Welcome to this month's edition of Comp Medical News. Doctor burnout, naloxone access, and cannabis are your headlines for July 2018.
Victims of Opioid Crisis Experiencing Difficulties Obtaining Naloxone
Kaiser Health News looked into the cost and access issues surrounding naloxone, the opioid reversal drug that can save lives but costs close to a hundred dollars for two doses. First responders are being issued directives from the federal government and receiving training in naloxone administration, but it remains a prescription drug in most states. Further, addicts that lack health coverage or are reluctant to seek medical attention remain at risk. More than a dozen U.S. senators have signed a letter urging Health and Human Services Secretary Alex Azar to negotiate with drug companies to lower the price of naloxone. Read more here.
FDA Releases Statement on “Balancing” Chronic Pain and Diversion Risk
The FDA held a Patient-Focused Drug Development meeting yesterday, to gather additional viewpoints directly from adult and pediatric patients living with chronic pain. They were asked to share their perspectives on the impact of chronic pain on their everyday lives; treatment approaches using medications such as opioids, acetaminophen, non-steroidal anti-inflammatory drugs, antidepressants, as well as other medications; and non-pharmacologic interventions or therapies, including medical devices that can deliver local analgesia and reduce or obviate the need for systemic therapy. Read more here.
Cannabis Not Effective at Treating Pain and Anxiety in MAT Patients
A paper published in Addictive Behaviors casts doubt on the efficacy of using marijuana to treat some symptoms associated with medication assisted treatment (MAT) in opioid use disorder. The study included 150 patients with a diagnosis of opioid use disorder taking buprenorphine or methadone daily. More than half the patients had used cannabis during the past month, and more than one-fourth had used it at least 20 times during that period. Many patients undergoing MAT had high levels of pain, anxiety and depression. These symptoms did not correlate with cannabis use. Rather, frequent cannabis use strengthened the relationship between pain and mood disorders. Read more via Pain Medicine News here.
Psychotherapy Underutilized as Chronic Pain Treatment
New numbers suggest that psychotherapy, though it is an effective treatment for nonspecific chronic pain, is not employed as often as it should be. There are 100 million Americans who suffer from chronic pain, and an unknown number complain of back pain, neck pain, fibromyalgia symptoms, or other forms of pain that have no diagnosed physical cause. Efforts by pharmaceutical companies (some of which led directly to the opioid crisis) encourage doctors and patients to use opioids or other pills as the first line treatment, even as cognitive behavioral therapy shows more promise without side effects. Read more from Vox here.
Israeli Company Gains US Approval for Non-opioid Painkiller Trial
Israeli pharmaceutical company PainReform has received approval from the FDA to begin late-stage clinical studies for a painkiller that does not depend on current opioid formulations. According to Reuters, PainReform said the FDA had given it a green light to carry out two Phase 3 trials on its product PRF-110, which prolongs the action of a local analgesic called ropivacaine. The drug is administered during surgery, before the wound is sutured. An earlier study showed PRF-110 was able to relieve pain for up to 72 hours – 10 times longer than the current standard of care. Read more here.
New Abuse-Deterrent Opioid Rejected by FDA
An FDA panel voted against the approval of extended-release (ER) oxycodone capsules (Remoxy ER, Pain Therapeutics), an abuse-deterrent opioid formulation. A joint meeting of the FDA's Anesthetic and Analgesic Drug Products Advisory Committee and Drug Safety and Risk Management Advisory Committee saw the two groups vote 14 to 3 against the use of ER oxycodone for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment. Read more via Pain Medicine News here.
The Atlantic: Is Tech in Doc's Offices Accelerating Burnout?
Pressure from electronic records efforts, retirement, and other bureaucratic tasks are pondered in a new Atlanticpiece that addresses “burnout” (and how it increases cost of care) in the medical profession. Read it here.
ABOUT THE AUTHOR
Nina Luckman is the writer and editor of New Orleans-based Louisiana Comp Blog, which launched in 2014 and is sponsored by LCI Workers' Comp. She is originally from Pennsylvania but lived most of her life in Florida. Her credentials include a Bachelor's and a Master of Arts degree from Tulane University, both in the study of English Literature.
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