APS Press Room
News Highlights from The Journal of Pain • April 2005
The Peer Review Journal of the American Pain Society
| For immediate release | Contact: Chuck Weber (847) 705-1802 |
GLENVIEW, Ill, April 25, 2005 -- The following news highlights summarize selected articles in the current (April 2005) issue of The Journal of Pain (Vol.6, No. 4), the peer-reviewed scientific journal of the American Pain Society (APS). Based in Glenview, Ill., APS is a multidisciplinary educational and scientific organization dedicated to serving people in pain.
The opinions and ideas expressed in articles appearing in the Journal of Pain do not necessarily reflect those of the editor and publisher or of the American Pain Society.
ACCESS TO CARE FOR CHRONIC PAIN: RACIAL AND ETHNIC DIFFERENCES
Marisa Nguyen, Russell Portenoy, et al, Beth Israel Medical Center, New York
Several studies have documented wide disparities in how racial and ethnic minorities are able to access care for chronic pain. One survey reported that access to opioid medication is limited in communities that are heavily populated by minorities. In this study, researchers sought to evaluate the influence of race and ethnicity on access to treatment for chronic pain. A telephone survey was used to solicit information from 454 white respondents, 447 African Americans and 434 Hispanics, all of whom experienced pain for three months before the interview. The questions explored demographic variables, pain treatment and perceived access to care.
The survey results showed that perceived low access to care correlated with being Hispanic or speaking Spanish, being younger or male, having low income or limited education, being unemployed, and having financial concerns that prevented pain treatment. From the data, the authors concluded that race and ethnicity, along with other demographic and socioeconomic factors influence access to care for chronic pain, and this is becoming a major US health care problem.
RELIEF OF PAINFUL DIABETIC PERIPHERAL NEUROPATHY WITH PREGABALIN: A RANDOMIZED, PLACEBO-CONTROLLED TRIAL
Ralph W. Richter, Russell Portenoy, et al, St. John Medical Center, Tulsa and Beth Israel Medical Center, New York
This study evaluated the drug pregabalin for treatment of a painful complication of diabetes, peripheral neuropathy. In a six-week, randomized, double-blind trial, 246 men and women were evaluated after receiving pregabalin or placebo. The drug has been shown in animal and human studies to have analgesic and anti-anxiety benefits and could be effective for treatment of neuropathic pain.
The results showed that subjects who received pregabalin at 600 mg per day had significantly less pain than the placebo group. The findings also suggest that pregabalin reduces sleep interference and helps improve mood. While the researchers concluded that pregabalin is safe and effective for treatment of pain from peripheral neuropathy, they noted that further studies are needed to explore responses at higher doses and to provide comparative efficacy data against other medications, such as antidepressants and anticonvulsants.
A CONTROLLED TRIAL OF PLACEBO VS. REAL ACUPUNCTURE
Greg Goddard, Yoshi Shen, University of California San Francisco
One of the main obstacles to evaluating pain-relief mechanisms of acupuncture is finding an appropriate control intervention to clinical research. Some efficacy studies have used sham acupuncture in which the needle penetrates the skin at a non-therapeutic level. However, this method proved to be inappropriate as a control for acupuncture studies because even sham acupuncture has an analgesic effect. For this study, researchers administered real acupuncture on 24 subjects and on 25 subjects they used a placebo method with a blunted needle that touched but didn’t penetrate the skin. All subjects were asked if they believed they received real or placebo acupuncture. The results showed that 79 percent of the real acupuncture subjects believed they received real acupuncture, while 88 percent of those given the placebo treatment also believed they had real acupuncture. Researchers concluded that the blunted needle is a valid control for acupuncture research involving acupuncture-naïve patients.
ADDING ULTRA LOW-DOSE NALTREXONE TO OXYCODONE ENHANCES AND PROLONGS ANESTHESIA; A RANDOMIZED CONTROLLED TRIAL OF OXYTREX
Vishala L. Chindalore, Richard A. Craven, et al, Anniston Medical Clinic, Anniston, Ala.
Patients with advanced osteoarthritis can require more aggressive drug therapy for chronic pain and often are given opiates. Oxytex combines oxycodone with ultra low-dose naltrexone, an opioid antagonist. In animals these antagonists enhanced and prolonged opiate analgesia and alleviated opioid tolerance and withdrawal. In this study, researchers assessed the safety and analgesic efficacy of Oxytrex in patients with moderate to severe pain from osteoarthritis. The data showed that the chronic morphine-induced signaling alterations of the opioid receptor were significantly suppressed by the naltrexone co-treatment. Thus, despite less frequent dosing, Oxytrex subjects had significantly lower pain scores than those treated with oxycodone.