NIH Director Dr. Francis Collins is pushing for the development of more specific tools for the assessment of pain, and measures of brain activity including electrodes and magnetic resonance imaging as well as pupil reactions have been studied as markers of pain. But no single pain signature is likely to be found, and the patient's voice will remain important, said David Thomas of the National Institute on Drug Abuse.
A clinical trial presented at the 2018 Palliative and Supportive Care in Oncology Symposium found that use of ePAL, a smartphone app using artificial intelligence-based algorithms, decreased pain and pain-related hospital admissions in a group of patients with metastatic, solid-organ cancers. Joseph Rotella, chief medical officer at the American Academy of Hospice and Palliative Medicine, commented that "[a]pplications like this may work on a number of levels, by engaging patients in their own care, providing them with helpful feedback and coaching, and alerting their health care teams to emerging problems."
Mindfulness studies have found its practice can be helpful against anxiety, depression and physical pain, but there's no indication it's a better alternative to other treatments, writes Chadwick Matlin, who is a skeptic. While mindfulness might be overstated by its enthusiasts, Matlin says studying the issue reminded him "that one can overcommit to skepticism, just as one can overcommit to certainty."
Many patients with cancer have lacked effective pain control since a parenteral opioid shortage was announced in February 2018, and data presented at the 2018 Palliative and Supportive Care in Oncology Symposium shows significantly increased inpatient treatment of pain and pain-related problems. Parenteral opioid prescribing by oncologists has decreased, and according to Dr. Joseph Rotella, chief medical officer for the American Academy of Hospice and Palliative Medicine, other opioid administration may not be as effective as parenteral for initially controlling pain.
Unrealistic expectations regarding pain relief contribute to the current opioid crisis, as do the cost of pain treatments, lack of physician training, and the nature of pain. In addition to measures such as limiting the number of opioids prescribed, these matters must be addressed if we are to be effective in battling opioid addiction, write Dr. Mahmud Ibrahim and Dr. Linda Girgis.
A study published in JAMA Network Open found that the number of opioid prescriptions written or dispensed to small animals at Penn Vet's Ryan Hospital rose by 41% from 2007 through 2017, while the number of pet visits rose by 13%. Changes in pain management protocols likely influenced the trend, but it's also possible some of those prescriptions were diverted for human misuse.
APS is giving you a second opportunity to share your findings with the pain science community at the Scientific Meeting, April 3-6. Submit your poster abstract and present your research to your colleagues in science and treatment from all over the field of pain. The submission portal closes January 17 at 11:59 PST. Learn more.
The APS 2019 Scientific Meeting brings together the best and brightest professionals in the pain community in Milwaukee, Wis., April 3-6. The meeting will focus on the theme, "Combating the Opioid Epidemic through Innovations in the Treatment of Pain." Early bird registration ends January 31. Learn more.
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