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American Pain Society
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Article Title: Pain Medication Beliefs and Medication Misuse in Chronic Pain
Authors: Beatrix Schaffer, et al, Veteran’s Administration Greater Los Angeles Healthcare System
GLENVIEW, Ill., Sept. 15, 2005 – According to a new study published in The Journal of Pain, chronic pain patients with a history of substance abuse showed greater medication misuse, compared with other pain patients, despite similar dosages and self reports of medication effectiveness.
Researchers from the VA Greater Los Angeles Healthcare System, led by Beatrix M. Schiefeer, PhD, assessed the influence of medication beliefs, symptom severity, disability, mood and psychiatric history on opiate medication misuse in 288 chronic pain patients. A key finding from the research is that even though both anxiety and substance abuse history are related to medication misuse, the misusers studied believed more strongly in the potential for opiate addiction and in the need for higher doses. They also had a greater belief in the effectiveness of opioids and the importance of free access to medications.
The authors concluded that, overall, their data suggests that assuming a better quality of life is associated with freer medication access and higher doses may override the individual’s recognition of addiction potential, which may lead to medication misuse. In addition, neurophysiologic changes, such as a lower threshold for pain and shorter tolerance of pain, may contribute to misusers believing they need higher doses of opiate medication than the average patient.
Article Title: A Psychophysical Evaluation of the Relationship Between Trait Anxiety, Pain Perception and Induced State Anxiety
Authors: Judy Tang and Stephen J. Gibson, University of Melbourne, Australia
GLENVIEW, Sept. 15, 2005 – Australian researchers writing in The Journal of Pain reported that anxiety-reducing therapies, such as controlled breathing and other relaxation techniques, could be beneficial for relieving pain.
Previous studies have reported that elevated state anxiety (a person’s current level of anxiety) is often associated with higher pain levels, while increased trait anxiety (general disposition to become anxious) tends to exacerbate pain. Research to date has not evaluated the combined effects of state and trait anxiety on self-rated pain.
Researchers from the University of Melbourne Department of Psychology, led by Judy Tang, PhD, investigated the possible interaction between state and trait anxiety on pain perception. They found that high trait anxiety individuals reported significantly higher pain intensity than low trait anxiety subjects. Further, their data showed an additive rather than a synergistic relationship between state and trait anxiety and pain perception. The authors also noted that relaxation techniques might be most beneficial for high trait anxiety pain patients who experience more intense levels of anxiety and pain.
Article Title: Individually Tailored Treatment Targeting Activity, Motor Behavior and Cognitions Reduces Pain-Related Disability: A Randomized Controlled Trial in Patients with Musculoskeletal Pain
Authors: Pernilla Asenlof, et al, Uppsala University, Sweden
GLENVIEW, Sept. 15, 2005 – A Swedish study published in the Journal of Pain shows the benefits of tailoring pain care interventions in accordance with an individual’s psychosocial needs and priorities. Tailored interventions are being viewed as an important new field of research in pain management.
In the study, 122 subjects with musculoskeltal pain were evaluated. One group was treated with individually tailored behavioral medicine interventions that based treatments on physical, cognitive and behavioral skills required to achieve prioritized goals, such as activities related to work, education, hobbies, etc. The control group received physical exercise therapy. The outcomes were compared.
Results showed the individually tailored treatment group had lower levels of disability, lower maximum pain intensity, higher levels of pain control and lower fear of movement. Self efficacy and physical performance increased over time for both groups.
The authors (Pernilla Asenlof, Eva Denison and Per Lindberg) concluded that the study supports use of individually tailored interventions, provided the strategies are determined according to the individual’s priorities for everyday life activity and a valid assessment of pain-related disabilities.
