Many Americans Eying CBD, Pot as Pain Relievers Without Knowing Risks

Most Americans are interested in using marijuana and CBD products to manage pain, but many don’t understand the potential dangers, a new survey finds.

Among more than 1,000 adults aged 18 and older, more than two-thirds have used or would consider using marijuana or cannabinoid compounds, including cannabidiol (CBD) and tetrahydrocannabinol (THC).

Nearly three-quarters of millennials expressed interest and 37% said they’ve used the compounds for pain. Two-thirds of Gen Xers and baby boomers expressed interest, while 25% of Gen Xers and 18% of baby boomers said they’ve used the compounds for pain.

Of the respondents who were interested in using marijuana and cannabinoid compounds to manage pain, three-quarters said they believed they’re safer or have fewer side effects than opioid painkillers or other medications, according to the survey commissioned by the American Society of Anesthesiologists (ASA).

“As experts in managing pain, physician anesthesiologists are concerned about the lack of research regarding the safety and effectiveness of marijuana and cannabinoids,” said ASA President Dr. Linda Mason.

“The good news is that until the research is completed and we fully understand the risks and potential benefits, physician anesthesiologists today can develop a personalized plan for patients’ pain drawing from effective alternatives such as non-opioid medications and other therapies, including injections, nerve blocks, physical therapy, radio waves and spinal cord stimulation,” Mason said in an ASA news release.

Only 13% of the survey respondents said they have used or would consider using marijuana or cannabinoids because no other type of pain management works for them.

Along with risks ranging from excessive sleepiness to liver damage, marijuana and cannabinoid compounds are not monitored for quality, according to the ASA.

Yet 40% of respondents believe that CBD products in grocery stores, health food stores and medical marijuana dispensaries are approved by the U.S. Food and Drug Administration. In truth, only one prescription version of CBD — for patients with one of two rare forms of epilepsy — has been approved by the FDA.

No form of marijuana is approved by the FDA. Thirty-three states and Washington, D.C., have legalized marijuana for recreational or medical use, but all have their own regulations, which vary widely.

Studies have shown that no matter what the label says, the actual ingredients in marijuana and cannabinoid compounds may differ, and they may contain dangerous synthetic compounds, pesticides and other impurities, according to the ASA.

Source: HealthDay

Chart of the Day: America Experiences More Physical Pain Than Other Countries

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Source : The Atlantic

Upbeat Attitude May Be a Pain Fighter

Steven Reinberg wrote . . . . . . . . .

Optimism may be key to coping with chronic pain, claims a new study of soldiers who served in Iraq and Afghanistan. And you don’t need to be a vet to benefit from a positive attitude, the research suggests.

Among nearly 21,000 veterans, those with a positive outlook before they were sent abroad reported fewer bouts with pain after deployment, including new back pain, joint pain and frequent headaches.

“What was striking was that optimism was associated with less pain even when taking into consideration what the soldiers experienced during deployment, such as combat stress and trauma, as well as injury,” said lead researcher Afton Hassett. She is an associate research scientist at the University of Michigan in Ann Arbor.

And an upbeat attitude can have the same power for civilians, the study authors said.

“Although the experience of the U.S. Army soldier is incredibly different than that of a civilian, there is a large body of literature that suggests that optimism is protective for the experience of pain,” Hassett said.

Optimistic people, for example, have lower levels of pain sensitivity as well as generally better adjustment when they do have pain, she added.

Hassett’s team also found that even moderate levels of optimism were protective for the development of pain after deployment, which suggests that you don’t need to be a hopeless optimist to still benefit.

Using data from the U.S. Army, the researchers found that among nearly 21,000 soldiers, 37 percent reported pain in at least one new area of the body after deployment: 25 percent reported new back pain; 23 percent new joint pain; and 12 percent new frequent headaches.

The findings showed that every increase in a score that measured optimism was linked with 11 percent lower odds of reporting any new pain after deployment.

Hassett’s group also found that, compared with soldiers with high optimism, those with low optimism had 35 percent higher odds of reporting new joint pain or back pain or frequent headaches.

Moreover, a larger increase for the risk of new pain was seen among those with low optimism when compared with those with moderate optimism.

However, the study didn’t account for psychiatric disorders, and data on pain were limited. In addition, the researchers couldn’t prove that optimism itself causes chronic pain risk to drop.

Dr. Jianguo Cheng, president of the American Academy of Pain Medicine, said that optimism can be an effective tool in helping to cope with chronic pain. This study shows clearly what is already known about how one’s mental attitude can affect one’s physical health, he added.

“It’s a fact that optimism is associated with better outcomes in stress or traumatic events,” Cheng said. “People can be prepared through training in optimism.”

Even those who suffer from chronic pain can be helped by cognitive behavioral therapy that includes positive thinking as part of their treatment, Cheng noted.

Adding optimism training to treatments such as cognitive behavioral therapy and physical therapy might help patients suffering from chronic pain to better cope, he suggested.

Treating pain requires an individualized approach that combines medication with talk therapy, physical therapy and, in some cases, surgery, Cheng said.

“Pain management has to be multifactorial. A single approach is usually not effective,” he explained.

The report was published online in JAMA Network Open.

Source: HealthDay

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Researchers Find Animations to be Effective in Accurately Measuring Pain

To improve communication about pain between patients and physicians, a team led by researchers from the University of Pittsburgh and UPMC has developed a mobile application called “Painimation” that has the potential to assess and monitor pain better than any previously used measurement tools. Results of the clinical trial were published today in the Journal of Medical Internet Research.

“Currently, our only available tools for patients to communicate their pain is to either give them 0 to 10 scales or a selection of words and phrases to describe their pain, methods that have been used for more than 50 years,” said lead author Charles Jonassaint, Ph.D., M.H.Sc., assistant professor of medicine, social work and clinical and translational science. “Many pain patients will say their pain can’t be measured on the 0-to-10 scale and that it is too challenging to describe their pain using words. As a result, their pain is misunderstood and patients in pain may be prescribed more opioids without always knowing whether they are needed or if they are working.”

Painimation is an electronic assessment tool that uses animations to assess pain quality, type and location. With this app, patients are first provided with a selection of animations that they can use to describe the severity of their pain. These animations can then be increased or decreased in speed, color saturation, focus and size to accurately match their pain experience. The app also provides users with the opportunity to label their pain on a human body, allowing them to identify where and how much of their body is affected by pain.

“By using animations, we have the potential to more quickly and accurately understand a person’s pain experience, and, more importantly, provide treatments that work and stop those that don’t,” Jonassaint said.

Jonassaint led a multidisciplinary team that included psychiatrists, technology designers and anesthesiologists as they examined 202 patients with chronic pain — pain more days than not for three months or more. Once the app was fully developed through three phases of testing, the patients used Painimation to characterize the quality and intensity of their pain, alongside the completion of the McGill Pain Questionnaire and the PainDETECT questionnaire, the current standards for assessing pain.

Study results showed that more than 80 percent of patients found the app to be enjoyable, and they would use the app to communicate their pain with their medical care providers. Also, Painimation was completed more quickly than either the McGill or PainDETECT questionnaires, and provided just as much or more information about the type and cause of pain.

“We believe using animations to measure pain can allow patients to not only describe pain sensations in a similar manner to how they experience them, but minimize potential barriers to pain assessment because the effects of language and literacy are taken out of the equation,” Jonassaint said. “Further, we can decrease the burden of long, detailed pain assessments while collecting pertinent information on each patient’s pain experience through an easy to administer, novel and engaging medium.”

“Painimation gives patients an opportunity to describe their pain to physicians in ways not possible with conventional pain rating scales,” said Ajay Wasan, M.D., M.Sc., vice chair of pain medicine and anesthesiology at UPMC. “While much development works remains to be done, these early results are very encouraging to the push for better ways to describe the pain experience.”

Source: University of Pittsburgh

Study: Medicinal Cannabis May Not Actually Relieve Pain

It’s safe to say most people think cannabis chills you out.

Now researchers have discovered that perception may be stronger than the drug itself.

In a large study of the effect cannabis has on pain in sufferers across Australia, the team from the National Drug and Alcohol Research Centre (NDARC) uncovered some unexpected results.

While they found most people “perceived it to help”, in reality, it didn’t really change their level of pain.

Researchers think this might be simply because medicinal cannabis can help people sleep so their pain is more tolerable the next day.

The University of New South Wales study followed 1500 people over four years to see how pain interfered with their everyday life and whether using medicinal cannabis would change their prescribed opioid use.

Worldwide interest in the area has been growing, particularly for chronic non-cancer pain.

There has also been increasing speculation that using cannabis for pain may allow people to reduce their prescribed opioid.

The results, published in Lancet Public Health on Tuesday, suggest that there is a need for caution given there were “no strong findings supporting a clear role for cannabis for these reasons”.

Participants who were using cannabis had greater pain and anxiety, were not coping as well with their pain, and reported that pain was interfering more in their life.

They found there was no clear evidence that cannabis reduced pain severity or pain interference or led participants to reduce their opioid use or dose.

NDARC director Professor Michael Farrell said medicinal cannabis had been a very hard sell and people needed to approach it with caution.

“People who otherwise wouldn’t have gone near cannabis have been experimenting with it,” he said.

“One of the things we think happens when people report benefits is the sleep and sedation effects it has.

“Often when you get a good night’s sleep your pain is a lot more tolerable.”

In what was one of the world’s longest in-depth community studies on pharmaceutical opioids and chronic non-cancer pain, participants were recruited through community pharmacies and completed comprehensive assessments of their pain, physical and mental health, medication and cannabis use annually.

They had been in pain for a median of 10 years and taken prescribed opioids for their pain for a median of four years, with “very high rates of physical and mental health problems”.

Lead author Dr Gabrielle Campbell said chronic non-cancer pain was a complex problem.

“For most people, there is unlikely to be a single effective treatment,” she said.

“In our study of people living with chronic non-cancer pain who were prescribed pharmaceutical opioids, despite reporting perceived benefits from cannabis use, we found no strong evidence that cannabis use reduced participants’ pain or opioid use over time.”


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