gabapentin are produced by Pfizer — under the brand names Lyrica and Neurontin — and are two of its top-selling drugs. Pfizer did not respond to a request for comment on the Canadian study.

A previous study linked pregabalin and gabapentin to an uptick in opioid overdoses in England and Wales. Some addicts believe the drugs can boost the “high” they get from heroin and other illicit substances.

Gabapentin is approved by the FDA to treat epilepsy and neuropathic pain caused by shingles. It is also prescribed “off-label” for depression, migraine, fibromyalgia, and bipolar disorder. About 64 million prescriptions were written for gabapentin in the U.S. in 2016, a 49% increase since 2011.

Pregabalin is approved by the FDA to treat diabetic nerve pain, fibromyalgia, epilepsy, post-herpetic neuralgia caused by shingles, and spinal cord injury. It is also prescribed off-label to treat a variety of other conditions.

The CDC’s opioid prescribing guidelines recommend both pregabalin and gabapentin as alternatives to opioids, without saying a word about their potential for abuse or side effects. Pfizer has signed agreements with local prosecutors in Chicago and Santa Clara County, California to support the CDC guidelines and withdraw funding from patient advocacy groups and non-profits that question their validity.

A recent commentary in The New England Journal of Medicine warned that gabapentinoids — the class of medication that Neurontin and Lyrica belong to — are being overprescribed.

“We believe… that gabapentinoids are being prescribed excessively — partly in response to the opioid epidemic,” wrote Christopher Goodman, MD, and Allan Brett, MD. “We suspect that clinicians who are desperate for alternatives to opioids have lowered their threshold for prescribing gabapentinoids to patients with various types of acute, subacute, and chronic noncancer pain.”

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10/08/2023
21 Little Things Partners Have Done for Their Loved Ones With Chronic Illness

Sometimes all it takes is a simple gesture from someone you love to help you feel a little bit better.

We asked people who live with chronic illnesses to share one (seemingly) small thing their partner has done for them that touched their hearts.

This is what they had to say:

1. “[My partner] reminds me daily I am wanted and needed and not just a burden.” — Ally Small

2. “I often feel bad that I can’t do ‘normal couple things’ with him like walking or standing much, going out when our friends do or even holding hands properly, so we often struggle to find ‘things to do other than just hanging around (which is lovely in its own right). One day he suggested we could go to the local nature preserve and he could wheel me around. He didn’t suggest we go for a walk (which would either make me feel bad because I would have to tell him I can’t walk that much or we would both know that ‘walking’ really meant ‘rolling’) but actually used the proper wording. He didn’t know how much that simple syntax meant to me until a few weeks later. It was at that moment I realized that he just ‘got it and understood me more than either of us thought. It was the perfect example of automatic acceptance.” — Katie Taaffe

3. “My husband is a research scientist. We were together 11 years before I got my diagnosis. When we finally had a name for what plagues me (severe rheumatoid arthritis) he read all of the medical literature available and [now] attends all of my medical visits including exams but doesn’t say a word unless I ask him for his opinion. I once joked he was more of an expert about my illness than I was and he dropped what he was doing, wrapped me in a hug, and said, ‘You’re my hero. I’m just your biggest fan.’” — Joy Hanford

4. “My boyfriend came home from the marines when I was admitted for fistulas, and he slept on the floor the whole week so he could be with me in the hospital.” — Grace Shockey

5. “My boyfriend has been my partner for going on seven years and caretaker for four years. He gets my medication for me every night. He brings juice and keeps track of all of my different pills for different nights.” — Katelyn Burd

6. “My partner does little things every day. He helps me keep my dignity by not [making me] have to ask for help when I need it most but am too stubborn to ask.” — Emma-Jayne Tucker

7. “I have ulcerative colitis so spend a lot of time in the bathroom. My husband wanted to give me something I could put all around the house to look at and feel better and know he’s there for me when I’m not feeling well. He bought a dozen little jars with a piece of chalkboard on the front. He wrote our initials on the chalk and put a folded-up copy of the lyrics to our wedding song inside each bottle. There is now a bottle in every bathroom, the kitchen, and all the bedrooms. It makes me smile every time.” — Heather Hecht

8. “My husband comes to every appointment with me to get a better understanding of how my illness really affects me. When he knows I’m nervous, he says something to make me laugh, and when he can tell I’m scared, he reaches out to hold my hand. His little gestures touch my heart every time.” — Rebecca Lalk

9. “I live with multiple sclerosis, major depressive disorder, anxiety disorder, and post-traumatic stress disorder (PTSD). My [husband] goes to work long before I wake. Before he leaves he often texts me links to funny or cute animal videos on YouTube to cheer me up in case I am wakened by a nightmare or an anxiety episode. It feels like his proactive strategy for keeping me laughing when I often want to cry.” — Shannon Gardner

10. “He calls me every day on his lunch break. If he knows I am having a rough day (or he just senses it) he will either text or call me at least every hour.” — Shelly Jones

11. “I suffer from chronic migraines, and at times I live in my dark, cold bedroom for days at a time. My husband of 19 years has done numerous little things that have touched my heart during my attacks, however, the one I love the most is when he climbs in bed and holds me. He doesn’t ask me how I am feeling because he already knows, he doesn’t try to fix my pain because unfortunately he cannot… he is simply there, loving me unconditionally.” — Robyn Eastwood

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12. “We’d been walking for a while, and he realized by the end of the walk I was starting to lean on him. I try my best not to most of the time, but I just didn’t realize it that night. When he felt me putting my weight on him, he asked if I was OK. I brushed it off, but he could tell I was really hurting. He picked me up. I vigorously protested because I was so embarrassed. I never wanted him to see my weakness. Not only did he accept me, but he didn’t look at me any differently. Not even for a second. He carried on the conversation we were having and carried me all the way home.” — Destin Shyann

13. “He told me, while I was mid-migraine, that he was not leaving. He said, ‘I need to make sure you are going to be OK.’” — Kristin Marie Kaskeski

14. “When I was hospitalized for the first time my husband packed me a picnic tea party complete with a teapot, my best teacups, and even a pretty tablecloth. We also wrote letters to each other every day and exchanged them at night during visiting hours. He’s also done really hard things for me too. Like when I would call him on the first night of my hospitalizations begging for him to take me home, weeping, and he would say he loves me but no, it breaks his heart, but I have to do this. Through all of this, he’s my hero.” — Claire Nieuwoudt

15. “I recently had one very good day where I had managed to shower, dry my hair, get dressed, and put on makeup. I joked, ‘I’m pretending to be a normal person today.’ He wrapped his arms around me, kissed me on the forehead, and said, ‘Just be a normal you.’ It told me he accepted me for who I am, illness and all.” — Jen Keating

16. “He lets me ask for help. He knows it makes me feel bad if he swoops in every time I struggle to open something or pick something up. He’s there when I need him, but he lets me make that call and that means so much.” — Emily Matejic Souders

17. “He gave up school and a fantastic job to be my 24/7 caregiver — riding out each seizure with me, carrying me to the bathroom, bathing me, taking me to each appointment, etc. He’s given up everything to fight for me.” — Melody Hitzeroth

18. “[My partner] washes my hair and ties my shoes when I don’t have the energy. I have multiple sclerosis (MS) and am seven months pregnant. Small things add up.” — Jordann Chitty

19. “He will just hold me. Any time I am symptomatic he will just hold me and it’s enough to help improve my mood and make everything seem tolerable and manageable. I don’t know if I would be doing as well as I am without him.” — Hallie Ervin

20. “[My partner will] ignore it, but not me. I’ll be doubled over, and she’ll ask if I’m good, and if I say, ‘Yes just dealing,’ she’ll leave it at that. She won’t hover or get in my way. She just keeps on about her business, still talking and interacting as much as she sees I can stand.” — Loretta Woods

21. “He believed me and helped fight for answers.” — Jennifer Peterson

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10/06/2023
Jeff Sessions Says People Should ‘Tough It Out’ and Take Aspirin Instead of Opioids

U.S. Attorney General Jeff Sessions recently shared his idea for solving the opioid crisis: aspirin, sleep, and less marijuana.

Speaking at an event in Tampa on Tuesday to celebrate Ronald Regan’s birthday, Sessions said his goal for 2018 is to see a greater decline in the number of opioids prescribed (he said last year there was a 7 percent decline).

“We think doctors are just prescribing too many. Sometimes you just need two Bufferin or something and go to bed,” Sessions said. “These pills become so addictive.”

Bufferin is an over-the-counter aspirin with an antacid. Sessions said according to the Drug Enforcement Agency, a “huge percentage” of heroin addiction starts with opioid prescriptions.

“That may be an exaggerated number, they had it as high as 80 percent. We think a lot of this is starting with marijuana and other drugs too,” Sessions said. “But we’ll see what the facts show, but we need to reduce the prescription abuse and hopefully reduce the addiction that’s out there.

On Wednesday, Sessions doubled down on his previous remarks during a speech to Tampa law enforcement.

“I am operating on the assumption that this country prescribes too many opioids. People need to take some aspirin sometimes and tough it out a little bit,” Sessions said, then cited White House Chief of Staff John Kelly as someone who refused to take painkillers after surgery on his hand. “You can get through these things.”

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Sessions’ remarks were met with criticism from the chronic pain community, who explained that pain relief isn’t always as simple as “taking aspirin and going to bed.”

AS I’M ONE OF THOSE CHRONIC PAIN SUFFERERS, COMPLEX REGIONAL PAIN SYNDROME (CRPS), ALLOW ME TO ADDRESS THE OBVIOUSLY IGNORANT AG, WHO HAS NO IDEA WHAT HE’S TALKING ABOUT!

CHRONIC PAIN SUFFERERS ARE SOME OF THE TOUGHEST PEOPLE THAT YOU WILL EVER ENCOUNTER…

LITTLE JEFF SESSIONS HAD OBVIOUSLY NEVER BEEN IN CHRONIC PAIN. LET HIM LIVE A WEEK WITH WHAT I ENDURE DAY IN AND DAY OUT. HE’LL BE SINGING A DIFFERENT TUNE. HE SHOULD LEGALIZE MARIJUANA FOR PEOPLE IN CHRONIC PAIN SO THEY CAN WEAN OFF OF OPIODS.

I MAY NOT PLAY A DOCTOR ON TV, BUT I AM A REAL ONE, AND I THINK
JEFF SESSIONS IS THE WORST MAN IN AMERICA TO BE GIVING MEDICAL ADVICE OR CREATING HEALTH CARE

Sessions’ comments are at odds with data on opioid use and addiction. The opioid crisis claimed approximately 63,000 lives in 2016, according to data from the National Center for Health Statistics. However, synthetic opioids like fentanyl caused about a third of these deaths — which have increased 88 percent per year since 2013. Heroin caused about a fourth, and prescription opioids caused 23 percent, down from 26 percent in 2009.

Studies show the majority of people prescribed opioids do not become addicted (only between 1 and 12 percent develop an addiction). And a 2017 study found that 51.9 percent of people entering treatment for opioid use disorder started with prescription opioids, which is down from 84.7 percent in 2005. Among those, research has found that 75 percent of all opioid misuse starts with medication not prescribed to them.

Research has also suggested that marijuana is correlated with lower opioid use. Studies have found that states with legal marijuana dispensaries have fewer opioid deaths and that chronic pain patients who use marijuana use fewer opioids.

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10/05/2023
Exploring Ways To Treat Pain Without Addiction As U.S. Opioid Crisis Worsens

Addiction to opioids often begins in the doctor’s office. These drugs are typically the only option to manage pain after an operation or in patients with serious injuries. They’re also frequently prescribed to patients with chronic pain, and it’s these patients who are most at risk for opioid addiction.

Ted Price is an associate professor of neuroscience at the University of Texas at Dallas. His work focuses on the molecular mechanisms that cause pain to persist even after the injury that triggered it has healed.

What he and his colleagues have discovered is that a buildup of a particular substance between neurons plays a major role in our experience of ongoing pain. That new understanding could help lead to a new treatment for chronic pain that leaves addictive drugs out of the equation altogether.

On KERA’s Think, he talks about the future of chronic pain research — and what it might mean for the U.S. opioid crisis, which claimed more than 50,000 American lives in 2016.

The signals behind chronic pain

Chronic pain is defined as pain that persists at least three to six months beyond the period of normal healing, according to NIH’s National Center for Complementary and Integrative Health.

It can go beyond acute feelings of pain. Chronic pain can result in a host of problems including cognitive disorders, clinical depression, and hair loss. The NIH reports about 11 percent of American adults to suffer from this condition.

“For many, it’s very disturbing. Even when they’re not doing anything, they’ll feel this stabbing or burning pain coming from the limb,” Price says. “Normally, pain is a danger signal to the brain that something’s wrong, but when they look, nothing looks wrong.”

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When we feel pain, nerve cells called “nociceptors” are activated and send that signal to the brain. When working normally, this process is helpful: It tells you that you’re hurt and you need to protect yourself. After a severe injury or surgery, nociceptors fire frequently and are meant to stop once you’ve healed.

But in the roughly 30 percent of patients who develop chronic pain, nerve cells rewire themselves before healing, which can cause them to fire at random, months after the injury is gone.

Price’s research focuses on this “rewiring” process, called “neuroplasticity.” It’s the idea that the nervous system can “rewire” itself throughout our lives to help us adapt to our surroundings.

“We were originally looking at how brains learn. We had this idea that pain is a learning phenomenon, too. Synaptic plasticity, or the cellular process of learning, is common to things that are beneficial and things that aren’t.”

There are some really complex genetic factors at play,” Price says, “but it really is a plasticity disease.”

Opioids, tolerance and chronic pain

Chronic pain, like opioid abuse, is often stigmatized. Price argues it’s not as important to try and quantify pain as it is to treat it more effectively. Chronic pain often affects every aspect of people’s lives. In that sense, the chronic pain epidemic and the opioid crises are one and the same.

“There’s no question that opioids are effective for acute pain,” Price says, “but the issue that we have right now is that the drugs that we have to treat chronic pain don’t work very well and the drugs that are efficacious are incredibly dangerous.”

While opioids are still often necessary after surgeries, Price says there’s evidence that they may actually increase the likelihood of chronic pain after surgery.

“We need to have better, non-addictive therapeutics that are not only going to treat acute pain but also prevent the development of chronic pain,” he says. “When you take a drug more frequently over time, it requires a larger dose to achieve the same efficacy. This will actually happen in almost everyone taking opioids.”

Tolerance is most problematic when people begin taking opioids again after a period without, Price says. Many chronic pain patients experience pain after a long period following surgery. They may take what used to be their normal dose of opioids. In many cases, this dose is enough to induce an overdose, as they may have lost their tolerance, he says.

The leap from the lab to the pharmacy

There is no cure yet. But Price says that science is very mature.

The leap from preliminary research to clinical trials is difficult to navigate for many scientists, especially those in an academic setting. So Price, and many researchers like him, are starting their own companies to try and bring their research into realization on their own.

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“If … there is one thing I try to convey to [my colleagues] … there really isn’t anybody else who is going to be quite as passionate about [turning] your ideas into medications as you are. […] It’s a steep learning curve … but it’s very exciting and extraordinarily rewarding.”

I would argue [we’re] completely failing in trying to treat this,” Price says. “There are some interesting treatments [for migraines] which may be approved by the FDA this year, but we need to see successes like this across the board.”

Price stresses the need to conduct clinical trials as early as safely possible so researchers don’t waste time on disproved hypotheses and patients can get treatments sooner. Price points to McGill University, in Montreal, as a good example. He attributes the success of the Canadian university to its emphasis on collaboration between basic science researchers and clinical trial labs.

Treating chronic pain takes a multimodal approach, Price says. Treatments should go beyond painkillers and other medications; for example, exercise, whenever possible, can help dramatically. Managing pain, much like managing an epidemic, requires creativity and collaboration.

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10/04/2023
Chronic pain patients need services beyond just opioids: B.C. advocate

People who live with chronic pain need options beyond prescription opioids, and it’s up to the British Columbia government to provide more services such as physiotherapy, says the head of a group that supports patients and their families.

“There has really been a lack of any appropriate response to chronic pain in our province and in our country,” said Maria Hudspith, executive director of Pain BC, the only non-profit society in Canada to bring together clinical experts and policy-makers to work on chronic pain management initiatives.

Besides painkillers, patients must have access to physical therapy and psychological support but wait for lists stretch from one to three years at the few specialized pain clinics in the province, she said.

“We’ve seen this overreliance on the prescription pad as the only tool in the toolbox,” Hudspith said. “Some people may become dependent on the medication in order to function and some of those people may become addicted.”

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One in five people in B.C. lives with pain that can be relentless and crippling but she said some communities have no specialized healthcare providers for patients who need intervention after an injury or surgery, for example.

A lack of dedicated pain services means patients make more doctors visits and may require more surgeries, resulting in high healthcare costs and poor quality of life, Hudspith said.

“There’s a growing recognition that this is a huge problem that is really, in any way, at the root of a lot of issues that we’re seeing.”

Hudspith said Pain BC has been in discussions with the provincial government to expand services.

Neither the Ministry of Mental Health and Addictions nor the Health Ministry could provide any information when the provincial government was contacted for comment.

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10/02/2023