Publications
The Journal of Pain • Volume 9, No. 4, April 2008
APS members and subscribers to The Journal of Pain may view this issue online at www2.jpain.org. Abstracts and table of contents of each issue of The Journal of Pain are available for online viewing.
The following news highlights summarize selected articles in the April 2008 issue of The Journal of Pain, the peer-reviewed scientific journal of APS.
Note: 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.
Study Shows Social Support Helps Pain Patients Cope
Alicia E. Lopez-Marinez, Rosa Esteve-Zarazaga and Carmen Ramirez-Maestre, Universidad de Malaga, Spain
People with chronic pain who receive strong social support have lower pain intensity and less risk for depression, according to research published in The Journal of Pain.
Spanish researchers evaluated 117 patients who had pain every day for at least six months. The mean age was 54 and 70 percent were women. Each participant was interviewed by a psychologist.
From the interviews and subsequent data analysis, the study concluded that patients who receive higher levels of social support not only showed lower incidence of depression but also had less pain. The authors noted that reduced pain intensity decreases impairment and increases the ability to function every day. The study underscores the potential importance of psychosocial factors in helping patients adjust to chronic pain.
Decreased Fear Helps Children Cope with Pain
Luis F. Buenaver, Robert R. Edwards, Michael T. Smith, Sandra E. Gramling and Jennifer A. Haythornthwaite, Johns Hopkins University School of Medicine, Baltimore, MD
Anxiety and magnified fear about pain, called catastrophizing, can exacerbate the pain experience. A study published in The Journal of Pain reports that headache sufferers who showed the highest levels of pain catastrophizing had greater pain intensity and significant depressive symptoms.
Researchers from Johns Hopkins University evaluated 202 undergraduate students in two groups: those with problem headaches and pain-free individuals. They were evaluated with the Headache and Facial Pain Screening Questionnaire, Beck Depression Inventory and the Coping Strategies Questionnaire.
The researchers found there were no significant differences in catastrophizing between the problem headache group and the pain-free subjects. However, the headache group reported greater depressive symptoms. Further, even though higher levels of catastrophizing predicted more severe headache pain and depressive symptoms, the use of other coping strategies did not influence pain or depression. The authors concluded their findings reflect the major role that catastrophizing and other negative emotional responses play in shaping pain-related outcomes.
New Evidence on Morphine-Alcohol Interaction
Franklin Johnson, George Wagner, Stephen Sun and Joseph Stauffer, Alpharma Pharmaceuticals, Piscataway, NJ
A study published in The Journal of Pain showed that an extended-release form of morphine, KADIAN, has negligible risk for harmful interaction with alcohol.
Alcohol enhances the effects of opioids on the central nervous system, and even moderate drinking risks potential drug interactions. Combining alcohol and pharmaceuticals, according to the Drug Abuse Warning Network, accounted for 13.5 percent of all emergency room visits in 2005.
Following the withdrawal of Palladone from the market, the FDA advised makers of other extended-release opioids to determine the risk of alcohol-induced dose dumping, in which an unintended rapid release of the active drug occurs. This study was conducted to evaluate potential interactions of KADIAN when dosed with alcohol in fasting and fed subjects. Thirty-two opioid-naive healthy adult males with a history of moderate alcohol consumption were evaluated. The subjects were randomly assigned to three regimens: KADIAN with four shots of 80-proof alcohol and water while fasting, the drug with four shots of alcohol after ingesting a high-fat meal, and the drug with water while fasting.
The authors reported no drug interactions with alcohol were observed, indicating the extended-release mode of action was not significantly affected by alcohol. They noted it is not known why some extended-release opioid formulations are subject to dose dumping with alcohol and others are not. Nevertheless, it is not recommended that alcohol be used when taking any opioid medications.
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