Dr. Patty's Chronic-Intractable Pain and You Sites, Inc.
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Dr. Patty's  Chronic-Intractable Pain and You Sites, Inc.
Our mission is to educate, empower and advocate for those individuals whose lives have changed due to chronic and/or intractable pain. My goal is to raise public and professional awareness for those who are unfamiliar with chronic pain about the factors that often result in having chronic pain and the need for ongoing medical care and research for new methods/medications for the treatment of chronic pain.
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Chronic-Intractable Pain And You, Inc. (Main Site)

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A safe place to talk about pain!
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Dr Patty's Course On How To Become A Better Advocate For Yourself And Others?
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A safe place to talk and take action against the laws of prescribing for chronic/intractable pain sufferers...

 

Describing your pain

http://www.chronicintractablepainandyou.org/group/cipay-s-chronic-pain-group/forum/topics/describing-your-pain-1#.UJwf2obYQtF

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Top 6 New Year’s Resolutions For Blogging

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With the New Year drawing closer, many people are carefully considering their New Year’s resolutions.  Effective blogging is integral to a

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Philippe Trebaul's curator insight, January 4, 2013 3:35 AM

Bonjour.


Merci !


Pour vos articles aux contenus toujours aussi intéressants, pertinents, utiles, faciles à intégrer, et d'actualité.


And...#NewYear


Philippe TREBAUL


: 0)


33-6-42-97-88-47


@ TREBAULPhilippe


Hello.


Thank you!


For your articles in the contents always also interessants, relevant, useful, easy to integrate, and of current events.


And... #NewYear


Philippe TREBAUL


: 0)


33-6-42-97-88-47


@ TREBAULPhilippe

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Treatment effects of low dose theophylline combined with an inhaled corticosteroid in COPD

Combination therapy with an inhaled corticosteroid and low dose theophylline may
attenuate airway inflammation in COPD patients.


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Hydrocodone Bitartrate and Acetaminophen Tablets 10 mg/500 mg: Recall - Potential for Oversized Tablets

UPDATED 12/21/2012: Mylan announced a voluntary nationwide recall to the retail level of three lots of Hydrocodone Bitartrate and Acetaminophen Tablets, USP 10 mg/500 mg (Lots 3037841, 3040859 and 3042573).
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Does your doctor understand?

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Does your doctor understand?

http://www.chronicintractablepainandyou.org/group/cipay-s-chronic-pain-group/forum/topics/does-your-doctor-understand#.UJwcZ4bYQtE

 

 

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Twitter / BUS2CRPS: Another crps bus decorated ...

Another crps bus decorated for anti bullying week!
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Spinal cord stimulator technology helping people with arthritis in spine

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Going inside the operating room was a last resort for Gary Showalter who had suffered with severe lower back pain for at least 12 years.
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ASAM Redefines Addiction as a Brain Disease

Friday, August 26, 2011

Addiction is a primary, chronic brain disease, not just bad behavior or bad choices, according to a new definition from the American Society of Addiction Medicine (ASAM). Pain practitioners need to understand the ramifications of addiction — especially involving Rx-opioid use — as a complicating factor in patient care. However, casual use of the term “addiction” or inaccurate diagnosis of the disorder is counterproductive for effective pain management and unjustly stigmatizing to patients.

According to ASAM in a news release [here], when people see compulsive and damaging behaviors in friends or family members — or public figures such as celebrities or politicians — they often focus only on the behaviors or substance use as the problem. However, these outward signs are actually manifestations of an underlying disease that involves various areas of the brain.

“At its core, addiction isn't just a social problem or a moral problem or a criminal problem. It's a brain problem whose behaviors manifest in all these other areas,” said Michael Miller, MD, past president of ASAM who oversaw the development of the new definition. “Many behaviors driven by addiction are real problems and sometimes criminal acts. But the disease is about brains, not drugs. It's about underlying neurology, not outward actions.”

The new definition resulted from an intensive, 4-year process with more than 80 experts actively working on it, including top addiction authorities, addiction medicine clinicians, and leading neuroscience researchers from across the country. The full Public Policy Statement on addiction [here] also includes this short version of the definition:

“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.”

“Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”

By defining addiction as a primary disease, ASAM stresses that it is not the result of other causes, such as emotional or psychiatric problems. Addiction also is recognized as a chronic disease — like cardiovascular disease or diabetes — that must be treated, managed, and monitored over a life-time.

Two decades of advancements in neurosciences convinced ASAM that addiction needed to be redefined by what is going on in the brain. Research shows that the disease of addiction affects neurotransmission and interactions within neural reward circuitry, leading to addictive behaviors that supplant healthy ones, while memories of previous experiences with food, sex, alcohol, and other drugs trigger craving and renewal of addictive behaviors.

Meanwhile, brain circuitry that governs impulse control and judgment also is altered in this disease, resulting in the dysfunctional pursuit of rewards such as alcohol and other drugs. This area of the brain is still developing during teen-age years, which may be why early exposure to alcohol and drugs is related to greater likelihood of addiction later in life.

“There is longstanding controversy over whether people with addiction have choice over anti-social and dangerous behaviors,” said Raju Hajela, MD, in the news release (he is past president of the Canadian Society of Addiction Medicine and was chair of the ASAM committee on the new definition). He further states, “the disease creates distortions in thinking, feelings and perceptions, which drive people to behave in ways that are not understandable to others around them. Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause.”

However, Hajela continues, “Choice still plays an important role in getting help. While the neurobiology of choice may not be fully understood, a person with addiction must make choices for a healthier life in order to enter treatment and recovery. Because there is no pill which alone can cure addiction, choosing recovery over unhealthy behaviors is necessary.”

COMMENTARY: The interface of pain, opioid analgesics, and addiction has been of great concern in the pain management field. Commonly, the term “addiction” has been loosely applied by practitioners, researchers, and the public, and this has frequently resulted in faulty diagnoses, unjust accusations, and stigmatization of patients.

Furthermore, there have been many studies in the field using definitions that inaccurately assess addiction among patients with pain prescribed opioid analgesics; consequently, more often than not, the prevalence of addiction has been inflated. Good quality studies, of which there have been few, suggest that de novo iatrogenic addiction in patients appropriately prescribed opioid analgesics for chronic pain is a relatively rare occurrence [see UPDATE here].

Will this reinterpretation of addiction from ASAM help to clarify the issues or add further confusion? In many respects, the definition is comprehensive but not entirely new thinking. In 2001, a trio of organizations — the American Academy of Pain Medicine, American Pain Society, and ASAM — released a consensus document, “Definitions Related to the Use of Opioids for the Treatment of Pain,” that defined addiction as follows:

“Addiction is a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.”

The new definition, from ASAM, notes that addiction is characterized by 5 features:

Inability to consistently Abstain;Impairment in Behavioral control;Craving, or increased “hunger” for drugs or rewarding experiences;Diminished recognition of significant problems with one’s behaviors and interpersonal relationships; andA dysfunctional Emotional response.

These are quite similar to features noted in the consensus statement of a decade ago, and ASAM emphasizes that the 5 “new” features are not diagnostic criteria for addiction. Rather, the diagnosis of addiction requires “a comprehensive biological, psychological, social and spiritual assessment by a trained and certified professional.” However, this raises some concerns about the new definition:

Who is a “trained and certified professional” qualified to make a bona fide diagnosis of addiction in a patient? Presumably, ASAM members are qualified; pain practitioners are not. However, chronic pain and instinctual human drives for pain relief may result in expression of any or all of the 5 features of addiction noted above, which can confound the diagnosis by someone inexperienced in both pain and addiction medicine.Acknowledgment of addiction as a chronic brain disease, which actually occurred some time ago, was a major breakthrough from a medical science perspective; although, when used inappropriately, as often has been the case, this viewpoint has stigmatized those afflicted with the disorder as being mentally unfit. Particularly in the pain management field, even a hint of past or present addiction in a patient can radically alter the sort of treatments that will be offered to them.The ASAM document catalogs many of the interesting and important neurobiological structures and functions that have been discovered in research studies to play a role in addictive processes. However, this knowledge has not been translated into everyday clinical application for the diagnosis and treatment of addiction.ASAM further notes that “genetic factors account for about half of the likelihood that an individual will develop addiction,” and these are further influenced by environmental factors. This may be of some importance from prevention perspectives but, since a person’s genetic makeup cannot be remediated, it is unhelpful in the treatment of current addiction.The inclusion by ASAM of a spiritual dimension in their definition and the assessment of addiction, which is so prominent and important in 12-Step recovery groups, is controversial from a medical science standpoint. Delving into patients’ connections (or disconnects) with a “Higher Power” is generally outside the bounds of typical clinical practice.

Finally, it is curious that ASAM released this extensive definition of addiction at this time, when the American Psychiatric Association (APA) is finalizing the 5th revision of their Diagnostic & Statistical Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Is this new ASAM definition intended to complement DSM-5, to supersede the APA’s work in defining addictive disorders, or as a standalone interpretation of the disorders by ASAM? Interestingly, other than a major section heading in DSM-5 titled “Substance Use and Addictive Disorders,” the APA continues to shun use of the term “addiction” as a descriptor, as they have in the past.

In any case, the new ASAM document [here] is recommended reading for all healthcare providers who want an understanding of addiction and addictive behaviors.

Posted bySB. Leavitt, MA, PhDat9:45 AM 

 

http://updates.pain-topics.org/2011/08/asam-redefines-addiction-as-...

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Hydrocodone Bitartrate and Acetaminophen Tablets 10 mg/500 mg: Recall - Potential for Oversized Tablets

UPDATED 12/21/2012: Mylan announced a voluntary nationwide recall to the retail level of three lots of Hydrocodone Bitartrate and Acetaminophen Tablets, USP 10 mg/500 mg (Lots 3037841, 3040859 and 3042573).
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Heparin-Bonded Central Venous Catheters Do Not Reduce Thrombosis in Infants With Congenital Heart Disease: A Blinded Randomized, Controlled Trial

Infants with congenital heart disease are at significant risk of both silent and clinically identified thrombosis. There seems to be no advantage in using heparin-bonded catheters in infants ≤1 year of age.


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Carpal Tunnel Syndrome http://www.chronicintractablepainandyou.org/forum/topics/carpal-tunnel-syndrome-1#/

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Yoga eases the pain of carpal tunnel syndrome

RT @kbellbombshell: Yoga eases the pain of carpal tunnel syndrome: http://t.co/t1a5wKKq #YOGA #FitFluential
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Chronic-Intractable Pain And You, Inc. (Main Site)

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A safe place to talk and take action against the laws of prescribing for chronic/intractable pain sufferers...

 

Describing your pain

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Ow.ly - image uploaded by @SweetPeaAngelz (Krista Lynn Hughes)

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View and share this image from @SweetPeaAngelz (Krista Lynn Hughes) and hosted by Ow.ly (Two types of CRPS are . .
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A Controversial ‘Cure’ for Multiple Sclerosis

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Are tens of thousands of multiple sclerosis patients really getting better, or are they just experiencing the power of suggestion?
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Fibromyalgia: Coping with an Illness Others Cannot See

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Ideally it becomes our decision when and how to make our experience visible and when to keep it invisible.
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Sophia Williams's curator insight, December 9, 2013 1:23 PM

Fibromyalgia has been a troublesome illness for many years, as it is difficult to diagnose, and difficult to cope with as it has so many symptoms and is also known as an 'invisible illness'. From a personal note I can identify with how difficult this can be to cope with, and this article is very useful for those suffering and those around them.