Opioid Prescriptions Reach A 15-Year Low

August 29, 2018 / Thomas Cohn, MD

The number of opioid prescriptions in the United States has fallen dramatically, and prescriptions now sit at their lowest levels since 2003 according to new data from the Food and Drug Administration.

The data shows that 74 million metric tons of opioid analgesics were dispensed in the first six months of 2018, down more than 16 percent from the first six months in 2017. Although opioid prescriptions have been declining for the past couple years, the bigger decrease in 2018 is likely linked to lawmakers, doctors and patients working against the problem of opioid dependence.

“These trends seem to suggest that the policy efforts that we’ve taken are working as providers, payers and patients are collectively reducing some of their use of prescription opioid analgesic drugs,” said FDA commissioner Scott Gottlieb, MD.

Not All Good News

If we just look at the headline, it’s easy to infer that this is good news. Fewer patients relying on passive and potentially dangerous treatment options should be a good thing, but there are some drawbacks. For starters, the opioid crackdown is undoubtedly hurting a section of patients who use these medications properly and need them to control their discomfort. I’ve talked to patients who have found it harder to get the medications they rely on, and it’s troubling. Good people are getting caught up in the crackdown on opioids.

Perhaps more shocking is that despite the sharp drop in opioid prescriptions, opioid overdoses continue to rise. Although the data from 2018 wasn’t available, nearly 49,000 Americans died from opioid-related overdoses in 2017. This includes overdoses from fentanyl and heroin, which can be eventualities for individuals who become addicted to opioids.

“It isn’t necessarily the case that more people are suddenly switching from prescription opioids to these illicit drugs. The idea of people switching to illicit drugs isn’t new as an addiction expands, and some people have a harder time maintaining a supply of prescription drugs from doctors,” said Gottlieb. “What’s new is that more people are now switching to highly potent drugs that are far deadlier. That’s driven largely by the growing availability of the illicit fentanyls.”

Police data shows that a record amount of fentanyl (1,640 pounds) and heroin (5,500 pounds) have been seized by law enforcement this year, and we’re not even two-thirds the way through the calendar year.

Clearly we’re still losing the war on opioid overdoses, even if we hear headlines that suggest prescriptions are at a 15-year low. Chronic pain patients are caught in the crossfire, and overdose-related deaths continue to surge. We need to invest more money into understanding and treating chronic pain conditions in order to really make a difference.

5 Things Patients With Chronic Pain Should Do Every Day

August 22, 2018April 5, 2023 / Thomas Cohn, MD

As anyone with chronic pain will tell you, it is a daily battle against their pain condition. Some days are good, some days are not. You have to take it one day at a time when it comes to managing your chronic pain and focus on winning small battles. While it’s easier said than done, we’ve found that if chronic pain patients perform some or all of the following activities on a daily basis, they put themselves in a better position to have more good days than bad.

Daily Habits For Chronic Pain Patients

If you deal with chronic pain on a regular basis, strive to do a couple or all of the following activities on this list every day.

1. Eat Healthy – Now, you don’t need to eat a perfect balance of fruits, vegetables and whole grains at every single meal, but you should strive to hit all the important food groups throughout the day. Getting a wide range of vitamins and nutrients from our diet can help to strengthen structures and keep muscle groups healthy. On the flip side, fatty or sugary foods can contribute to the onset of inflammation, which can compress structures and make chronic pain worse.

2. Exercise – We don’t expect you to go to the gym every day, but if you want to fight back against your chronic pain, activity is your friend. Even if it’s just in the form of a 30-minute walk around the neighborhood, mild and moderate intensity exercise helps to promote healthy blood flow throughout the body, strengthen muscles and wards off inflammation. More intense exercise can also lead to the release of endorphins, which can mask pain sensations.

3. Challenge Your Mind – While it’s important to exercise your physical body, it is just as important to challenge our minds each and every day. Not only can brain stimulation enhance our mood, but it can also take our mind away from the pain. Don’t just lay in bed watching Netflix, challenge your brain by reading, doing crossword puzzles or playing along with Jeopardy. If your mind is focused on a task it won’t be as focused on your chronic pain.

4. Laugh – Speaking of enhancing your mood, few things are better for your mindset than a good laugh. Whether you find humor in a conversation with a friend or in a book or a movie, let some laughter into your life. Being able to change your psychological state for the positive can go a long way with helping you manage and deal with the annoyances of chronic pain.

5. One Active Treatment – Finally, take time each day to do one active treatment to manage your chronic pain. Painkillers and rest are passive treatment options, but physical therapy, aqua therapy, yoga, cycling, cognitive behavioral therapy or meditation are all ways we can actively confront our chronic pain issues. Your active treatment may differ depending on your specific pain condition, but if you can end the day saying you did at least one active treatment to fight back against pain, you’re going to have a lot more good days than bad.

How To Talk To A Pain Specialist About Your Pain

August 16, 2018 / Thomas Cohn, MD

Pain can be fluid or come in waves, so it can be very difficult to explain what you’re going through to your family, friends or doctor. When it comes to explaining your pain to us, we don’t expect you to be able to perfectly describe it or be able to give us a clear idea of what’s going on. After all, if you knew what was causing the issue, you’d probably already have a strong treatment plan in place.

We want to do everything in our power to help you find a solution to your chronic pain issue, and that begins when you come in for your consultation and talk to us about your pain. Below, we share some tips for helping convey what you’re going through, and how to best open up about your experience.

Explaining Your Chronic Pain

Here are some tips for helping to convey to the pain specialist what you’re going through.

1. Document Your Pain When It Happens – Some people have a hard time describing their pain because they aren’t having a flareup when they are in the office. This is why it’s important to really focus on what’s going on when you’re dealing with a chronic pain flare up. Catalog in your head your symptoms and where pain is located when flare ups occur, or better yet, create a pain journal to write down your experiences. This will give you a clear and documented history of what you’re dealing with.

2. Don’t Hold Back – Another way in which patients inhibit their treatment is by holding back when it comes to explaining or bringing things up to the specialist. Whether it’s because you’re embarrassed or afraid, the only person you’re hurting by withholding information is yourself. We’re not here to judge you, we’re here to help you, so don’t hide anything pertaining to your condition from us.

3. Don’t Lie – Along a similar vein, don’t lie to your pain specialist. If you haven’t been the best about sticking with your physical therapy program or you’ve forgotten to take your medications at times, let your doctor know. You need to stick with your treatment plan in order to have the best chance of a full recovery, and if you’re not giving it your all, your doctor may move on to other treatments when a simpler solution was all that was needed. And this goes for things like your exercise and diet habits too, not just truths about your pain condition.

4. Specifics – Be as specific as possible when you’re describing your pain. Don’t just say that your back hurts, tell us that your back hurts when you’re standing for long periods or when you wake up in the morning. The more details we have, the easier it will be to pinpoint potential problems. Again, some people find it easier to be specific if they document their symptoms with a pain journal.

5. Ask Questions – Finally, both you and your pain specialist can benefit from asking and answering questions. Ask if certain symptoms are normal, or what types of treatment they’ve found to be most successful. Your conversation with your pain provider needs to be two-way in nature in order to have the most benefit.

Hopefully these tips can help you the next time you visit a pain specialist, and if you’d like to talk with Dr. Cohn about your pain, contact his office by clicking here.

Could Music and Art Lower Chronic Pain Risk?

August 14, 2018 / Thomas Cohn, MD

If you’re a frequent reader of this blog, you know that we like to pitch certain conservative treatment options for chronic pain. Activities like controlled exercise, stretching techniques and a healthy diet can help to control chronic pain and decrease your likelihood of flare ups. But what if other activities could provide similar benefits? Activities like going to a concert or checking out an art exhibit?

According to a new study published in the Journal of Pain, adding some culture to your regular routine could help to reduce your likelihood of chronic pain. For their study, researchers looked at data from a 10-year study that tracked the progression of pain in more than 2,600 older adults living in England. None of the participants were experiencing pain at the beginning of the study, but after 10 years, more than 42 percent said they experienced moderate to severe chronic pain.

Chronic Pain and Culture

Some of the findings were not all that surprising. Researchers found that individuals with poor sleep patterns, those who had mental health problems and those who were poorer and less educated were more likely to suffer from chronic pain. But one aspect they found interesting was the association between participation in cultural or social events and the development of chronic pain. Researchers noticed that stretching and endurance training were more likely to reduce the risk of developing chronic pain when those activities were paired with participation in cultural and social events.

“This study also found evidence that psychosocial factors may be protective against the development of chronic pain, in particular engagement in cultural activities such as going to museums, art galleries, exhibitions, concerts, the theatre or the opera,” wrote lead author Daisy Fancourt, PhD, a senior research associate at University College London. “It is notable that the odds ratios for cultural engagement were directly comparable with those of vigorous physical activity, suggesting a reduction of 25-26% in risk of chronic pain incidence.”

Why The Reduction In Chronic Pain?

So why do researchers believe that chronic pain likelihood may be reduced by visiting a museum or checking out a summer concert? According to them, the event is likely paired with some gentle physical activity, which can be beneficial for your body, as well as psychological benefits that come from social engagement and positive cultural experiences.

“This study is the first to explore simultaneously potential physical and psychosocial protective factors for the development of chronic pain in older adults. Our results demonstrate that both vigorous weekly activity and regular cultural engagement appear to reduce risk of incident chronic moderate-severe pain,” the researchers concluded.

Although the study was observational in nature, it points to an interesting correlation. Get outside, explore new places and find an enjoyable cultural experience, and you may be able to reduce your chronic pain risk. A visit to the museum shouldn’t be your only treatment technique, but when added to a regular care plan, it may have some rewarding effects!

Dr. Cohn Featured In Minnesota MD News!

July 31, 2018 / Thomas Cohn, MD

Chronic pain is a huge problem in Minnesota and throughout the United States, and more people are becoming aware of the issue and trying to help spread awareness. One group that is attempting to help keep people informed and find solutions to chronic pain is Minnesota MD News!

Recently, Sheri Levisay sat down with Dr. Cohn and other members of the CDI Pain Care team to get a better understanding of how we’re working to treat chronic pain and find permanent solutions for every patient.

We’ve pasted a snippet of the feature story below, but for the full story, head on over to Minnesota.MDNews.com. Thank you to Sheri and her team for helping to put a spotlight on pain conditions that affect millions of Americans each and every day!

Few conditions affect more Americans than chronic pain. The American Academy of Pain Medicine estimates 100 million adults suffer from chronic pain, at an annual direct and indirect cost of up to $635 billion. A 2015 National Institutes of Health analysis found 25.3 million people with chronic pain suffered daily for at least three months, and 40 million described their pain as severe.

Compounding the problem is overreliance on opioids. Annual opioid prescriptions in the United States exceed 200 million, according to the CDC, and 165,000 Americans died from overdoses related to opioid pain medication from 1999 to 2014.

As leaders in health care and government search for solutions, patients with pain are left wondering whether their only alternatives are painkillers and surgery.

At CDI Pain Care, Thomas G. Cohn, MD, board-certified in physical medicine and rehabilitation as well as pain medicine, has an answer to that dilemma which reflects his 25 years of experience in the field: conservative pain management.

CDI Pain Care’s comprehensive approach starts with…continued here.