½ of the UK Is Living With Chronic Pain ...

Half Of The UK Living With Chronic Pain, Study Finds

Robert Glatter, MD Jun 21, 2016 - 6:00am 
The was published yesterday in the journal BMJ Open.
The researchers believe that this number is almost certain to climb, especially as the population ages and is living longer with conditions including arthritis, fibromyalgia,  neuropathic pain, and cancer.

OxyContin pills at a pharmacy (AP Photo/Toby Talbot, File)
Physicians caring for such patients clearly realize that chronic pain is a major cause of disability and need better solutions to manage such patients as the danger of opiate addiction and dangerous side effect profile are finally receiving well deserved attention in light of a plethora of recent fatal overdoses.

Researchers searched a large database of patients from 1990 onward to get a better idea of the number of patients living in chronic pain, since there is no current agreement on the proportion of people actually affected. They focused on chronic pain–defined as pain lasting more than 3 months—including fibromyalgia as well as chronic neuropathic pain.
The researchers evaluated over 1,700 studies, but settled on 19 studies which encompassed 140,000 adults. Data from the 19 studies was combined to arrive at an estimate of the prevalence of chronic pain, overall, and chronic widespread pain. Researchers also categorized patients’ pain as moderate to severely disabling chronic pain, fibromyalgia, and chronic neuropathic pain.

Researchers calculated that the prevalence of chronic pain is from 35% to 51% in the adult population living in the UK. The prevalence of moderate to severely disabling chronic pain– according to four studies is between 10% to 14%, roughly around 8 million persons.
When the data was combined, UK live with chronic widespread pain 43% of the population lives with chronic pain, and 14% of adults living in the UK live with chronic widespread pain.  8% of UK adults experience chronic neuropathic pain, with 5.5% of adults suffering with fibromyalgia .
The prevalence was 14% among those 18-25 years of age, rising to nearly 30% among 18-39 year old persons. This is concerning because these persons represent the bulk of the working population.
Among those 75 and older the prevalence of chronic pain was was nearly 62% or 2% of the population. Among those 75 and older, the prevalence  of chronic pain was was nearly 62% or 2/3 of the population. And, if this trend continues, chronic pain management will certainly continue to strain our resources as the population ages.
Regardless of age or type of pain, the researchers found that women were more likely than men to be affected by chronic pain the researchers found that women were more likely than men to be affected by chronic pain.
One limitation, the researchers caution, is that some of the studies did not have high quality evidence, making it problematic to draw any conclusions.
The studies did, however, demonstrate a trend toward increasing prevalence of chronic pain since 1990. The researchers estimate that the prevalence of chronic pain in the UK is now close to 43%, or 28 million people according to population data as of 2013.

“Such prevalence data does not itself define need for care or targets for prevention, but reliable information on prevalence will help to drive public health and healthcare policymakers’ prioritization of this important cause of distress and disability in the general population,” the researchers offer.

The bottom line is that those who are living in chronic pain on a daily basis may have difficulty doing their jobs, leading to lost work days. Ultimately affecting their independence, this may place them at high risk for depression which can ultimately lead to suicide.

“This news brings significant numbers into play when you combine this UK study with the 2015 NIH study in the USA,”said Rich Able, Chief Strategy Officer, Stratos Group.
“Life science, technology and medical device companies must allocate significant resources to develop and deliver meaningful, non pharmacologic pain relief platforms to address this issue. The overprescribing of opiates and pain relief medications will continue to skyrocket. Our country is fighting a losing battle with prescription pain medications and it’s time for consumer healthcare companies to stand and deliver,” added Able.

http://www.forbes.com/sites/robertglatter/2016/06/21/half-of-the-uk-living-with-chronic-pain/2/#67ca33896140

Major wrote:Unless ya wanna get addicted to Morphine which your GP can prescribe in various forms your only choices are the run of the mill USELESS parrutzeatemaul,
Co Dy-dramol thingies or Zapain, stay off them all if possible.

eddie wrote:No 4ever, doctors only offer pills and potions and we all know that they cause more problems eventually, than they solve.
If I was told I had to stay on certain tablets forever I'd find something else and bin them.

Painkillers are addictive and of course, the side affects of painkillers are more pain, so the cycle is endless.

I'd try something else.

eddie wrote:Nicko have you thought about trying cannabis oil for pain relief? Lots of non smokers use it that way.

Physician’s Organization in Canada Releases Guidelines for Prescribing Medical Cannabis for Pain

 by Arielle Gerard

Prescribing Patients Medical Cannabis for Pain

In December 2014, the College of Family Physicians of Canada published its preliminary recommendations for physicians recommending/prescribing smoked cannabis for chronic non-cancer pain in the organization’s journal, Canadian Family Physician. The authors reviewed the information available on cannabis for medical use, utilizing mainly level II (“well conducted observational studies”) and level III (“expert opinion”) evidence to create guidelines on the following aspects of medical cannabis use for chronic non-cancer pain:

• conditions recommended for use
  
• circumstances under which medical cannabis should not be recommended
  
• circumstances under which caution should be taken when recommending medical cannabis use
  
• dosing
  

Guidelines For Canadian Physicians

The guidelines are as follows, taken verbatim from the guidelines set forth in the study:

• Smoked cannabis might be indicated for patients with severe neuropathic pain conditions who have not responded to adequate trials of pharmaceutical cannabinoids and standard analgesics (level II evidence).
  
• Smoked cannabis is contraindicated in patients who are 25 years of age or younger (level II evidence); who have a current, past, or strong family history of psychosis (level II evidence); who have a current or past cannabis use disorder (level III evidence); who have a current substance use disorder (level III evidence); who have cardiovascular or respiratory disease (level III evidence); or who are pregnant or planning to become pregnant (level II evidence).
  
• It should be used with caution in patients who smoke tobacco (level II evidence), who are at increased risk of cardiovascular disease (level III evidence), who have anxiety or mood disorders (level II evidence), or who are taking higher doses of opioids or benzodiazepines (level III evidence).
  
• Cannabis users should be advised not to drive for at least 3 to 4 hours after smoking, for at least 6 hours after oral ingestion, and for at least 8 hours if they experience a subjective “high” (level II evidence).
  
• The maximum recommended dose is 1 inhalation 4 times per day (approximately 400 mg per day) of dried cannabis containing 9% delta-9-tetrahydrocannabinol (level III evidence).
  
• Physicians should avoid referring patients to “cannabinoid” clinics (level III evidence).
  

Evaluation/Explanation of Guidelines

Generally, the regulations seem reasonable considering that the recommendations are specifically for patients with chronic non-cancer painwho are smoking their medical cannabis.

Adolescent Use

It is currently unclear whether or not cannabis use, when started in adolescence, leads to impairment in brain development. While some studies have found a link between early cannabis use and morphological brain changes, others which are more carefully controlled have found no link.
Due to the fact that cannabis use may interrupt normal brain development, children and adolescents should avoid use of cannabis unless it is deemed by a physician, in rare cases, that the potential benefits of use outweigh the risks.

History of Psychosis and Anxiety/Mood Disorders

While a link between cannabis use and certain mental health disorders has been noted, a cause-effect relationship has never been assessed. In other words, there is no definitive evidence that cannabis use actually causes mental health disorders, and the link is potentially due to the fact that those predisposed to certain mental health disorders may choose to self-medicate with cannabis.

Psychosis

Due to its classification as a hallucinogen, cannabis use may exacerbate certain mental health disorders, such as psychosis. Additionally, during intoxication with use of cannabis strains with higher levels of delta-9-tetrahydrocannabinol (THC), users (especially those who are inexperienced) may experience paranoia and emotional discomfort. Therefore, avoiding use in those with a past or family history of psychosis is recommended.

Anxiety and Mood Disorders

Many patients find that cannabis helps to relieve their anxiety. Regarding mood disorders, a recent study found that those with baseline major depressive disorder were more likely to begin cannabis use, but that cannabis use was not linked to an increased likelihood of having major depressive disorder. Additionally and interestingly, while “weekly to almost daily” cannabis use was associated with an increased likelihood of having baseline borderline personality disorder, daily use was not; there was also no link found between baseline borderline personality disorder and an increased likelihood to begin using cannabis. However, for those with mood and anxiety disorders, caution should be taken in using medical cannabis, for similar reasons as those noted at the beginning of this section.

Lung/Heart/Vascular Problems

Cannabis use may result in heart and vascular (i.e. blood vessel) problems in some patients (e.g. low blood pressure which can be harmful in certain diseases/disorders, potential increased risk of heart attack). While there is some evidence that cannabis use increases the risk of stroke, other evidence has suggested a decreased risk of stroke with a history of past cannabis use. Due to the fact that the impact of cannabis use on heart/vascular problems is not fully understood, use should be avoided by individuals with these health issues.
Additionally, smoking cannabis can irritate the airways and lungs. While a recent Harvard study found that low to moderate frequency of cannabis use does not result in decreased lung function in the general population, for those (1) with health issues related to the lung or (2) who also smoke tobacco (which is highly damaging to the lungs and strongly linked to the development of cancer of various organs), smoked cannabis should be avoided. Vaporization and ingestion methods are an alternative form of cannabis administration that will help to prevent additional lung damage.

Substance Abuse Disorders

Cannabis use should be avoided for patients with past cannabis or other substance abuse disorders in most cases, due to the potential for continuing or reestablishing dependence issues.
https://www.medicaljane.com/2014/12/31/physicians-organization-in-canada-releases-guidelines-for-prescribing-medical-cannabis-for-pain/

Home / Health News
 Americans spending billions on alternative medicine
By Dennis Thompson, HealthDay News   |   June 22, 2016 at 9:55 AM

WEDNESDAY, June 22, 2016 -- Americans spend a good chunk of their healthcare dollars on alternative medicine, such as acupuncture, yoga, chiropractic care and natural supplements, a new government report shows.
In fact, they paid more than $30 billion out of pocket in 2012 on chiropractors and other complementary health practitioners, as well as supplements and other forms of alternative medicine.
"Substantial numbers of Americans spent billions of dollars out of pocket on these approaches -- an indication that users believe enough in the value of these approaches to pay for them," said study co-author Richard Nahin.
He is lead epidemiologist at the U.S. National Center for Complementary and Integrative Health.
Expenditures in 2012 included:

• $14.7 billion out of pocket on visits to complementary practitioners such as chiropractors, yoga instructors, acupuncturists or massage therapists -- nearly 30 percent of what people spent on traditional medical services.
  
• $12.8 billion on natural product supplements, which was about one-quarter of what people spent on prescription drugs.
  
• $2.7 billion on books, CDs, videos and other self-help materials related to complementary health.
  

Overall, spending on complementary medicine amounted to just over 9 percent of out-of-pocket healthcare expenditures and about 1 percent of all money spent on healthcare in the United States, the researchers found.
Most of this alternative healthcare is being used by adults, not children, the report found. The researchers said about $28 billion was spent on adults, compared with just $1.9 billion for children.
Even people with lower incomes spend quite a bit on complementary medicine, according to the report published Wednesday in the National Health Statistics Reports.
Nahin and his colleagues found that families making less than $25,000 a year spent, on average, $314 out of pocket on visits to complementary health practitioners in 2012, and an average $389 on natural supplements.
"That's telling us that even people with low incomes are willing to spend a substantial amount on these products and interventions," Nahin said.
Families earning much higher incomes -- $100,000 or more a year -- spent an average of $518 on complementary practitioners and an average of $377 on supplements, the findings showed.
Other data suggests that there are trends within complementary medicine regarding the popularity of different approaches.
For example, Nahin explained, the use of yoga has increased dramatically, while chiropractic care and massage therapy has remained level.
"Yoga is going up because it's more accepted in the culture, and it's being used for lifestyle changes and as a form of low-impact exercise," Nahin said.
But while people use yoga to promote wellness and well-being, they use chiropractic care and acupuncture as a treatment for a medical condition, most often chronic pain, he said.
"If you look at data on back pain across the last 10 years, it's been fairly flat," Nahin said. "It hasn't changed, so perhaps use of these types of practitioners that treat back pain wouldn't change."
While it remains a multibillion-dollar industry, the use of natural supplements has decreased a bit, Nahin said, possibly due to increased attention from health researchers regarding these products.
Sales of fish oil supplements have increased fourfold since 2002, based on studies showing the heart health benefits of omega 3 fatty acids, Nahin pointed out. However, research that found no substantial benefit from echinacea and ginkgo biloba has likely helped drive down sales of those particular supplements.
According to Stephanie Romanoff, communications director for the Academy of Integrative Health & Medicine, consumer demand for complementary medicine has caused more researchers to look into how well these approaches work, which in turn has provided consumers with better information.
"Integrative medicine is not going to have the same funding as pharmaceuticals do, but because of the consumer demand and increased interest from academia and our national government in integrative medicine and health, there has been an increase in research," Romanoff said. "And increasingly, there's more research validating the value of these approaches."
People interested in trying chiropractic, acupuncture or some other form of complementary medicine should talk about it with their doctor, and make sure there is clear coordination between their primary care physician and their complementary medicine providers, Romanoff said.
"If someone is taking supplements or if they are seeing a different type of clinician, sometimes they don't want to talk with their primary care medical doctor about it because they might feel self-conscious," she said. "It's absolutely critical that patients have those conversations and tell their doctors about the different types of care they're receiving and demand that there is coordination."
Your doctor might even be able to point you to a properly accredited provider, particularly if your doctor is board-certified in integrative medicine, Romanoff added.
"Ask your primary care doctor for recommendations. That's how I find many of my best clinicians," she said.
http://www.upi.com/Health_News/2016/06/22/Report-Americans-spending-billions-on-alternative-medicine/2731466603248/