Medicare Is Cracking Down on Opioids. Doctors Fear Pain Patients Will Suffer. - The New York Times

Medicare officials thought they had finally figured out how to do their part to fix the troubling problem of opioids being overprescribed to the old and disabled: In 2016, a staggering one in three of 43.6 million beneficiaries of the federal health insurance program had been prescribed the painkillers.

Medicare, they decided, would now refuse to pay for long-term, high-dose prescriptions; a rule to that effect is expected to be approved on April 2. Some medical experts have praised the regulation as a check on addiction.

But the proposal has also drawn a broad and clamorous blowback from many people who would be directly affected by it, including patients with chronic pain, primary care doctors and experts in pain management and addiction medicine.

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https://www.nytimes.com/2018/03/27/health/opioids-medicare-limits.html?

America's War on Pain Pills Is Killing Addicts and Leaving Patients in Agony - Reason.com

Craig, a middle-aged banking consultant who was on his school's lacrosse team in college and played professionally for half a dozen years after graduating, began developing back problems in his early 30s. "Degenerative disc disease runs in my family, and the constant pounding on AstroTurf probably did not help," he says. One day, he recalls, "I was lifting a railroad tie out of the ground with a pick ax, straddled it, and felt the pop. That was my first herniation."

After struggling with herniated discs and neuropathy, Craig consulted with "about 10 different surgeons" and decided to have his bottom three vertebrae fused. He continued to suffer from severe lower back pain, which he successfully treated for years with OxyContin, a timed-release version of the opioid analgesic oxycodone. He would take a 30-milligram OxyContin tablet twice a day, supplemented by immediate-release oxycodone for breakthrough pain when he needed it.

Then one day last May, Craig's pain clinic called him in for a pill count, a precaution designed to detect abuse of narcotics or diversion to nonpatients. The count was off by a week's worth of pills because Craig had just returned from a business trip and forgot that he had packed some medication in his briefcase. He tried to explain the discrepancy and offered to bring in the missing pills, to no avail. Because the pill count came up short, Craig's doctor would no longer prescribe opioids for him, and neither would any other pain specialist in town.

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http://reason.com/archives/2018/03/08/americas-war-on-pain-pills-is

What's in a Name for Chronic Pain? | Pain Research Forum

For decades, pain researchers have set their sights on understanding pain mechanisms—the cellular and molecular machinery underlying chronic pain. In doing so, they became increasingly aware that the terms they used to describe the neurobiological workings of pain did not always match what they had learned.

But now, official adoption by the International Association for the Study of Pain (IASP) of an IASP terminology task force recommendation for a so-called "third mechanistic descriptor" of chronic pain could move the field forward in its efforts to more fully characterize the known pathophysiological mechanisms of pain. The new term, christened "nociplastic pain," joins "nociceptive pain" and "neuropathic pain" as terms officially adopted by the association to describe the underlying neurobiological basis of chronic pain.

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https://www.painresearchforum.org/news/92059-whats-name-chronic-pain

Handing out naloxone doesn’t fix opioid crisis | Dalla Lana School of Public Health

In the midst of a national opioid crisis, take-home naloxone programs have expanded rapidly. Ontario's Minister of Health and Long Term Care Dr. Eric Hoskins recently announced that naloxone kits will be provided to fire and police departments across the province, but U of T researchers are questioning whether naloxone distribution might distance people from health-care services or worsen health inequities.

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http://www.dlsph.utoronto.ca/2018/02/handing-out-naloxone-doesnt-fix-opioid-crisis/?