FDA Warns Against Pain Curing Claims Of CBD Industry

January 29, 2020 / Thomas Cohn, MD

cbd oil When it comes to selling healthcare products, companies often try to walk a fine line between marketing their product and making false claims about the true ability of their product. Oftentimes there are a lot of semantics at play and the Food and Drug Administration rarely intervenes over product claims unless they feel that the consumer is being grossly misled about a product. It appears they recently felt that way over claims made in the CBD industry.

We’ve talked about cannabidiol on the blog in the past, and like CBD, medical marijuana or other relatively new products on the healthcare market, our stance has been pretty similar. We want patients to find a solution that works for them, we want further scientific research to better understand these products, and we want patients to pair passive treatment options with active treatments like exercise and physical therapy. Until we can point to the science behind a product, we’re leery to suggest it as a solution other than to say, if it works for you and isn’t compromising your health, go for it.

CBD For Pain, Cancer and More

That’s not exactly the same sentiment felt by Rooted Apothecary LLC, a company based in Naples, Florida, that has been pushing CBD products on its customers. They are legally selling CBD products, but the FDA and the Federal Trade Commission believes the claims they are making about the effectiveness of the products are misleading and even illegal.

Some of the claims made by the company about their CBD products include such unsubstantiated claims as it can be effective for teething pain and earaches in infants, or that “CBD was effective in killing human breast cancer cells.” They also made claims that CBD has been effective in treating Parkinson’s disease, Alzheimer’s disease and can safely be used in conjunction with opioids. Not only are these claims unsubstantiated by science, but they can put the consumer’s health at risk.

“Cannabis and cannabis-derived compounds are subject to the same laws and
requirements as FDA-regulated products that contain any other substance,” said
Acting FDA Commissioner Ned Sharpless, MD, in a press release. “We’ve sent
numerous warning letters that focus on matters of significant public health
concern to CBD companies, and these actions should send a message to the
broader market about complying with FDA requirements. As we examine
potential regulatory pathways for the lawful marketing of cannabis products,
protecting and promoting public health through sound, science-based decision-
making remains our top priority.”

Whether it’s CBD or another health and wellness product, we recommend that you do your own research and consult with your physician if you have any questions, especially if you’re already trying certain treatments for your pain. If something sounds too good to be true, it probably is. CBD is far from snake oil, but it’s not a magic pill either. Do your research, trust your gut and consult a professional for any questions you have.

Can You Sleep Your Way To Less Chronic Pain?

January 15, 2020 / Thomas Cohn, MD

As we’ve talked about on the blog in the past, there is a clear link between sleep health and pain sensitivity, and we’re going to further explore the interconnections of these two things in today’s blog. A recent study published in the Journal of Science built on our knowledge of this connection, which leads to the question, can we sleep ourselves out of the cycle of chronic pain?

For their study, researchers took a closer look at a person’s brain and the pathways through which pain is perceived. This is the area that processes pain stimuli. In other words, it tells us where the pain sensation we’re feeling is coming from. This pain signal then moves to the insula, a part of the brain that integrates incoming signals and forms our perception of pain. Finally, that signal is sent to the nucleus accumbens, an area that plays a significant role in decision-making, reward and pain evaluation.

During their research, the team found that the activity of the nucleus accumbens in sleep deprived patients differed from those who regularly receive adequate amounts of sleep. The nucleus accumbens helps to dull incoming pain signals, but this process doesn’t occur as frequently or as greatly in patients who are sleep deprived.

Takeaways

The findings are in line with a previous study that found that burn victims increased their opioid consumption after just one night of interrupted sleep, which also reinforces the idea that sleep quality and our perception of pain is linked. But what does that mean for the average patient with chronic pain? It means you should focus on getting a healthy amount of quality sleep while also pairing that restful period with physical activity during the day. You’re not going to get rid of your chronic pain by laying in bed all day, but you’re also due for trouble if you get six hours of interrupted sleep each night.

Check out this old blog post on ways to improve your sleep quality, but we’ll provide some quick tips here. Get in the habit of going to bed at roughly the same time each night, make the room cool and as dark as possible, and avoid reading, watching Netflix or scrolling through your phone while in bed. Make the bedroom a place for sleeping and your body will begin to get in the habit of falling asleep and staying asleep. Also, avoid caffeine or alcohol late in the day as those beverages can make it harder to fall asleep and stay asleep.

Finally, you also need to pair this quality rest with activity. You need to put in some work to overcome your pain, whether that’s in the form of physical therapy, daily exercise or a regular stretching routine. These activites will help to increase our pain threshold and strengthen supportive muscle groups that can help prevent pain. Be active during the day and work on achieving quality sleep at night, and you may soon find your chronic pain under control! For help with any of this, reach out to Dr. Cohn’s office today.

Why Gabepentin Isn’t A Perfect Solution To Opioids

January 6, 2020 / Thomas Cohn, MD

Roughly one in five Americans suffers from chronic pain, and millions of opioid prescriptions were written just last year alone. However, it has become clear that opioids are far from a perfect solution for chronic pain. Overdoses and cases of addiction have skyrocketed as doctors have tried to help patients find a way to reduce their pain. As we’ve learned more about the dangers of opioids, doctors have begun to turn to different solutions to the chronic pain puzzle, one of which being gabapentin.

Gabapentin is an anticonvulsant drug that was originally designed to prevent seizures, but more recently it’s been used to help prevent neuropathic pain. It also won doctors over because it doesn’t present the same addiction threats as traditional opioids. From 2012-2016, presecriptions for gabapentin increased 64 percent, and now it’s the 10th-most-commonly prescribed medication in the US.

Baclofen, a muscle relaxant, has also become popular as an opioid replacement. Both drugs can produce a “boozelike” high in patients and help drown out some pain signals, and while they are safer in larger quantities than opioids, recent data on the drugs prove they also have their pitfalls. A researcher by the name of Kimberly Reynolds at the University of Pittsburgh and co-authors found that from between 2013-2017, people tried to commit suicide using gabapentin nearly 42,000 times, and countless more misused the drug.

Finding A Balance

When used correctly, these drugs can provide the type of assistance that some chronic pain sufferers need. However, their use needs to be carefully monitored and part of a larger care effort. A doctor can’t just write this prescription and send the patient on their way. There needs to be a coordinated care effort alongside the prescription. Patients need to try other forms of treatment in combination with their medications, because simply taking a passive drug isn’t going to solve the root problem.

Eventually, if you just rely on this drug, you’re going to need higher doses in order to achieve the same level of relief. Similarly, you may experience withdrawal symptoms if you stop taking the drug, which can have adverse effects on a person’s health. Even though these drugs are being championed as safer than traditional opioids, they aren’t a magic pill that will solve your pain. You need to be doing more alongside these medications to truly address the underlying problem. That type of care is something we try to provide to every patient because we truly want them to find a cure, not just short-term relief.

We’re not anti-medications, but they can’t be used as a stand alone option if you want to have the best results treating your chronic pain. And as recent studies about gabapentins show, they aren’t a perfect solution either. You need to develop a comprehensive treatment strategy with a pain specialist like Dr. Cohn if you want to have the best chance of putting your pain in the past. For more information, or for assistance with your pain condition, reach out to Dr. Cohn’s office today.

Exercise Your Way To A Better Memory

January 3, 2020 / Thomas Cohn, MD

If you’re trying to exercise more in the new year, you may need to remind yourself to make time to exercise in the first few weeks before it becomes a habit, but according to new research, exercise may also help you remember daily tasks later in life.

According to research out of Norway, experts say that exercise and being physically fit may help sharpen our memory and reduce our dementia risk, even if we don’t really start exercising until later in life. There have been numerous studies on the link between being physically fit and staving off dementia risk, but no study has tackled the topic of when the participant begins their exercise regimen. For this study, researchers focused on whether getting physically fit at midlife or retirement age was too late to see any improvements.

Researchers used medical records of more than 30,000 individuals and tracked how their health changed over a 10-year period. They grouped individuals into three separate groups:

Those who remained in the lowest 20 percent of aerobic fitness for the entire study.
Those who moved into or out of that bottom 20 percent at any point during the 10-year period.
Those who remained outside of the bottom 20 percent for the entire 10-year period.

Memory and Exercise Results

After analyzing medical records, nursing home data and specialized memory clinics to determine which participants developed dementia during a 20-year follow up, researchers came to some interesting conclusions. They found that people who were fit throughout the entire study were almost 50 percent less likely to develop dementia than the least-fit men and women. Possibly more of note, those men and women who entered middle age out of shape but gained fitness showed a similar substantial reduction in their subsequent risk for dementia.

Researchers said that the study didn’t examine which types of exercise were being performed by those who gained fitness, so it appears that any physical exercise that helps to remain fit could be beneficial for your memory, even later in life. Another study on the topic found that individuals saw similar gains when they participated in exercise that raised their heart rate and boosted fitness, so while walking may be an okay form of exercise, walking with some interval training may provide more benefits.

“I tell people to add in some hills when they go for a walk,” said Jennifer Heisz, an associate professor at McMaster University who oversaw the second study, “or pick up the pace between streetlamps.”

So if you want to increase your chance of having a strong memory later in life, find some daily exercises that boost your physical fitness! And for help with any aspect of fitness or your health, don’t hesitate to reach out to Dr. Cohn’s office today.

Should You Eat Before Or After Exercise?

December 23, 2019 / Thomas Cohn, MD

Should you fuel up before hitting the gym, or is it best to burn calories on an empty stomach? That’s the question researchers at the University of Bath in England sought to answer with their latest study.

For their research, the team decided to look at the fat burning capabilities of exercise based on when the participant last ate. They were wondering if when a person ate influenced how much muscle fat was burned during activity, because muscle fat can be a key contributor to the eventual onset of insulin resistance and diabetes. For their study, the team divided 30 overweight men into three groups.

A control group that lived their normal lives.
A group that consumed a vanilla-flavored shake two hours before cycling exercise.
A group that consumed a placebo shake two hours before cycling exercise.

Participants wore monitors and masks that tracked a number of different factors, including their heart rate and the amount of fat and sugar they burned. After exercise, the participants drank the shake they had not yet consumed (placebo for the vanilla shake group, and a vanilla shake for those who consumed a placebo before exercise).

The study lasted for six weeks, and researchers drew some interesting conclusions after looking at the data. As expected, the control group’s insulin sensitivity remained unchanged, while the men in both exercise groups improved their fitness and narrowed their waistlines, although few actually lost weight. Notably, participants who pedaled on an empty stomach burned about twice as much fat during each ride as the men who consumed their shake prior to exercise. All riders burned about the same number of calories while pedaling, but more of those calories came from fat when the men did not eat first. Riders that consumed the shake afterwards also had greater improvements in insulin sensitivity and had developed higher levels of certain proteins in their muscles that influence how well muscle cells respond to insulin and use blood sugar than the other groups.

“You can probably get more out of your workout without increasing its intensity or duration by exercising before breakfast,” said Javier Gonzalez, a professor of physiology and nutrition at the University of Bath, who oversaw the study.

So if you’re wondering when the best time to exercise is, it might be first thing in the morning after you wake up. That being said, any exercise is better than no exercise, so just get it in when it works for you!