Category Archives: Pain Medicine

Most Americans say they have a personal tie to prescription drug abuse



By Lisa Gillespie

The growing abuse of prescription painkillers now touches home for a majority of Americans, according to a poll released Tuesday.

One in three say either they have been addicted to painkillers or they have known a family member or close friend who was.

More than 56 percent of the public say they have a personal connection to the issue, reports the latest monthly tracking poll of the Kaiser Family Foundation.

That share includes those who say they know someone who died from a painkiller overdose, have been addicted themselves or know someone who has and those who know someone who took painkillers not prescribed to them, the poll’s results show. (KHN is an editorially independent program of the Foundation.)

Details from the poll:

— 16 percent say they know someone who has died and 9 percent say that person was a close friend or family member.

— 27 percent say either they have been addicted to painkillers or they have known a family member or close friend who was.

— 63 percent of whites say they have a personal connection to the abuse of prescription painkillers compared with 44 percent of blacks and 37 percent of Hispanics.

Half of those surveyed rank prescription painkiller and heroin abuse as a top priority for their governor and legislature, behind improving public education and making health care more accessible and affordable, which drew 76 percent and 68 percent shares, respectively.

Sixty-two percent of those polled said the drug Naloxone, which can reverse an overdose and is handed out in some states without a prescription and for little or no cost, should only be available via prescription.

Efforts to reduce painkiller abuse would be at least somewhat effective, many Americans say. Providing treatment for addicts is cited by 85 percent, monitoring doctors’ prescribing habits by 82 percent and encouraging people to dispose of leftover medication by 69 percent.

Kaiser’s tracking poll was conducted Nov. 10 to 17 among 1,352 adults.The margin of error for the full sample is +/- 3 percentage points.

Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.

khn_logo_lightKaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.


From pills to pins: Oregon is changing how it deals with back pain

kfv-oregon-pain-3-570 (1)

Doris Keene (right) at Portland’s Quest Center for Integrative Health. (Photo by Kristian Foden-Vencil/Oregon Public Broadcasting)

By Kristian Foden-Vencil
Oregon Public Broadcasting

When Portland resident Doris Keene raised her four children, she walked everywhere and stayed active. But when she turned 59, she says, everything fell apart.

“My leg started bothering me. First it was my knees.” She ignored the pain, and thinks now it was it the sciatic nerve acting up, all along. “I just tried to deal with it,” Keene says.

But eventually, she went to a doctor who prescribed Vicodin and muscle relaxants. In 2012, about one in four Oregonians received an opioid prescription – more than 900,000 people. The state currently leads the nation in nonmedical use of opioids. And about a third of the hospitalizations related to drug abuse in Oregon are because of opioids.

Keene says the drugs helped her, but only to a degree. Continue reading


Pain by the numbers

 Illustration of the pain pathway in René Descartes' Traite de l'homme (Treatise of Man) 1664

Illustration of the pain pathway in René Descartes’ Traite de l’homme (Treatise of Man) 1664

By Rachel Gotbau

In one of the largest population studies on pain to date, researchers with the National Institutes of Health estimate that nearly 40 million Americans experience severe pain and more than 25 million have pain every day.


Those with severe pain were more likely to have worse health status, use more health care and suffer from more disability than those with less severe pain. Continue reading


Pain patients say they can’t get medicine after crackdown on illegal Rx drug trade


Lesley Young testified that she has driven 100 miles to try to find a pharmacy that would fill painkiller prescriptions for her husband Chris. (Photo by Jessica Palombo/For KHN)

By Rachel Gotbaum

The accident happened 10 years ago when Chris Young was 35.

He owned a salvage yard in Maui, Hawaii, and his employee had hoisted a junker on a machine called an excavator when the hydraulics gave out.

The car fell on him from above his head, smashing his spine.

“He was crushed accordion-style,” says his wife Lesley.

The accident left Young with a condition known as “partial paraplegia.” He can’t walk and he needs a wheelchair, but he does have some sensation in his legs. Unfortunately for Young, that sensation is often excruciating pain.

“It feels like electric shocks, like lightning bolts going down my legs. And when it gets down to the bottom, it feels like someone is driving a big metal spike up my legs,” says Young.

To control the pain, Young, who has since moved to Florida, needs high doses of narcotic painkillers, but he can’t always fill his doctor’s prescription.

He is not alone. In what may be an unintended side effect of a crackdown on prescription drug abuse, Young and other legitimate chronic pain patients are having increasing trouble getting the medicine that allows them to function on a daily basis. Continue reading


The gray areas of assisted suicide

jd-falk-2-570 (1)

When J.D. Falk was dying of stomach cancer in 2011, his wife says doctors would only talk about death in euphemisms. (Photo: courtesy of Hope Arnold)

By April Dembosky, KQED

SAN FRANCISCO — Physician-assisted suicide is illegal in all but five states. But that doesn’t mean it doesn’t happen in the rest. Sick patients sometimes ask for help in hastening their deaths, and some doctors will hint, vaguely, how to do it.

This leads to bizarre, veiled conversations between medical professionals and overwhelmed families.

Doctors and nurses want to help but also want to avoid prosecution, so they speak carefully, parsing their words. Family members, in the midst of one of the most confusing and emotional times of their lives, are left to interpret euphemisms.

Doctors and nurses want to help but also want to avoid prosecution, so they speak carefully, parsing their words.

That’s what still frustrates Hope Arnold. She says throughout the 10 months her husband J.D. Falk was being treated for stomach cancer in 2011, no one would talk straight with them.

“All the nurses, all the doctors,” says Arnold. “everybody we ever interacted with, no one said, ‘You’re dying.’”

Until finally, one doctor did. And that’s when Falk, who was just 35, started to plan. He summoned his extended family. And Hope made arrangements for him to come home on hospice. Continue reading


Most states list deadly methadone as a ‘preferred drug’


465px-Methadone.svgBy Christine Vestal

The federal government has been issuing warnings about the dangers of methadone for nearly a decade.

Two years ago, states started removing it from their Medicaid “preferred drug lists.” (Joe Amon/Getty Images)

As prescription drug overdose deaths soar nationwide, most states have failed to take a simple step that would make it harder for doctors to prescribe the deadliest of all narcotics.

Methadone is four times as likely to cause an overdose death as oxycodone, and more than twice as likely as morphine, yet as many as 33 states make it easy for doctors to prescribe. 

Methadone overdoses kill about 5,000 people every year, six times as many as in the late 1990s, when it was prescribed almost exclusively for use in hospitals and addiction clinics where it is tightly controlled.

It is four times as likely to cause an overdose death as oxycodone, and more than twice as likely as morphine. In addition, experts say it is the most addictive of all opiates.

Yet as many as 33 states make it easy for doctors to prescribe the pain medicine to Medicaid patients, no questions asked. Continue reading


Narcotic Painkillers in Pregnancy Common, Harmful to Baby: Study – WebMD


Blue Pregnant BellyUse of prescription narcotic painkillers is common in pregnancy and increases the likelihood a baby will be born small or early, or go through painful drug withdrawal, a new study finds.

These prescription painkillers, also called opioids, include drugs such as hydrocodone (Vicodin), oxycodone (Oxycontin), codeine and morphine.

Nearly 30 percent of the Tennessee mothers-to-be in the new study used at least one of these drugs while pregnant, and the associated risks went up if they also smoked or took antidepressants.

via Narcotic Painkillers in Pregnancy Common, Harmful to Baby: Study – WebMD.


Too little, too late for many New Yorkers seeking hospice


By Fred Mogul, WNYC

Sandra Lopez and her Chihuahua, Coco, were inseparable. He followed her everywhere, and kept Lopez’s mood up when she was in pain – which was often.

On Oct. 15, Lopez, died at age 49 of pancreatic and vaginal cancer that had slowly spread throughout her body over two years. She left behind a 15-year-old daughter and little Coco. But with hospice care, she spent her last weeks where she wanted to be — at home, with her pain under control.

Sandra was in and out of the hospital in 2014, but for the months she was home, a hospice nurse from Metropolitan Jewish Health System visited once a week to help manage the pain, backed up by a 24-hour, nurse-staffed phone line that Lopez called often.

“Some days the pain is so excruciating,” she told me in August from the couch in her Brooklyn apartment, “that the pain overrides the medication.”

But despite evidence that hospices can greatly relieve discomfort, extend life and save money, and despite a generous hospice benefit available through both Medicare and Medicaid, relatively few people in New York take advantage of it, compared to elsewhere in the country.

Continue reading


Cambia gives its largest grant ever to UW Medicine: $10 million for palliative care – Puget Sound Business Journal

Dr. Randy Curtis, right, director of the UW Palliative Care Center of Excellence.

Dr. Randy Curtis, right, director of the UW Palliative Care Center of Excellence.

The grant is Cambia’s largest ever given to any organization and will come in four separate parts, creating three endowments totaling $8 million and $2 million dedicated to immediately improving care at the center.

via Cambia gives its largest grant ever to UW Medicine: $10 million for palliative care – Puget Sound Business Journal.


Vicodin, some other pain meds will be harder to get – DEA


Patients who use drugs containing hydrocodone as a pain reliever or cough suppressant are going to have to jump through more hoops to get them starting next month.

The Drug Enforcement Administration is reclassifying so-called “hydrocodone combination products” (HCP) from Schedule III to Schedule II under the Controlled Substances Act, which will more tightly restrict access. Vicodin, for example, is an HCP because it has hydrocodone and acetaminophen.

The final regulation, which takes effect Oct. 6, will mean that patients generally must present a written prescription to receive the drug, and doctors will no longer be able to call in a prescription to the pharmacy in most instances.

Many patients with painful chronic diseases, including cancer, take hydrocodone combination products

.The regulation is a response to the widespread misuse of prescription pain killers.

In an emergency, doctors will still be able to call in a prescription, according to the new rule. And although prescription refills are prohibited, a doctor can, at his discretion, issue multiple prescriptions that would provide up to a 90-day supply.

These measures don’t satisfy consumer advocates or pharmacists who are opposed to the new rule. Continue reading


Women’s health – Week 49: TMJ


tacuin womenFrom the Office of Researcher on Women’s Health

Temporomandibular joint (TMJ) and muscle disorders are a group of conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement.

Some estimates suggest that TMJ disorders affect over 10 million Americans and appear to be more common in women than men.

The exact cause of TMJ is not clear. Trauma to the jaw or temporomandibular joint plays a role in some TMJ disorders but, in most cases, symptoms seem to start without obvious reason.

A variety of symptoms may be linked to TMJ disorders. Pain in the chewing muscles and/or jaw joint is the most common symptom. Continue reading


Medicare experiment could signal sea change for hospice


Diane Meier 176By Michelle Andrews
KHN / JUL 29, 2014

Diane Meier is the director of the Center to Advance Palliative Care, a national organization that aims to increase the number of palliative care programs in hospitals and elsewhere for patients with serious illnesses.

Meier is also a professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City.

We spoke about a recently launched pilot program under the health law that allows hospice patients participating in the pilot to continue to receive life-prolonging treatment. This is an edited version of that conversation.

Q. There’s a lot of confusion about how hospice care differs from palliative care. Maybe we should start by clearing up what those terms mean. Continue reading