FDA Declares Kratom An Opioid

February 13, 2018 / Thomas Cohn, MD

We’ve blogged about Kratom in the past, but now the FDA is chiming in on the subject. According to the FDA, Kratom is more than a plant, it is an opioid.

“As the scientific data and adverse event reports have clearly revealed, compounds in kratom make it so it isn’t just a plant — it’s an opioid,” said FDA commissioner Scott Gottlieb. “And it’s an opioid that’s associated with novel risks.”

Kratom, which has been credited with giving users feelings of euphoria, strength and pain relief, has now been linked with 44 deaths. Aside from its obvious dangers, the FDA decided to classify the plant as an opioid because the drug taps into some of the same brain receptors as opioids.

The Dangers of Kratom

Like a number of drugs in their infancy, the dangers of kratom stem from the fact that we haven’t had much time to scientifically study the substance. Despite never gaining approval from the FDA, kratom was advertised as a concentration booster and workout enhancer in largely unregulated supplements. Because of its properties, it also made its way into the pain management community as a potential option for individuals with chronic pain. And ironically, it’s also been touted as a treatment option for opioid addiction.

“Patients addicted to opioids are using kratom without dependable instructions for use and more importantly, without consultation with a licensed health care provider about the product’s dangers, potential side effects or interactions with other drugs,” Gottlieb said in a previous statement.

Now that we’ve had more time to study the substance, researchers are realizing just how dangerous unregulated kratom use can be. After studying the chemical structures of the 25 most prevalent compounds in kratom, researchers discovered that they all shared similarities with opioids like derivatives of morphine. Moreover, two of the five most prevalent compounds in kratom latch onto the brain’s opioid receptors, just like other opioid painkillers do.

“The new data provides even stronger evidence of kratom compounds’ opioid properties,” Gottlieb said.

Some states have already taken steps to ban the substance, and it wouldn’t be surprising if Minnesota followed suit in short order. Kratom is already banned in Alabama, Arkansas, Indiana, Tennessee and Wisconsin.

At the end of the day, we have to remember that there is no miracle pill that can cure us of our pain or treat our opioid addiction. Trust that doctors have your best interests at heart, and that clinically tested and proven methods are best.

More Findings On The Daith Piercing

October 24, 2017 / Thomas Cohn, MD

As you’re probably aware if you read this blog, we’ve been helping push patients who have undergone the Daith Piercing for headaches to Dr. Chris Blatchley’s website. Dr. Blatchley has been attempting to conduct one of the foremost studies on the Daith Piercing, and he recently completed his findings. You can see the full results from Version 1 of the study by clicking here. If that link is no longer working, head to his website and look for a link to the survey results.

Before we get into some of the findings in Version 1, Dr. Blatchley reached out to us to see if we could help direct people to take a second version of the Daith Piercing survey. This will again help us learn more about pain pathways and how the piercing may help some individuals with certain types of headaches and migraines. So if you haven’t yet taken the second version of the Daith Piecing Survey, please click here and consider taking a couple minutes to help advance our medical knowledge.

Daith Piercing Survey Results

As we mentioned above, you can take a closer look at the full report by clicking the above link, but here are some of the takeaways in bullet point form:

More than 1,250 individuals completed the survey.

98.5 percent of survey respondents were women.

90% had seen a family doctor and 40% a medical specialist. 44% had underwent a brain/MRI scan.

Roughly 80 percent of patients said they were either “Delighted” or “Very Happy” with the results from the Daith Piercing in terms of headache relief at measured intervals after receiving the piercing (first 30 days, 1-3 months, 4-6 months, etc.).

Only 2.6% of respondents said they were “Very Unhappy” with the piercing, with the most common reason why being that it did not provide them with headache relief.

Interestingly, the side the piercing was on was split almost right down the middle. 51 percent got the piercing in their right ear, while 49 percent got it in their left ear.

About 20 percent of respondents had both ears pierced with the Daith technique.

The majority of respondents reported a decrease in symptoms of headache frequency after undergoing the piercing, and many of these decreases occurred quickly after the piercing was administered.

For more information about the study, or to check out the results, I urge you to head over to Dr. Blatchley’s site. Hopefully Version 2 of the study will be as enlightening as the first version.

The Daith Piercing Survey Is Complete!

September 28, 2017 / Thomas Cohn, MD

If you’ve been following this blog, you probably remember that we’ve been helping Dr. Chris Blatchley collect responses for a study he was conducting on the Daith piercing and vagal nerve stimulation. We’re happy to report that the first report of the findings has been published.

You can find the first report on the role of Daith piercings and vagal nerve stimulation by clicking here. That link will take you to the report, but updated versions of the report can be found on Dr. Blatchley’s main site, which you can get to by clicking here, so be sure to visit the site in the future to see the updated reports.

You Can Still Take The Study

Although the first version of the findings are in, you can still participate in the study if you haven’t taken the survey yet. Remember, this is an updated version of the survey, so even if you completed the survey in the past, you may still be eligible to complete the second version. To take the second version of the daith survey, click here.

Thank you to everyone who helped Dr. Blatchley with his research. He’s informed me that’s he has shared the findings with the British Medical Journal, and he hopes that they will publish the findings. If they are published, it would be the first of its kind research published in a medical journal! He’s also planning to release a full research article in the future based on the second version of the survey.

So please check out the findings, and keep your fingers crossed that they’ll make their way to the BMJ. The more migraines and vagal nerve stimulation are talked about in major medical journals, the more eyeballs we’ll have on the problem, and the more people we’ll have working towards a solution. Thanks to everyone who took part in the survey, and congrats to Dr. Blatchley for finishing the first version of the findings.

Updating The Daith Piercing Survey

August 23, 2017 / Thomas Cohn, MD

We wanted to give you another quick update on the Daith piercing survey that a colleague of mine is running in order to help us better understand how the Daith piercing may help individuals with chronic headaches. This update won’t have a lot of information, but that’s a good thing. Medical journals are pretty picky when it comes to publishing studies that have already been published in another source, so in order to ensure the findings get shared in a major medical journal, this update can only speak in generalities.

Daith Piercing Update

That being said, this update is also encouraging. Over 1,000 people have taken part in the survey so far, and you still have time to do so if you haven’t taken it yet. You can participate in the survey by following this link and answering the questions on that page.

The results show very promising results when it comes to successful management of certain headaches with the Daith piercing. To be safe, that’s all we can really say right now, but we still need your help. My colleague Dr. Chris Blatchley, who is running the study, has created a second version of the Daith piercing survey to address some areas that he felt the first version did not adequately cover. If you are willing, please click here to take the second version of the survey. Regardless of whether you completed version one or not, it would be wonderful if you could take a couple of minutes to fill out the new version of the survey. The first version of the survey is no longer available, to the two links we’ve posted in this blog will take you to the same place.

Thank you so much for taking the time to help us get a better understanding of the Daith piercing and how it may be able to help certain patients. We promise to keep you updated about future studies, this study’s results, as well as when and where the full data analysis will be published. Thank you for your continued support, and please reach out to Dr. Blatchley if you have any questions. You can visit his website by clicking here.

Thanks!

Dr. Cohn

Pain Catastrophizing and Chronic Pain Care

June 20, 2017June 20, 2017 / Thomas Cohn, MD

When it comes to managing chronic pain, it’s imperative to take as much care of your mental health as it is your physical health. Ignoring your mental health can lead to more negative attitudes towards your pain, which can lead to even more problems according to a new study.

A new report out of the Stanford University School of Medicine suggests that individuals who negatively fixate on their symptoms have been found to report greater pain intensity and are more likely to be prescribed opioids. Interestingly, the association was much higher in females than it was in men.

“When it comes to opioid prescriptions, pain catastrophizing has a greater effect on the likelihood for having a prescription in women than it does in men,” said medical student and lead researcher Yasamin Sharifzadeh.

Pain Catastrophizing

According to researchers, “pain catastrophizing” is defined as the cascade of negative thoughts and emotions in response to actual or anticipated pain. When you begin to let these negative thoughts continue to build and take hold over your pain, it can actually amplify the pain process and lead to greater pain and increased disability. Previous studies have shown that pain catastrophizing has been linked to increased pain sensations, but this is the first study to find a correlation between it and an increased likelihood of being prescribed opioids.

For their research, Sharifzadeh and her team analyzed clinical data from more than 1,800 patients with chronic pain. After analyzing the data and parsing out the results between genders, researchers came to an interesting conclusion.

“In men, it is pain intensity that dictates whether or not they are prescribed opioids,” Sharifzadeh said. “However, in women, there is a more nuanced issue where relatively low levels of both pain catastrophizing and pain intensity are associated with opioid prescription. Pain catastrophizing and pain intensity are working together in determining if a woman has an opioid prescription.”

This is especially problematic when you consider that women are more likely to suffer from chronic pain, be prescribed pain relievers and given higher doses for longer periods than men, according to the Centers for Disease Control and Prevention. However, by recognizing this correlation, doctors can help to mitigate this risk.

“If physicians are aware of these gender-specific differences, they can tailor their treatment,” Sharifzadeh said. “When treating chronic pain patients — especially women — they should analyze pain in its psychological aspect as well as its physical aspect.”

If you feel like your mental health is fighting a losing battle with chronic pain, reach out to your doctor. Contact Dr. Cohn today.