Older Adults, Doctors Differ Over Opioid Concerns For Chronic Pain Treatment

March 8, 2024 / Thomas Cohn, MD

A new study took a closer look at some of the concerns patients and providers have when it comes to older adults taking opioids for chronic pain, and the results show that the groups have some different underlying concerns about opioid use.

When patients were asked about the risks associated with long-term opioid use, older adults were more likely to express concerns about becoming addicted to the medication. When providers were asked the same question, their concerns centered around adverse events associated with how the medication may affect the individual, like a balance issue causing a devastating fall.

Plenty Of Similar Thoughts

Despite that main difference, providers and patients agreed on a number of different subjects in regards to opioid use for older adults with chronic pain. Areas of agreement include:

Conversations about “deprescribing” can be difficult and oftentimes unsuccessful.
Opioids as a treatment of last resort is OK.
The goal of pain therapy is to improve patients’ comfort and functional ability.
Trust is paramount in the doctor-patient relationship.

The new study decided to focus on older adults because they are the group with the greatest prevalence of prescription opioid use for chronic pain. Study researchers pointed to earlier data from 2019 that found that 15 percent of Americans age 65 and up had received an opioid prescription and 5 percent had been using the drugs chronically. While it’s encouraging that older adults are aware of some of the potential pitfalls of opioid use, they may be overlooking some of the more pressing concerns that are obvious to providers.

Doctors in the study went on to describe some other issues they regularly face that we’ve also seen first hand here in Minnesota and even in our office. One concern doctors regularly brought up were the challenges associated with deprescribing a patient. While patient reluctance was oftentimes an issue, other concerns also muddied the water. Doctors said that these conversations were often time-consuming and difficult to fit into the time allotted for the patient visit. Additionally, many patients had other pressing concerns during these appointments that took precedence over the prospect of weaning a patient off opioids. Finally, doctors also noted that in some situations there aren’t a lot of reliable alternatives for patients who are looking to move away form an opioid regimen, further complicating the matter.

It’s great that this study took a closer look at some of the opinions and attitudes on both sides of the equation when it comes to treating older adults with chronic pain with an opioid regimen. Hopefully these answers can guide future conversations and lead us to find new solutions to the challenges facing patients and providers battling the chronic pain crisis.

In the meantime, if you want a provider who will do everything in their power to listen to your concerns and help you find a solution to your chronic pain issue, reach out to Dr. Cohn and his team today at (952) 738-4580.

When Your Pain Concerns Are Being Ignored By Your Doctor

November 2, 2023 / Thomas Cohn, MD

As we’ve talked about on the blog numerous times in the past, chronic pain can be an extremely frustrating condition, and that frustration only ratchets up another level when you feel like your needs are not being met by your pain care provider. The one person who should have your back during your battle with chronic pain is your doctor, so what should you do if you feel like you’re not being heard or your needs aren’t being met? We share some tips on what you should do in this situation.

When You’re Not Being Heard By Your Pain Specialist

If you feel like your concerns simply aren’t being met by your pain care provider, take a deep breath and follow some of this advice.

1. Let Your Doctor Know – First and foremost, you’ll want to have a conversation with your doctor. There’s a very good chance that you and your doctor have different expectations or goals for your pain care, and oftentimes you can get on the same page with a simple conversation. When communicating with your doctor, be specific. Give examples of situations where you felt like you weren’t being heard or your needs weren’t met. We want this communication to be conversational, meaning that you want to talk and you also want to listen to what the other side has to say. You’d be amazed at how often care problems can be resolved with a constructive conversation.

2. Self-Evaluate – It’s also important that you take time to reflect on yourself and your situation to make sure that your frustrations are valid and directed in the right place. As we mentioned above, chronic pain can be extremely frustrating, and it’s not uncommon for patients to take that frustration out on their provider, despite the fact that their doctor is doing everything in their power to help them manage their condition. We’re not saying that your concerns aren’t valid, but self-evaluation is important in all walks of life, and it would be a shame for misplaced frustration to cause a rift between you and your care provider.

3. Ask For An Explanation – One thing many providers are guilty of is not deeply explaining the “why” behind their treatment recommendations. Whether it’s because they assume the patient has a better understanding of their condition and treatment than they do, or they simply focus on the end result and not the method itself, it’s easy for doctors to overlook important aspects of your care. Perhaps you feel like your concerns aren’t being met because you don’t understand why they are recommending the treatment they are, so please ask for clarification. We’d be more than happy to explain exactly why we believe our recommended treatment course is right for your specific situation.

4. Don’t Dwell On One Specific Instance – If you’re working to overcome a chronic pain condition, odds are you’ve visited your provider on a number of occasions. Many of those visits probably went fine, but it can be easy to really focus on one negative experience. Try not to let one bad interaction sour your experience with your doctor. We all have bad days and are juggling personal and professionally responsibilities, and we’d all like a do-over from time to time. Try to grant your provider some grace, but if the behavior becomes a pattern, move on to the last tip.

5. Find A New Provider – Finally, if you’ve tried all of the above and still feel like your doctor isn’t the right provider for you, it’s time to look elsewhere for care. We know that switching providers can be a headache, but it will be worth it to connect with a professional who truly puts your needs first. We’d love to be that provider for you, so if you want to connect with a doctor who will make sure your concerns are always heard, reach out to Dr. Cohn and his team today at (952) 738-4580.

These 10 Factors Linked To Increased Risk Of Opioid Overdose In Chronic Pain Patients

October 26, 2023 / Thomas Cohn, MD

Chronic pain patients who take opioids as part of their treatment plan always need to take steps to mitigate their risk of dependence or overdose, but that’s especially true for patients facing 10 specific factors, according to a new study out of Canada.

The study, published in the Canadian Medical Association Journal (CMAJ) and led by researchers at McMaster University, found that the risk of fatal and non-fatal opioid overdose by prescription medication increased up to sixfold in patients dealing with certain risk factors or predictors. To get a better understanding of some of the predictors of fatal and nonfatal overdoses in patients managing prescription medications, researchers looked at data from more than 24 million patients across Canada, the US and the United Kingdom. Researchers identified a total of 103 predictors, but 10 stood out from the rest because they showed a risk increase of two to six times compared to patients who didn’t have these factors.

According to the study, the 10 biggest predictors of fatal and nonfatal opioid overdose for patients taking prescription medication are:

High-dose opioids
Use of multiple pharmacies
Multiple opioid prescribers
Fentanyl prescription
Current substance use disorder
Depression
Bipolar disorder
Other mental illness
History of opioid overdose
Pancreatitis

The findings are important because they can help us map out chronic pain care and take different approaches in patients who may be considered high risk. For example, mental health screenings and questionnaires should absolutely become standard practice for patients dealing with a chronic pain condition. As we’ve said many times on the blog in the past, chronic pain is much more than just a physical issue. It also weighs heavily on your mind and your emotions, and if a doctor isn’t working to also control for these aspects, patients may end up depressed, anxious or facing other mental health issues that drastically increase their risk of overdose.

It’s also important that doctors work to provide a comprehensive treatment plan that involves more than just an opioid prescription. Opioids inherently become less effective as our body gets used to the medication, so patients may start to take larger doses to find the same level of relief. Needless to say, this greatly increases their risk of accidental overdose. Treatment tends to be more effective and patients can actually wean off opioids when they pursue other active techniques, like exercise, physical therapy, sleep improvements and better nutrition. Pain is rarely effectively managed through just one specific type of treatment, so find a provider who is willing to develop an individualized treatment plan to give you the best chance of overcoming your pain issue.

Whether you’re considered low-risk, high-risk or somewhere in between, we want to be your resource for overcoming a chronic pain condition. Nobody plans to become addicted to opioids, and it can happen to even the best of us, so be aware of the risk factors and connect with a provider who can help counter these potential predictors. For more information, or to set up an appointment with Dr. Cohn, give his office a call today at (952) 738-4580.

Improving Your Emotional Intelligence Can Help Manage Chronic Pain

March 30, 2023 / Thomas Cohn, MD

Chronic pain is more than just a physical issue. While physical pain is the most obvious symptom of chronic pain, an underlying pain condition can also impact our mental and emotional health. While this may make overcoming chronic pain a little more complex, it also offers us more ways to target the totality of the condition. One way to regain more control over your chronic pain condition is by working to improve your emotional intelligence.

But what is emotional intelligence, and how can we try to improve it? We offer some tips on improving your emotional intelligence in today’s blog.

What Is Emotional Intelligence?

Emotional intelligence is defined as a person’s ability to recognize and manage their emotions and those of others. In other words, emotional intelligence describes your ability to identify your emotions and to react appropriately to maintain a positive or neutral mindset. Needless to say, training your brain to identify negative emotions and to find ways to put a positive or neutral spin on them isn’t easy.

That said, for chronic pain patients, chronic pain is one of the most common sources of negative emotions, so if we can improve how we respond to these stimuli, it stands to reason that we may find more control over our pain condition. But how can we work to improve our emotional intelligence?

Improving Your Emotional Intelligence

There’s no perfect formula for improving your emotional intelligence, but if you consider these tips and try to incorporate them into your daily life, you may find it easier to allow your emotions to control your chronic pain condition instead of having them exacerbate it.

1. Acknowledge Your Feelings – It is common for chronic pain patients to bottle up their emotions and try to handle everything on their own, but this can be harmful to the process. Don’t try to run from your feelings and emotions – acknowledge them. Take stock of how you’re feeling throughout the day, as acknowledging your emotions is the first step in improving your emotional intelligence.

2. What Are Your Emotions Telling You? – Next, try to determine why you’re feeling the way you are. It may be pretty easy to figure out why you’re feeling sad or lonely, but don’t stop there. Try to understand what you need in response to these emotions. Do you need time by yourself? A walk to clear your head? A conversation with a good friend? Figure out what your emotions are trying to tell you, and seek out that need.

3. Get Rid Of Guilt – While this point is often easier said than done, it’s important to acknowledge that you should not feel guilty for your emotions. You’re going to have good days and you’re going to have bad days, but make it a point to not feel guilty when you’re having a tough day because of your chronic pain. You have enough on your plate without being burdened by guilt.

4. Reciprocate – Finally, you also want to be aware of the emotions of other people. You want others to recognize and empathize with your emotions, and you should show them the same respect. Try to understand without judgement, because that’s what you’d want from others.

If you can do these four things and recognize how your emotional intelligence can contribute to or fight back against your chronic pain sensations, we’re confident that you’ll be able to gain more control over your pain condition. For more information, or to talk to a specialist about how you can tackle different physical, mental or emotional aspects of your pain condition, reach out to Dr. Cohn and his team today at (952) 738-4580.

5 Ways To Treat Your Arthritis Today To Feel Better Tomorrow

November 11, 2022 / Thomas Cohn, MD

Arthritis is one of the most common medical issues, having been diagnosed in roughly 1 in every 4 adults. Because it’s so common, many people assume that arthritis-related symptoms are simply something that they have to get used to dealing with, but that simply isn’t true. And while you can’t turn back the clock and restore your joint health to how it felt decades ago, you can improve your symptoms and slow or stop the progression of joint degeneration.

Best of all, treatment is oftentimes pretty simple and only involves a few adjustments to your daily life. With that in mind, we highlight five things you can do to treat your arthritis today so that you’ll feel better tomorrow.

Daily Treatments For Arthritis

Arthritis is a degenerative condition that can be caused by natural factors like normal wear and tear and aging, or it can be exacerbated by injuries and illnesses. However, you can fight back against your arthritis by doing these five things regularly:

1. Exercise – Perhaps the best thing you can do to improve the health of your joints and help them become stronger for tomorrow is exercise. Exercise strengthens your joints and the soft tissues that help to keep them stable. Pressure on your joints has less of a degenerative impact on the joint when the supportive structures are stronger and better able to disperse this stress. Strive to get at least 30-45 minutes of exercise each day, or at least 3-4 times a week.

2. Eat Right – Your diet can also play a role in arthritis symptom prevalence. Foods that are high in sugar or fat tend to be pro-inflammatory, and this inflammation can cause problems for you joints. Avoid these pro-inflammatory foods and reach for more fruits and vegetables, and you may find that you are experiencing fewer arthritis symptoms.

3. Use Ice And Heat To Your Advantage – Ice and heat can help to improve your circulation or prevent swelling and inflammation, so use their powers wisely! Ice your arthritic joints after exercise or periods of extended activity to help keep swelling and inflammation at bay, or use a heating pad if your joints are feeling stiff or uncomfortable.

4. Physical Therapy – Physical therapy is very similar to exercise, but it can be even more beneficial at controlling symptoms because you can target specific areas. Your pain management specialist or a physical therapist can help set you up with some home-based therapy exercises to perform each day or when symptoms begin to help you get more control over your arthritis. Physical therapy can be both a treatment and prevention technique, so don’t underestimate the power of connecting with a physical therapist!

5. Mind Your Posture – Finally, it’s important to be mindful of your posture each and every day. When your body is out of alignment, you’re putting excessive stress on certain areas, including pivotal joints. Poor posture or body mechanics can cause problems for your facet joints in your spine, the joints in your wrists or put excess pressure on your knees. Improve your posture each day, and your joints will thank you for it!

If you do these things each day, and you connect with a pain management specialist like Dr. Cohn, we’re confident that you’ll notice an improvement in your arthritic symptoms! For more information, or for help with a different pain issue, give our office a call today at (952) 738-4580.