March 2013

David Craig, PharmD
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APS E-News is made possible through an unrestricted educational grant from Purdue Pharma.

Annual Meeting

Annual Meeting Speaker Highlight

Story Landis, PhD, Director, National Institute of Neurological Disorders and Stroke/National Institutes of Health
Keynote Address
The Future of Pain Research: Challenges and Opportunities


Please give us a brief description of your current area of specialty. What sparked your interest in your field?
I am a developmental neurobiologist by training. I was particularly interested in how, during development, functionally appropriate synapses form in the nervous system. For the past 17 years, I have devoted my time to science administration, first as the scientific director of the intramural program at the National Institute of Neurological Disorders and Stroke (NINDS) and then for the past 9 years as director of NINDS, responsible for both intramural and extramural activities.

What is the one thing you hope APS attendees will take away from the information you present during your keynote address at the annual meeting?
The National Institutes of Health (NIH) funds a broad range of investigations into the basic mechanisms of pain as well as translational projects aimed at better treatments and clinical studies, both epidemiological and interventional. My talk will highlight a number of important advances and lay out opportunities for future progress.

In your opinion, what is spurring pain research in our current healthcare climate?
It is important to recognize that the ultimate goal of all individual research programs and the nation’s collective pain research efforts is to improve care for people with pain. As such, the urgent need to bring research advances into the clinic can be met only through action at all levels and from all stakeholders. No single entity, including NIH, has adequate resources to meet this challenge. Fortunately, many organizations and individuals contribute enormous efforts toward this end.

The Interagency Pain Research Coordinating Committee, a newly established entity in the pain research arena, is providing a platform for stakeholders with diverse interests to identify opportunities and gaps in the federal pain research portfolio. All of these efforts to translate research into clinical practice need to be enhanced by better communication between researchers and clinicians, increased collaboration among private and public funding sources of pain research, more sharing of knowledge and resources between industry and public entities, and greater outreach to and from professional societies and patient groups on research findings.

Our healthcare system faces huge hurdles in providing integrated and multidisciplinary care for millions of people with chronic pain. Overcoming barriers to providing integrated pain management can only be achieved through consolidated efforts at many levels. A crucial part of those efforts is support of pain research aimed at developing, validating, and assessing multidisciplinary approaches. Successful steps have been taken by NIH and other federal agencies to support and encourage collaborative and multidisciplinary programs that span basic through clinical pain research. Funding announcements and special programs encourage nonpain researchers to partner with experts in the pain field, workshops bring together diverse expertise, grants are awarded to assess efficacy of multidisciplinary interventions, and multifaceted research projects to understand and treat chronic pain conditions are supported. Such research efforts are helping to build a foundation for implementation of more integrated and effective approaches to pain management.

Have You Registered Yet? It’s Your Last Chance to Save $100!

We hope you will join us at the APS Annual Scientific Meeting in New Orleans May 8–11. Register today to experience these valuable and exciting opportunities:

  • Gain knowledge from 30 symposia sessions, 3 in-depth workshops, and 17 special interest group meetings.
  • Learn information necessary to effectively assess the pain patient, develop a treatment plan, assess for risk of opioid abuse, and plan for ongoing assessment of the patient by attending a 3-hour risk evaluation and mitigation strategies (REMS) session on Saturday, May 11.
  • Connect with more than 400 poster presenters.
  • Earn more than 15 hours of continuing education/contact hours in four discipline areas.
  • Learn about innovative and compelling clinical and basic science research by attending the Clinical and Basic Science Data Blitz.
  • Enjoy the sound of the Pain Sensations, APS’s house band, in the French Quarter on Thursday night.

The Early-Bird Deadline Is Quickly Approaching! Register by March 27 to Receive $100 Off Your Registration Fee

To learn more about APS’s Annual Scientific Meeting and to register, visit the 2013 Annual Scientific Meeting website.

Don’t Miss the CAM SIG Preconference Symposium

Join us in New Orleans for an opportunity to participate in a new symposium sponsored by the National Center for Complementary and Alternative Medicine in conjunction with APS’s 32nd Annual Scientific Meeting.

This preconference symposium, which will take place just prior to the annual meeting, will raise awareness of approaches and challenges for Complementary and Alternative Medicine (CAM) researchers and discuss possible clinical applications for healthcare professionals. The challenges and opportunities associated with current CAM research as it relates to chronic pain management in the field of medicine will be addressed. A primary goal of the conference is to encourage collaborations among pain clinicians and researchers in CAM practice and research.

Registration for this symposium is required. This symposium is not included with registration for the APS 32nd Annual Scientific Meeting. For more information about conference registration and fees, visit the APS website.

Recognizing Excellence: 2013 Clinical Centers of Excellence Awards

The 2013 Clinical Centers of Excellence (CCOE) awards will be presented at the President’s Recognition Reception taking place on Thursday, May 9, 6:30–8 pm. The evening’s events will include a cocktail reception, remarks from the APS President, and an awards presentation. Congratulations to the following winners:

Neuromedicine Pain Management Center, University of Rochester Medical Center
Rochester, NY
University-Based Program
The Neuromedicine Pain Management Center offers a uniquely integrated approach to the treatment of over 2,000 patients each year. The Center combines medical, behavioral, procedural, and rehabilitation modalities at a single regional outpatient hub. Because chronic pain arises in the nervous system, evaluation begins with specialists in neuromedicine. With specialists from neurology, neurosurgery, and allied fields working together, a range of diagnostic perspectives are considered and treatment courses outlined at the outset. For example, in the course of a visit, a patient with possible trigeminal neuralgia is examined by a neurologist, a neuroradiologist who interprets imaging findings, and a neurosurgeon who explores the gamut and timing of procedural treatment options. Case conferences and routine measurement along 16 dimensions of patient experience are mainstays of the effort to improve outcomes. The Center is committed to educating practicing providers and trainees at all levels. The Advances in Pain Management Continuing Medical Education (CME) Series annually draws more than 160 participants. Its monthly Translational Pain Research Forum CME series, launched in 2009, brings together basic and clinical scientists with pain practitioners of all types throughout the region. One CCOE award reviewer noted, “This program has a very robust commitment to education of pain scientists and clinicians.” The Center’s clinical research focuses on neuropathic pain conditions, low back pain syndromes, and novel therapies. Another reviewer summarized, “This program seems to nail it in translational research! This is something rare, even among top university pain programs.” Access to comprehensive care is a major barrier to improved treatment for the population of patients with chronic pain. The Center addresses this problem by ensuring provider continuity; staffing a bilingual team; and with its recent launch of a regional outreach clinic located 70 miles away, providing services in an underserved rural area with limited access to integrated care.

Children's Hospitals and Clinics of Minnesota
Minneapolis, MN
Community-Based Program
Children’s Hospitals and Clinics of Minnesota has one of the largest, long-standing pediatric pain medicine, palliative care, and integrative medicine programs in North America. This program combines state-of-the-art pharmacology, along with non-medicine strategies and integrative medicine therapies to alleviate pain in pediatric patients at home, in clinic, or on inpatient units. The team consists of 33 interdisciplinary staff members that include physical therapists, psychologists, massage therapists, physicians, advanced practice nurses, child life specialists, social workers, nurses, and a chaplain. These team members are devoted to controlling acute, chronic, complex, and procedural pain in all in- and outpatients, in close collaboration with all pediatric subspecialties at Children’s of Minnesota. The program also provides holistic, interdisciplinary care for children with life-limiting or terminal diseases and their families. The staff provides and teaches integrative, non-pharmacological therapies such as massage, acupuncture and acupressure, biofeedback, aromatherapy, and self-hypnosis to provide care that promotes optimal health and supports the highest level of functioning for each child's activities.

CO*RE Educational Initiative to Address Extended-Release/Long-Acting Opioid REMS Receives Funding

APS is a partner of the Collaboration for REMS Education (CO*RE), which recently received approval from the REMS Program Committee (RPC) for its national initiative to support educational activities addressing the public health crisis surrounding the use, abuse, diversion, and overdose associated with of extended-release/long-acting (ER/LA) opioids.

A Risk Evaluation and Mitigation Strategy (REMS) is a risk management program required by the U.S. Food and Drug Administration (FDA) to ensure that the benefits of a drug outweigh its risks. The FDA has determined that a single, shared REMS is required for all brand and generic ER/LA opioid pain medicines. This is the first time the FDA has mandated a REMS to include accredited professional education. The FDA has also required the pharmaceutical companies that produce these agents to provide the financial support for independent professional education.

A multidisciplinary, 10-partner collaboration representing nearly 400,000 clinician members, CO*RE was founded in June 2010 to specifically address this crisis. CO*RE members include the full continuum of targeted prescribers—doctors of medicine or osteopathic medicine, nurse practitioners, and physician assistants—who practice in primary care, addiction, pain, hospice and palliative care medicine, and other specialties in settings ranging from solo practice to academic research.

CO*RE’s goal is to leverage the strength and reach of its organizations to provide effective prescriber-focused education on the safe and effective prescribing of LA/ER opioids to safely manage pain. CO*RE’s ultimate mission is to ensure that these medications are prescribed, when indicated, in a manner that enhances patient well‐being and does not contribute to individual or public harm.

Dissemination is key to the success of this initiative. APS will host an online self-directed training program on its website. APS will also share this content at the upcoming APS 2013 Annual Scientific Meeting in New Orleans, LA, during an intensive, live 3-hour special course. APS will reach out to area clinicians to encourage them to attend this event. A similar course will also be conducted later this summer at PAINWeek, the largest pain meeting for the primary care clinician. For information on the REMS educational event or to register, visit the REMS page on the APS website.


Funding Announcements

Urologic Chronic Pelvic Pain Syndrome (UCPPS) Research (R01)

The purpose of this funding opportunity announcement (FOA), issued by the National Institutes of Health, is to seek innovative research proposals that improve our understanding of the etiology, pathology, natural history, and risk factors for urologic chronic pelvic pain syndromes (UCPPS), traditionally referred to as interstitial cystitis/painful bladder syndrome (IC/PBS) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Office of Research on Women’s Health (ORWH) are seeking innovative 1-year research applications that improve our understanding of the etiology, pathology, natural history, and risk factors for UCPPS. Since it is obvious from past experience that focusing on urologic organs may not be enough to make progress in our understanding of UCCPS, a multidisciplinary team approach to this chronic pain condition is strongly encouraged. Basic scientists, epidemiologists, data analysts, and clinicians are needed to investigate and complement the efforts already in place for advancing the research on UCPPS.

This program is designed to solicit a broad scope of UCPPS research. Applicable studies may include basic cellular, molecular, and biochemical strategies to identify mechanisms involved in the development of UCPPS and in vivo studies using animal models that mimic key, clinically relevant human UCPPS symptoms and include a strong translational potential. Clinical studies are also encouraged. These may include, for example, testing of novel pharmacologic and nonpharmacologic strategies in humans to mitigate pain associated with bladder filling, manage symptoms, improve function, reduce disease burden, and enhance quality of life. Minimally invasive and noninvasive methods to assess lower urinary tract dysfunction and pain in UCPPS may aid in diagnosis and/or identify different subsets of patients. Analysis of available data sets may have the potential to identify the associations between UCPPS and other chronic pain conditions. The incorporation of large amounts of data into computer models may prove to be a powerful approach for studying UCPPS. Systems biology and bioinformatics can identify distinguishable patterns and networks from complex and sometimes big data, which may help identify patients with different forms of disease. Such information would have significant implications for improving diagnosis and prognosis and choosing therapy.

More information is available on the Grants & Funding page on the NIH website.

Mechanisms, Models, Measurement, and Management in Pain Research (R01)

The purpose of this funding opportunity announcement (FOA), issued by the National Institutes of Health (NIH), is to inform the scientific community of the pain research interests of the various institutes and centers (ICs) at the NIH and to stimulate and foster a wide range of basic, clinical, and translational studies on pain as they relate to the missions of these ICs. New advances are needed in every area of pain research, from the micro perspective of molecular sciences to the macro perspective of behavioral and social sciences.

Although great strides have been made in some areas, such as the identification of neural pathways of pain, the experience of pain and the challenge of treatment have remained uniquely individual and unsolved. Furthermore, our understanding of how and why individuals transition to a chronic pain state after an acute injury is limited. Research to address these issues conducted by interdisciplinary and multidisciplinary research teams is strongly encouraged, as is research from underrepresented, minority, disabled, or women investigators.

More information is available on the Grants & Funding page on the NIH website.


Education

2013 RADARS System Annual Meeting

The RADARS System Annual Meeting, Thursday, April 18, 2013, in Rockville, MD, encourages prescription drug abuse experts, representatives from the pharmaceutical industry, medical professionals, and federal regulatory agencies to discuss current trends in prescription drug abuse research and to develop strategies to ensure the safe and proper use of prescription medications. Detailed information, agenda, and speaker list will be posted to www.RADARS.org.


Members

Member Benefit: APS Launches New SmartBrief

As an APS member, you have been receiving introductory issues of APS SmartBrief, a free weekly e-newsletter specifically designed to bring the most important and timely news stories on pain research, science, treatment, policy, and trends directly to your inbox. The inaugural issue of APS SmartBrief launched on February 20 and is delivered every Wednesday.

APS SmartBrief provides easy-to-read summaries of articles relevant to your work, in one convenient newsletter. News stories are selected from hundreds of publications, summarized, and then provided to subscribers with links leading to the original sources, making staying up to date on professional news easier and faster.

This service is available to you with the option to share and forward to your colleagues. We hope you find this new member benefit valuable and subscribe today.


Summaries

The Journal of Pain Highlights

The following highlights summarize selected articles from March 2013 (Volume 14, Number 3).

Acceptance, Cognitive Restructuring and Distraction as Coping Strategies for Acute Pain
Annika Kohl, Winfried Rief, and Julia Anna Glombiewski; Philipps-University of Marburg, Germany

Those who accept their pain condition are best able to tolerate pain, while distraction can be the way to lower pain intensity, according to research reported in The Journal of Pain.

A team of German researchers evaluated the most common short-term cognitive pain management techniques for acute pain–acceptance, distraction and cognitive restructuring. They noted that little is known about the relative efficacy of acceptance strategies compared to other cognitive approaches, such as distraction and cognitive restructuring. The objective was to explore the differential short-term effects of these methods in a sample of 109 female students exposed to thermal mode experimental pain stimuli.

As an adjunctive pain treatment, acceptance is intended to disrupt the link between thoughts and behaviors so patients are more willing to tolerate pain. The majority of experimental studies have shown that acceptance strategies are more effective at increasing pain tolerance than other pain-regulation strategies.

In the study sample, distraction was used to shift attention away from pain stimulation to lessen pain intensity. With cognitive structuring, patients are trained to shift their appraisals of pain from maladaptive/alarming appraisals to more adaptive/reassuring appraisals, in order to improve their ability to cope with pain. Proponents of this approach hypothesize that restructuring pain-related thoughts may affect disability-related behavior, such as avoiding work or recreational activities in fear of pain.

Results of the study showed that acceptance led to increased pain tolerance relative to cognitive restructuring, and that distraction lowered pain intensity compared to acceptance. However, no significant differences were detected between distraction and acceptance, or between distraction and cognitive restructuring, with regard to pain tolerance. The study’s findings provide basic information that can be used to further develop and refine chronic pain management interventions.

Effects of Monoamine Reuptake Inhibitors in Assays of Acute Pain Stimulated and Pain Depressed Behavior in Rates
Marisa B. Rosenberg, F. Ivy Carroll, and S. Stevens Negus; Center for Organic and Medicinal Chemistry, Virginia Commonwealth University

Monoamine reuptake inhibitors are medications designed to block the neurotransmitters serotonin, norepinephrine and dopamine in treatment of depression. They have become increasingly used for treating chronic pain.

Data from multiple studies have shown that dopaminergic systems influence the subjective experience and behavioral expression of pain. There is a high comorbidity between pain and depression, and pain often is associated with depression of behavior and can serve as a diagnostic indicator of pain and a target for pain treatment.

Researchers from Virginia Commonwealth University sought to evaluate the effects of monoamine reuptake inhibitors in complementary assays of acute pain stimulation and pain depressed behaviors in rats. Preclinical studies have reported anti-nociceptive attributes of monoamine reuptake inhibitors in assays of acute pain.

In the research, assays of acute acid-stimulated and acid-depressed behavior were performed, and the authors hypothesized that monoamine reuptake inhibitors would block acid-stimulated pain behaviors but would be less effective in assays of inter-cranial self-stimulation (ICSS). Ninety-eight rats were studied and trained with a continuous reinforcement schedule of brain stimulation.

Results of the study showed that monoamine reuptake inhibitors significantly reduced acid-stimulated pain behaviors but failed to block acid-induced depression in doses effective for suppressing the pain behaviors. However, the mixed action dopamine reuptake inhibitors did block acid-induced depression of ICSS.

The authors concluded that the anti-nociceptive efficacy of selective and mixed-action dopamine reuptake inhibitors modulates the affective dimensions of pain. They noted that their results support further consideration of selective or mixed-action dopamine reuptake inhibitors as analgesics, especially when pain relief without sedation is desired.

Clinical Journal of Pain Highlights

The following highlights summarize selected articles from March 2013 (Volume 29, Number 3).

Adapting the Iconic Pain Assessment Tool Version 2 (IPAT2) for Adults and Adolescents with Arthritis Pain Through Usability Testing and Refinement of Pain Quality Icons
Chitra Lalloo, Jennifer N. Stinson, Jacqueline R. Hochman, Jonathan D. Adachi, and James L. Henry; Department of Psychiatry and Behavioural Neuroscience, McMaster University; St Joseph’s Healthcare, Hamilton; Departments of Anesthesia and Pain Medicine, Nursing, Child Health Evaluative Sciences, The Hospital for Sick Children; and Women’s College Hospital, Canada

This study evaluated usability and pain iconography of the Iconic Pain Assessment Tool Version 2 (IPAT2), an interactive Web-based visual self-report instrument that combines word descriptors and representative images (icons) to assess pain quality, intensity, and location, among adults and adolescents with arthritis. The prevalence of chronic pain is nearly 50% among adolescents and adults with arthritis who are 12 to 44 years of age.

Adults with inflammatory arthritis and adolescents with juvenile idiopathic arthritis partook in a single, semistructured, audio-recorded interview to evaluate the concreteness (object representativeness) and semantic distance (pain representativeness) of the IPAT2 iconography, participants’ current pain, and perceptions and likes/dislikes of the IPAT2.

The sample comprised 15 adults and 15 adolescents. There was no significant difference between the adult and adolescent groups in terms of median duration of arthritis at 4.6 years and 3.1 years, respectively. The median time needed to complete a single pain diary record after minimal training was 2.3 and 1.4 minutes for adults and adolescents, respectively.

A commonly cited favorite feature of the IPAT2 was the ability to describe the nature of pain in a nonverbal manner. All participants agreed that the IPAT2 could be valuable for helping to communicate pain with their healthcare provider. Several participants also noted that using the IPAT2 could prompt them to document details about their pain that they otherwise may not have disclosed. These findings indicate that the IPAT2 represents an innovative contribution to the field of arthritis pain assessment.

Improved Quality of Life, Working Ability, and Patient Satisfaction After a Pretreatment Multimodal Assessment Method in Patients with Mixed Chronic Muscular Pain a Randomized-Controlled Study
Mats Georg Rothman, Monica Ortendahl, Andreas Rosenblad, and Ann-Christin Johansson; Psychosomatic Medicine Clinic and Centre for Clinical Research; Centre for Clinical Research, Uppsala University, Central Hospital; and Royal Institute of Technology Department of Safety Research, Sweden

This study investigated whether a pretreatment multimodal (MM) assessment of patients with chronic muscular pain would influence treatment outcome. This randomized controlled study evaluated an MM assessment compared with a routine multidisciplinary assessment given to a control group. The study population consisted of primary care patients with mixed chronic muscular pain. Variables assessed were pain intensity, depression, life stress, quality of life (QOL), disability, working ability, and treatment satisfaction. Followup was performed at 15 months.

There were three treatment choices in the MM group after assessment: Multidisciplinary group therapy was chosen when doubt remained as to whether patient motivation and readiness was sufficient for successful rehabilitation. Group therapy included interventions designed to enhance further motivation. The individual multidisciplinary therapy program, however, required that motivation and readiness for the personal change process be obtained during the MM assessment. The individual program was also an option when group therapy was not suitable. The selection of patients who were referred back for treatment after assessment was based on the judgment that recommended therapy outside the Psychosomatic Medicine Clinic would be sufficient in itself, or that the patient’s condition demanded specific therapy. In the control group, treatment options were conventional multidisciplinary pain management or unidisciplinary treatment from the general practitioner and associated staff.

Patients who underwent an MM assessment before treatment in comparison with patients receiving routine multidisciplinary assessment improved QOL and working ability and were also significantly more satisfied with the assessment they received. Moreover, working ability improved and patient satisfaction with assessment was significantly higher in several aspects in the MM group. However, no significant difference was found in pain intensity between the groups, as measured by Visual Analog Scale. There were no differences between groups regarding a patient’s pain intensity, depression, stress symptoms, or disability levels at the 15-month followup.

These results indicate that MM pretreatment assessment can be advantageous in the selection of patients for suitable rehabilitation treatment in primary care settings, and also be used to prepare patients for future rehabilitation.

PAIN Highlights

The following highlights summarize selected articles from Pain (Volume 154, Number 2, February Issue).

Increased Pain Sensitivity Among Adults Reporting Irritable Bowel Syndrome Symptoms in a Large Population-Based Study
Niklas Stabell, Audun Stubhaug, Trond Flægstad, and Christopher Sivert Nielsen; University Hospital of Northern Norway Department of Pediatrics, University of Tromsø Department of Clinical Medicine, Oslo University Hospital Department of Pain Management and Research, and Norwegian Institute of Public Health Division of Mental Health

Irritable bowel syndrome (IBS) is most common among women, and comorbid chronic pain and psychological distress are highly prevalent. IBS symptoms are consistently found to be associated with psychosocial factors, as seen in the high rates of anxiety and depression in this patient group. Although there is consistent evidence of visceral hyperalgesia among most IBS patients, there is conflicting evidence regarding whether this also includes hyperalgesia in somatic tissues, and, if so, whether it is limited to the lower body or present throughout all body regions.

The aim of this study was to examine whether IBS is associated with somatic pain sensitivity in a large population-based sample; to test whether this association was significant after controlling for sex, age, comorbid chronic pain, and psychological distress; and to analyze whether the association was related to the degree of abdominal pain.

This is the first published large-scale population-based study of experimental pain sensitivity in adults reporting IBS symptoms, including measures of heat- and pressure-pain threshold and cold-pressor pain tolerance and pain intensity ratings. Overall, patients with IBS were more pain sensitive than other participants regardless of pain modality, but the differences were only significant for heat-pain threshold, cold-pressor pain tolerance time, and cold-pressor pain intensity ratings. The associations between IBS and heat- and cold-pressor pain were only slightly attenuated by adjustment for psychological distress, comorbid chronic pain, and demographic factors.

These results indicate that IBS is associated with increased pain sensitivity independent of these comorbid factors. The fact that presence and degree of chronic abdominal pain are important predictors of widespread hyperalgesia can support theories of central pain dysregulation mechanisms in IBS. Sex differences were present in all of the tests, with women being more pain sensitive than men. These results can be generalized to both adult men and women with mild to severe IBS pain symptoms and to patients with and without comorbid chronic pain and psychological distress in the general population.

Is the Pain-Reducing Effect of Opioid Medication Reliable? A Psychophysical Study of Morphine and Pentazocine Analgesia
Christopher D. King, Burel Goodin, Toni L. Glover, Joseph L. Riley, Wei Hou, Roland Staud, and Roger B. Fillingim; University of Florida Department of Community Dentistry & Behavioral Science, University of Florida Department of Epidemiology and Health Policy Research, and University of Florida Department of Medicine

The purpose of this study was to conduct secondary analysis of a previous study of opioid analgesia to examine the repeatability of experimental pain and analgesia produced by morphine and pentazocine. Thermal, pressure, and ischemic pain responses were evaluated before and after intravenous administration of the test drug.

It was hypothesized that the analgesic efficacy of morphine and pentazocine, as determined by a reduction in experimental pain, would be highly comparable between two experimental testing sessions. A number of analytic methods were used to determine the ability of a drug to reduce pain. Subjects attended four psychophysical testing sessions, two sessions during which the active drug was administered, and two sessions with placebo saline administered in a randomized, counterbalanced fashion. Placement into an active drug group was also randomized and counterbalanced. Each subject was randomly assigned to receive only one active drug, and this drug was administered during both of the testing sessions.

The study examined the stability of morphine and pentazocine analgesic responses across three experimental pain modalities. To accomplish this goal, analgesic index scores were used as indicators regarding the degree of change in pain sensitivity from pre- to postdrug administration. The results suggest that in general, analgesic responses showed moderate stability over a 2-week period, which varied somewhat across pain modalities and analgesic indices; all analgesic indices were sensitive indicators of analgesia, able to distinguish between active drug and saline, and the consistently high intercorrelations among analgesic index scores suggest that they capture similar aspects of analgesic efficacy. Both opioids produced significant levels of analgesia, with ischemic pain exhibiting the greatest degree of analgesia, which is consistent with previous experimental studies of opioid medications.

The data also revealed that the strength of relationship between repeated drug sessions was dependent on the stimulus modality. For example, the most consistent analgesic responses to morphine and pentazocine were observed with ischemic pain, while heat pain demonstrated low to moderate repeatability.


Research

APS Announces Sharon S. Keller Chronic Pain Research Grant Recipients

APS is pleased to announce the inaugural recipients of the Sharon S. Keller Chronic Pain Research Grants. The Sharon S. Keller Grant was established by private investor David Keller in memory of his wife, who died in 2011 after 25 years of battling cancer, rheumatoid arthritis, chronic musculoskeletal pain, and the side effects of pain medications.

The Sharon S. Keller Chronic Pain Research Grants are intended to fund research to promote a more comprehensive approach to the management of chronic pain. Emphasis is on investigating noninvasive, nonpharmacologic interventions with favorable side effect profiles to improve chronic pain management. The grants are awarded to APS members’ projects that have a high likelihood of leading to new treatments and increased or expanded access to treatment options for people with chronic pain.

This year, APS and Mr. Keller are pleased to announce the 2013 grant recipients:

Benedict Kolber, PhD
Duquesne University
Cyanobacterial Natural Products to Treat Comorbid Pain and Depression

Laura E. Simons, PhD
Boston Children's Hospital
Exposure Treatment of Pain-Related Fear for Children with Chronic Pain


Society

SIG Updates

The Measurement of Pain and Its Impact SIG is asking APS members to take its short pain assessment survey. The goal of this brief survey is to obtain information about the status of pain assessment in current clinical practice, which should inform us about future research and educational needs. The survey is estimated to take 5–10 minutes to complete, and we thank you in advance for taking the time to help us gather this information. By completing this survey, you agree to the use of the compiled data for an overall report on this topic. The survey is anonymous, and no individual data will be used for any other purpose.


In the Media

FDA Warns Against Codeine Use in Children After Tonsillectomy (MedlinePlus)

Teenage Drug Hunter (The Scientist)

Drug Overdose Deaths Up for 11th Consecutive Year (The Seattle Times)

Mass. Shuts 11 Pharmacies Following Inspections (The Seattle Times)

Walgreens’ Florida Pain Pill Woes Mounting (Pain Medicine News)

UF Physician Argues That Medical Marijuana Really Isn’t Medicine (The Gainesville Sun)

Long Term Effect of Reduced Pack Sizes of Paracetamol on Poisoning Deaths and Liver Transplant Activity in England and Wales: Interrupted Time Series Analyses (BMJ Group)

New York Law Targets Painkiller Abuse (Pain Medicine News)

Study Connects Early Childhood with Pain, Depression in Adulthood (ScienceDaily)

SCS Reduces Complications, Length of Hospital Stay in Failed Back Surgery Syndrome (Pain Medicine News)

Kaiser Permanente Study Finds Men Taking Long-Acting Chronic Pain Medications Five Times More Likely to Have Low Testosterone Levels (Kaiser Permanente News Center)

MRI-Guided Cryoablation to Alleviate Pain in Head, Neck and Spine (ClinicalTrials.gov)

Cancer Pain Undertreated, Especially Among Minorities (Pain Medicine News)

People with a Severe Unexplained Psychological Illness Have Abnormal Activity in the Brain (Medical News Today)

Chronic Pain Alters DNA Marking in the Brain (Medical News Today)


Call for Submissions

Do you have a topic that is relevant to APS members? Is there a member who is doing work that APS should spotlight? Is there a funding opportunity APS members need to know about? Please submit stories, events, and more to enews@americanpainsociety.org for consideration.


Copyright © 2013 American Pain Society. All Rights Reserved.