Pain medicine : the official journal of the American Academy of Pain Medicine
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Review Meta Analysis
Systematic review and meta-analysis of cannabis treatment for chronic pain.
Cannabis preparations have been used as a remedy for thousands of years in traditional medicine. Clinical use of cannabinoid substances is restricted, due to legal and ethical reasons, as well as limited evidence showing benefits. ⋯ Currently available evidence suggests that cannabis treatment is moderately efficacious for treatment of chronic pain, but beneficial effects may be partially (or completely) offset by potentially serious harms. More evidence from larger, well-designed trials is needed to clarify the true balance of benefits to harms.
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Comparative Study
A comparison of common screening methods for predicting aberrant drug-related behavior among patients receiving opioids for chronic pain management.
The ability to predict risk for violating opioid medication policies, known as aberrant drug-related behavior, is critical for providing optimal treatment. Many pain management centers measure risk using one of several partially validated measures: the Screener and Opioid Assessment for Patients with Pain (SOAPP), the Diagnosis, Intractability, Risk, and Efficacy inventory (DIRE), and/or the Opioid Risk Tool (ORT). However, little is known about how these measures compare with each other in predicting aberrant drug-related behavior and discontinuance of opioid pain medications. The current study aimed to address this research question. ⋯ Among patients who were discontinued from opioids for aberrant drug-related behaviors, the clinical interview and the SOAPP were most effective at predicting risk at baseline. Implications for future research and clinical practice are discussed.
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The aim of this study was to describe the rationale behind the choice of fentanyl administration forms among Danish pain specialists. ⋯ The study had shown that the rationales behind the choice of administration form with fentanyl reported by a panel of Danish pain specialists partly differed from those overviewed in the literature and those thought to be important while developing fentanyl patches and OTFC.
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Restless legs syndrome (RLS) occurs in polyneuropathy with small fiber involvement, possibly as a peculiar form of neuropathic pain; however, the relationship between pain and RLS has been poorly investigated in polyneuropathy. ⋯ RLS is frequent in painful polyneuropathy and is significantly associated with decreased small fiber input, thus nociceptive deafferentation may represent a factor interacting with RLS "generators," possibly at spinal level. We suggest that overactivity of the spinal structures implicated in RLS may be triggered by nociceptive deafferentation in a subgroup of patients with painful polyneuropathy. Our findings, prompting a mechanistic characterization of RLS associated with painful polyneuropathy, have to be confirmed in a prospective study.
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Catastrophizing has been broadly conceived as an exaggerated negative "mental set" brought to bear during actual or anticipated pain experience and has risen to the status of one of the most important psychological predictors of pain. The present study aimed at investigating the relationship between catastrophizing and postoperative pain outcomes (pain intensity and analgesia use) in patients undergoing elective instrumented lumbar fusion surgery. ⋯ The present study findings suggest that it is possible to preoperatively identify patients at risk for experiencing more severe pain in the postoperative recovery period. In such cases, consideration might be given to utilizing a variety of resources to ameliorate or prevent pain.