Literature Review

Alternative therapies for pain management in senior careMedCity News, by Bent Philipson; by 1/30/24Chronic pain, an enduring concern for many older adults, is no longer confined to the traditional realm of pharmaceuticals. While traditional pain management methods like medication were once the go-to approach, alternative therapies are emerging as a viable and holistic approach to addressing this issue.

Ethical issues in pain and palliationCurr Opin Anaesthesiol, by Marco Cascella, Alessandro Laudani, Giuliana Scarpati, Ornella Piazza; 1/30/24Summary: Palliative care in the ICU should involve a multidisciplinary team, to mitigate patients suffering and futility. Providing spiritual support in the ICU is an important aspect of holistic patient care too. Increasingly sophisticated tools for diagnosing and treating pain, as those involving artificial intelligence, might favour disparities in access, cause informed consent problems, and surely, they need prudence and reproducibility. Pain clinicians worldwide continue to face the ethical dilemma of prescribing opioids for patients with chronic noncancer pain. Balancing the need for effective pain relief with the risk of opioid misuse, addiction, and overdose is a very controversial task.

Washington State reaches a nearly $150 million settlement with Johnson & Johnson over opioid crisisAP, by Manuel Valdes and Hallie Golden; 1/24/24The Washington state attorney general announced a $149.5 million settlement Wednesday with drugmaker Johnson & Johnson, more than four years after the state sued the company over its role in the opioid addiction crisis. “They knew what the harm was. They did it anyway,” Attorney General Bob Ferguson told reporters Wednesday. 

New research challenges the commonly held view that opioids are the most powerful pain relieversSciTechDaily, by University of Sydney; 1/21/24A University of Sydney-led study challenges the prevailing view of opioids as the most effective pain relievers for cancer, revealing significant evidence gaps and suggesting NSAIDs as a potential alternative. This research advocates for more informed choices in cancer pain management, emphasizing patient empowerment and the consideration of non-opioid options.

Northwestern researchers find significant racial disparities in pediatric health careThe Daily Northwestern, by Isaiah Steinberg; 1/21/24Despite controlling for health insurance status, researchers found vast disparities in health care quality in several pediatric specialties such as neonatal care, emergency medicine and palliative care. ... Researchers saw greatest disparity in care occurred in pain management, with non-white children less likely to be prescribed painkillers for serious medical conditions.

Hollywood's portrayal of cancer in movies fuels misconceptions, new study findsPR Newswire; 1/17/24... Researchers reviewed more than 100 films released between 2010-2020 and found several key findings about films' lasting impact on public perception of cancer treatment, prevention and care options. Key findings from the study include:

Upcoming e-prescribing regs could give relief to hospice, palliative care providers, advocates sayMcKnights Home Care, by Adam Healy; 1/5/24Proposed rules, if finalized, could make it easier for providers to prescribe controlled substances via telemedicine. The Drug Enforcement Administration is expected to develop a “special registry” for certain controlled substances that could be prescribed without an in-person visit, according to Katy Barnett, director of home care and hospice operations and policy at LeadingAge. Certain substances were already granted similar prescription flexibilities during the COVID-19 public health emergency (PHE); a new registry would subject these substances to oversight by the DEA.

Should patients be allowed to die from anorexia?DNYUZ; 1/3/24The doctors told Naomi that she could not leave the hospital. She was lying in a narrow bed at Denver Health Medical Center. Someone said something about a judge and a court order. Someone used the phrase “gravely disabled.” Naomi did not think she was gravely disabled. Still, she decided not to fight it. She could deny that she was mentally incompetent — but this would probably just be taken as proof of her mental incompetence. Of her lack of insight. She would, instead, “succumb to it.” [Read more of Naomi's story, followed by this examination of palliative care.]The field of palliative care was developed in the 1960s and ’70s, as a way to minister to dying cancer patients. Palliative care offered “comfort measures,” like symptom management and spiritual guidance, as opposed to curative treatment, for people who were in pain and would never get better. Later, the field expanded beyond oncology and end-of-life care — to reach patients with serious medical illnesses like heart disease, H.I.V. and AIDS, kidney failure, A.L.S. and dementia. Some people who receive palliative care are still fighting their diseases; in these cases, the treatment works to mitigate their suffering. [Read more of this discussion of emerging issue.]

We’re Thinking About Pain All WrongNew York Times, By Maia Szalavitz. Opinion Writer, 12/24/23For many years I’ve written about people suffering intractable pain, and how their agony and increased risk of suicide and death has been ignored in the rush to end the overdose crisis. ... Between five million and eight million Americans currently rely on opioids to treat chronic pain, and thousands need them for end-of-life pain at any given time. Despite their risks, opioids remain the best available pain treatment for many patients—and there is little evidence that addictions are prevented or treated by denying them to those who have already used them safely for years. Concerns about the harms associated with indiscriminate cutbacks have been raised by the Centers for Disease Control and Prevention, the Food and Drug Administration and major medical organizations. Nevertheless, doctors continue to abandon these patients while the overdose crisis worsens.

Medical marijuana takes off in Mississippi, but stalls out in AlabamaBirmingham (AL) NewsDecember 5, 2023Alabama passed a law legalizing medical marijuana in May 2021. Mississippi followed seven months later in January 2022. While Alabama’s medical marijuana licensing process has faced several deadlocks in the face of lawsuits, mismanagement and political opposition, Mississippi’s has marched steadily forward. Its first dispensaries opened in early 2023, and the number has already grown to about 100 by year’s end, said Henry Crisler, assistant director of the Mississippi Medical Marijuana Association. ... Dispensary owners said the industry has encountered some obstacles in Mississippi but have also shown that medical marijuana has a place in the Deep South.