Chronic pain research in 2019 has delved even deeper than before into topics that affect everyone, including those who don’t suffer from chronic pain. This year, researchers examined the ongoing challenges with opioids, who feels pain (and how they remember it), and many other topics. Here are 13 fascinating findings from chronic pain research in 2019.
1. The opioid epidemic costs U.S. state and federal governments nearly $38 billion
The human cost of opioid use and abuse in the U.S. is staggering. Now hard data has emerged that measures the cost in dollars. Researchers at Penn State have found that the loss of tax revenue and income due to opioids has reached nearly $38 billion between 2000 and 2016.
The state with the most lost income was Pennsylvania, with just over $638 million in lost income and sales tax.
The point of the study, notes Joel Segel, assistant professor of Health Policy and Administration, is not to focus on the loss of dollars but to reframe the treatment discussion:
“This is a cost that was maybe not thought about as explicitly before, and a cost that governments could potentially try to recoup,” Segel said. “Instead of focusing on the cost of treating people with opioid use disorder, you could think about it in terms of a potential benefit to getting people healthy, back on their feet, and back in the workforce.”
2. Opioid use is fueling a dramatic rise in suicide rates
A new review and analysis of research completed by the University of Michigan found that suicide and death by drug overdose have doubled in the past 17 years. Further analysis found that opioids were responsible for just over 41% of suicides and accidental overdoses in 2017, an increase of 24% from 2000.
Drilling down even further, in 2017, opioids accounted for 66% of accidental overdoses, and a third of suicides related to overdose.
Mark Ilgen, Ph.D., one of the authors of the article published in The New England Journal of Medicine, noted the connection between these rising rates of suicide and overdose, saying:
“Individuals with chronic pain are at clear elevated risk for both unintentional overdose and suicide. To date, many system-level approaches to address overdose and suicide have addressed these as if they are unrelated outcomes. Our goal was to highlight the fact that these adverse outcomes likely go together and effective efforts to help those with pain will likely need to simultaneously consider both overdose and suicide risk.”
3. Treatment options for opioid withdrawal continue to expand
While still in the experimental stages, researchers at Villanova and Duke Universities have found a new drug that could reverse opioid withdrawal symptoms without the adverse side effects of medications currently in use.
Julia Ferrante, an undergraduate at Villanova University conducted the research with Cynthia M. Kuhn, PhD, professor of pharmacology and cancer biology at Duke University. They found that the drug rapastinel was able to help treat withdrawal symptoms in rats during the first three days after opioid use stopped.
“We have found that rapastinel has potential as a new treatment for opioid dependence, as it is effective in reducing withdrawal signs and has not been shown to produce any negative side effects. By reducing withdrawal symptoms, the patient feels less discomfort during treatment, and we hypothesize this would lead to a decreased risk of relapse.”
Current medications used to treat opioid withdrawal, buprenorphine and methadone, are themselves opioids and pose the real risk of addiction and side effects. Rapastinel, originally developed as an antidepressant, is not addictive. It may be effective in managing withdrawal from opioids without serious side effects.
4. Mindfulness meditation reduces opioid cravings (and chronic pain)
With the understanding that nearly half of all people treated for opioid addiction with methadone relapse within six months, associate professor Nina Cooperman, a clinical psychologist in the Division of Addiction Psychiatry at Rutgers Robert Wood Johnson Medical School, looked at the potential role of mindfulness meditation to reduce anxiety, cravings, and chronic pain, and withdrawal symptoms in those struggling with opioid dependence.
Cooperman found that although they were more aware of their cravings and anxieties, people who used mindfulness meditation in conjunction with methadone therapy for opioid dependence were nearly one and a half times better at controlling cravings and anxiety. They also experienced less pain and stress (with more positive emotions).
5. Medical cannabis continues to rise in popularity
Daniel Kruger of the University of Michigan Institute for Social Research and co-author Jessica Kruger, a clinical assistant professor at the University of Buffalo, found that 78% of people surveyed used medical cannabis to treat chronic pain, back pain, depression, and headaches. Of these, 42% discontinued their use of prescribed pharmaceuticals in favor of medical cannabis. Another 38% reported using less of their prescription medication in favor of cannabis.
This may be fine, except that 30% of patients surveyed reported that their doctors were unaware of their medical cannabis use. The consequences of this gap in the two types of treatments may have consequences that are as yet unknown, but require study.
6. Men and women remember pain differently
Researchers at McGill University confirmed that women and men remember pain differently. The study started by returning both male mice and female mice to previous areas where pain was experienced. The female mice did not seem to remember or react to pain as much as the male mice did.
Jeffrey Mogil, the E.P. Taylor Professor of Pain Studies in McGill’s department of psychology and Alan Edwards Centre for Research and the senior author on the study noted:
“… we decided to extend the experiment to humans to see whether the results would be similar. We were blown away when we saw that there seemed to be the same differences between men and women as we had seen in mice.”
Loren Martin, the first author on the paper and an assistant professor of psychology at the University of Toronto Mississauga found these results unusual:
“What was even more surprising was that the men reacted more, because it is well known that women are both more sensitive to pain than men, and that they are also generally more stressed out.”
7. Adults dismiss girls’ pain
In a study that seems related to the one above, researchers at Yale University found that adults are less likely to take girls’ pain seriously.
Study participants viewed a video of a child receiving a fingerstick and reliably rated the boy’s pain as more serious than the pain of the girl, not knowing that they were watching the same child, with the same reaction and a different gendered name.
The researchers correctly identified the seriousness of this discrepancy, noting that:
“[if] the phenomena that we observed in our studies generalize to other contexts, it would have important implications for diagnosis and treatment. Any biases in judgments about pain would be hugely important because they can exacerbate inequitable health care provision.”
8. New target for relief of chronic pain identified
Although new medications for chronic pain are slow in coming, researchers have identified a new potential target for chronic pain relieving medications.
Sortilin is a protein on the surface of nerve cells that contributes to pain. In early studies of laboratory mice, researchers at Aarhus University have found that blocking this protein kept the molecule neurotensin, a pain regulator in the spinal cord, from moving freely to inhibit pain.
Associate professor Christian Vaegter noted that:
“Our research is carried out on mice, but as some of the fundamental mechanisms are quite similar in humans and mice, it still gives an indication of what is happening in people suffering from chronic pain.”
9. The roots of chronic pain may be cellular
Researchers at the University of Texas at Dallas, UT MD Anderson Cancer Center, UT Health Science Center at Houston, and Baylor College of Medicine have found that the roots of chronic pain may be cellular, nestled deeply in the RNA of living cells.
While this study, like the one above, does not produce new treatments for chronic pain, it does open up new doors for treatment. Researchers have focused their attention on the dorsal root ganglion. They’ve noted the differences in gender and the way pain is expressed differently based on sex.
The collaboration between the neuroscientists and neurologists is a landmark one. It indicates the future of potential chronic pain research and therapeutic treatments.
Read more: http://dx.doi.org/10.1093/brain/awz063
10. Blocking pain’s emotional component can help treat pain
Researchers at Washington University School of Medicine in St. Louis have found that blocking a receptor in rodents for the emotional component of pain can help restore their motivation.
This research is crucial for patients who are currently using opioids for chronic pain control. These drugs are associated with a type of euphoria that is a key component to addiction.
Senior investigator Jose Moron-Concepcion, PhD, an associate professor of anesthesiology, of neuroscience and of psychiatry, noted that:
“We’re in the midst of an opioid epidemic, and the euphoria associated with opioids is a major driver of opioid dependence. By targeting the emotional aspects of pain, we hope to make pain less debilitating so that patients won’t crave the emotional high they get from opioids.”
11. Taking care of someone else not as harmful as previously thought
Many studies on the dangers of caregiving have included dire warnings for those who take on these daily tasks. However, in a new review of 30 studies on immune and inflammatory molecules in caregivers, researchers at Johns Hopkins Medicine have found that it’s not as bad as previously thought.
First author David Roth, M.A., Ph.D., professor of medicine and director of the Center on Aging and Health at the Johns Hopkins University knows that caring for a loved one is hard, but not as dangerous as some reports would have it. He notes that:
“We’re not saying that family caregiving can’t be stressful, but there’s a notion that it’s so stressful that it causes deteriorating health and increased mortality. This can lead to fear of caregiving and a reluctance to care for loved ones in need. We’re challenging that narrative as being too exaggerated.”
The study found a less than 1% variance in immune and inflammatory biomarkers between caregivers and non-caregivers. This was a variance too small to be causal when it comes to health issues in caregivers.
Read more: http://dx.doi.org/10.1093/geront/gnz015
12. Now more than ever, staying active is crucial to a long life
The European Society of Cardiology reported in August that those who maintain sedentary lifestyle for two decades or more have twice the risk of mortality from any cause than those who remain active.
Worried that you haven’t been active and now it’s too late? Don’t be.
Study author Dr. Trine Moholdt of the Norwegian University of Science and Technology, notes that it’s never too late to start, saying:
“Our findings imply that to get the maximum health benefits of physical activity in terms of protection against premature all-cause and cardiovascular death, you need to continue being physically active. You can also reduce your risk by taking up physical activity later in life, even if you have not been active before.”
13. Synthetic opioids need dramatic strategies
Finally, the rise in street use of synthetic opioids like fentanyl calls for more innovative and dramatic action than previously taken to curb the increases in accidental overdose and death. Because the majority of opioid users prefer opioids other than fentanyl, enforcement must target suppliers: not users.
And the pressure to act quickly is real and crucial.
Beau Kilmer, study co-author and director of the RAND Drug Policy Research Center, notes that dealing with fentanyl may need a new approach that isn’t yet online.
“Indeed, it might be that the synthetic opioid problem will eventually be resolved with approaches or technologies that do not currently exist or have yet to be tested. Limiting policy responses to existing approaches will likely be insufficient and may condemn many people to early deaths.”
Learn more about pain
While chronic pain research has focused much attention in 2019 on the opioid crisis, other significant findings on the treatment of tennis elbow; the impact of stem cells 20 years after their discovery; and the importance of the gut microbiome of chronic pain patients have all been explored this year.
To learn more about the latest chronic pain research in 2019 and to see how it applies to you, it’s time to get in touch with a pain specialist. You can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.