State of Emergency Message

Outpatient Opioid Addiction Treatment Using Buprenorphine

By: Dr. Sanford M. Silverman Pain and Addiction Opioid (narcotic) dependence is a serious and growing problem in the United States.  Over 4.4 million people use prescription pain relievers non-medically.  An estimated 2.4 million have used heroin at sometime in their lives.  In 2001, an estimated 2.4 million used pain relievers non-medically for the first time-up from 628,000 in 1990.  An estimated 1.9 million people 12 years of age and older have used oxycodone non-medically.  In the general population, approximately 6-15% of patients suffer from the disease of addiction The number of people using prescription pain relievers non-medically is increasing dramatically.  This, added to the level of established heroin dependence, has set the stage for a critical shortage of qualified opioid dependence treatment physicians. Chronic pain affects millions of people United States and costs of approximately 120-$150 billion annually.  Untreated chronic pain often leads to substance and alcohol abuse.  Over 80% of Americans will experience back pain at sometime in their life. The problem that we are facing in the United States is one in which pain patients are presenting with substance dependence or addiction problems.  Since the incidence of addiction in the general population is 6-15%, the number of patients with chronic pain and addiction can be quite high.  Many physicians with good intentions treat these patients with narcotic painkillers.  However, they often overlook the signs and symptoms of opioid dependence and addiction. Furthermore, some patients treated with opioid painkillers can develop hyperalgesia, which is a state of heightened pain.  One might consider opioid hyperalgesia a form of super tolerance, which is simply that more and more drug is required to an effectively treat the pain. At some point even huge doses of narcotic pain medications can lead to hyperalgesia and simply be ineffective. Often these patients will be receiving very large doses of narcotic painkillers with marginal control of pain.  These patients may or may not present with signs of addiction or opioid dependence.  They are simply being treated with large doses of narcotic painkillers by their physicians and their opioid hyperalgesia is overlooked or not diagnosed. The Drug Addiction Act of 2000 (DATA). The Drug Addiction Act of 2000 (DATA) passed by Congress allows qualified physicians to treat opioid addiction in an office-based setting with the use of Suboxone.  Prior to this, opioid addicted patients had to be treated with methadone in federally licensed and operated methadone clinics. These clinics often were in less than desirable neighborhoods and were quite stigmatized. With the passage of DATA, qualified physicians and can treat opioid addiction in their offices on an outpatient basis. Suboxone, a relatively new drug contains buprenorphine, a partial MU receptor agonist that addresses the biological basis for drug dependence.  Basically, this drug binds to the same receptors in the brain as does morphine, oxycodone and other opioids.  However, buprenorphine not only binds to the receptor but blocks it, which shuts down the cravings, and desires to continually use opioids and also prevents hyperalgesia.  On the other hand, morphine and oxycodone continually activate the receptors, which may lead to tolerance and hyperalgesia in certain patients.  In certain genetically predisposed patients, this will lead to substance dependence and addiction. For more information on this subject, please visit http://www.naabt.org

An Easier Way To Research For Qualified Pain Physicians

We know that researching for a physician can be a difficult task. Even more so when you’re living with pain. So The Pain Truth has done the initial research for you.

Visit this link to find a qualified pain physician in your area based on city locations within the state of Florida.

Next, be sure to find this logo below to certify that the pain physician is a Pain Truth participating office.

Remember, individual qualifications vary. Please check with the physicians you choose for their particular qualifications.

4 Ways To Support The Fight Against Prescription Drug Abuse In Florida

The SUNSHINE STATE is going dark for a day

On the day Florida’s PDMP goes into effect early in 2011, The Pain Truth will be raising awareness of this crisis, throughout the state and the nation, by having the Sunshine State go dark for a day.

What does this mean?

1. Residents throughout the state will be encouraged to wear black clothing, or black armbands in remembrance of the      thousands of individuals who have died due to prescription drug abuse.
2. Corporations in larger cities are encouraged to darken their building lights for the night to show how Florida’s cities are    mourning the loss of so many lives.
3. Residents will be asked to darken their porch lights for a unified moment of mourning for the lives lost due to prescription drug abuse.
4. And hopefully, Florida’s Governor and City leaders will join forces and declare that day, Pain FREE FLORIDA Day and ask that all Florida residents join us in this day of mourning.

Over 9,000 Floridians have died in the past seven years due to prescription drugs…that’s more than 5% of all Florida deaths.

Contact us today for more information or to let us know if you would like to work with us to help coordinate efforts in your city.

Hello Washington…DC

Earlier this month “The Pain Truth” was invited to come to Washington, D.C. to present the campaign to officials from the Office of National Drug Control Policy.

From Florida to the Capital, we landed this morning at Ronald Reagan National Airport.

A firsthand glimpse at some national monuments was quite a treat especially during this time of year.

Then we buckled down for some last minute prep before our meeting.

After an hour and a half presentation we left the meeting feeling motivated about our campaign.

We’d like to thank the ONDCP for meeting with us and allowing us the opportunity to discuss the current epidemic of prescription drug abuse.

 

We are encouraged to continue on with our education initiative regarding the dangers of this unfortunate trend.

6 Tips To Prevent Rx Drug Abuse in the Workplace

Statistics from Quest Diagnostics, a diagnostic testing company, reported the use of prescription opiates by American workers and job applicants has increased by 40% since 2005.

In an effort to help reduce accidents in the workplace, The Pain Truth, has drawn up some recommendations to help employers and employees raise awareness of prescription drug abuse in the workplace.

For Employers

• Provide materials that will educate employees on the harmful effects of prescription drug abuse.
• Be sure to have clearly stated rules in place outlining the disciplinary actions should prescription drug abuse be present in the workplace.
• Train managers, human resource personnel, and others to identify and handle substance abusers.
• Look for abuse among the workforce; some signs of abuse include increased absences, decreased productivity and involvement in accidents both on and off the job.

For Employees

• Take responsibility – whether legal or otherwise, prescription pills do have side effects so be sure to be aware of the implications for both employee and employers if accidents do occur.
• If affected by prescription drug addiction, take advantage of the programs and information available.

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WOULD YOU LIKE “The Pain Truth” MATERIALS FOR YOUR SCHOOL, EVENT OR OFFICE?

Write us today for posters, educational flyers, booklets for high school and college students, banners and radio or television public service announcements on DVD or CD.

The Pain Truth is designed as a public education program, which will include a series of public service announcements, education, awareness, Internet, and community events across the state.  This full-on offensive will canvas the state and reach people at home, workplaces, schools, churches and more, leading up to a 2011 event when The SUNSHINE STATE Goes Dark for a Day.  The event is meant to recognize lives lost, by offering an official day of mourning for families and friends of thousands who have died. (Exact event date TBD)
Largely to blame for the growing crisis are prescription drug abusers, doctor shoppers and the unethical and/or illegal conduct by some members of the medical profession—a small number of practitioners that besmirch the many outstanding medical practitioners in our state.

 **Contact us for The Pain Truth to visit your school, event, or office for a prescription drug abuse education talk.  

 

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Our Newest PSA–Become Part of the Solution

Speaking the “Truth” on Rx Drugs…to Kids

  Interventional pain management specialist and Pain Truth partner, Dr. Lora Brown spoke to students from Lakewood Ranch High on Tuesday, Nov.  9 about the dangers of abusing Rx drugs.

Black bracelets were distributed to students with the message “Wake up! Rx drugs kill” imprinted on them. To illustrate the death rate statistics from prescription drugs, seven student volunteers stood next to seven ambulance gurneys, reflecting the seven Floridians who die daily abusing prescription drugs.

Brown was able to answer questions from the student audience. “Drug abuse is a disease and it’s not unique to Lakewood Ranch High School. Every high school and every community across the country has similar problems,” Brown said.

Shooting pains down the leg???

By: Dr. Jonathan Daitch

Sciatica is the general tem for pain radiating down the leg.  Sciatic pain starts from the buttuck or back usually and radiates down below the knee.  It can be worse with walking, standing or sitting.  If it present all night long, it is often secondary to a large disk herniation.  It is usually intense, deep and aching.  Sometimes it is electrical and shooting. 
 
The most frequent cause of sciatica is irritation of a nerve root such as from a disc herniation or smaller disc protrusion.  Another cause stems from spinal stenosis, where aging and degeneration cause narrowing of the spinal canal and exiting nerve roots causing nerve root irritation.  Also, there are many cases of chemical sciatica where leaking inflammatory substances from a damaged disc can irritate and inflame the nerve root causing pain. 
 
Treatment of sciatica depends on the cause.  A disc protrusion or small herniation often responds to several injections of steroid along the affected nerve root.  Steroid is a potent neutralizer of these inflammatory substances which promote pain.  The injections are performed by an interventional pain physicians under fluoroscopic X-ray guidance.  Usually 2 or 3 injections suffice to quell the pain.   Injections coupled with physical therapy have the best success.
 
Rarely, people need to be sent for surgery.  Surgery is recommended when pain is so unrelenting from a large disk herniation, that conservative therapy fails.  It is also recommended for progressive weakness of the leg.  However, long term, there is no statistical difference in future pain in cases of herniated discs, whether patients had surgery or not.  That is why we advocate conservative, non-surgical treatment for sciatica whenever possible.