January 2008
In
this issue…
DEA
Issues Rule on Multiple Prescriptions for Controlled Substances
State
Pain Initiatives in Action: Florida Pain Summit
The
New York Times Details Pain Treatments
“Ticket
To Work” Helps Manage Pain
DEA
Issues Rule on Multiple Prescriptions for Controlled Substances
The Drug Enforcement Agency (DEA) recently published a final ruling that allows multiple prescriptions to be issued for controlled substances. The final rule, “Issuance of Multiple Prescriptions for Schedule II Controlled Substances,” was published in the Federal Register on November 19, 2007, but will not take effect until December 19, 2007. It allows licensed prescribers to write multiple prescriptions for Schedule II drugs with staggered fill dates, thus providing patients with the equivalent of a 90-day supply of medication when appropriate. The ASPI is one of many organizations that supported this rule change, which was initially proposed in September 2006. Visit the ASPI Web site to view a PDF of their original letter to the DEA regarding this rule.
State
Pain Initiatives in Action: Florida Pain Summit
The
Florida Pain Initiative hosted their Second Annual Pain Summit on November
2, 2007 at the MD Anderson Cancer Center in Orlando, FL. The Summit drew
over 80 attendees from around the state and
featured several distinguished
speakers who lectured on a variety of current issues in pain management in
the state of Florida, including ethical considerations in pain management,
evaluating the role of Cannabinoids, and new approaches for treating
headache pain. The Florida Pain Summit was a big success in promoting both
professional and public awareness of pain as an important public health
issue in Florida. Click
here to learn more about the Florida Pain Initiative.
The
New York Times Details Pain Treatments
Writer
Jane Brody’s third article on
pain, that appeared in The New York Times,
examines treatments for chronic pain. Brody cites a September supplement to
Practical Pain Management which says, “Very few patients with chronic
disabling pain have access to a pain specialist,” which results in most
patients relying “on primary care physicians for pain treatment, obliging
them to learn as much as they can about treatment approaches and to persist
in their search for relief.”
Brody
cites the three categories of drugs used for treating chronic pain as NSAIDs,
those originally marketed for other uses (antidepressants, antiepileptics
and muscle relaxants) and opioids.
She
also lists other possible pain remedies:
-
TENS, or transcutaneous electrical nerve stimulation;
-
Acupuncture;
-
“Guided imagery, meditation, relaxation therapy and hypnosis or hypnotherapy,” hydrotherapy and massage;
-
Physical or occupational therapy, and
-
Mental adjustments to one’s condition.
Brody also refers readers to three organizations that can provide chronic pain information: the American Chronic Pain Association, the American Pain Foundation, and the National Foundation for the Treatment of Pain. (The New York Times, 11/20, The Carolinas Center Weekly Updates, 11/30)
“Ticket
To Work” Helps Manage Pain
Nebraska’s Ticket to Work Palliative Care Program
is a pilot project designed to keep people with pain active and working. The
federally-funded program “uses the expertise of the Nebraska Hospice and
Palliative Care Partnership and its 60 member
organizations.”
Sharon
Johnson, a grants coordinator with the Nebraska Department of Health and
Human Services, says that the program is “an effort to merge medical and
social services, to bring pain management techniques to Nebraskans whose
pain is limiting their ability to work,” and the goal is to “help people
live more productive lives.”
Ed Sewell is one of the beneficiaries of the
program. He’s had eight back surgeries since 1990, and the pain limits his
work time to only one or two hours some days. Ticket to Work helped him find
someone to design a desk that raises and lowers, so he can choose to stand
or sit. “I do not want to be a burden on anybody. I want to work. I’m
hoping this will be positive. This is the first ray of light in a while,”
Sewell said.
The program employs a nurse, a social worker, a
pharmacist and a services coordinator, all part-time. Johnson says that the
program promises no miracles. “We are making no promise that we are going
to remove the pain, or that we are a job placement agency. But if we can
move a person into a position where the pain is tolerable and they can
return to work or increase their hours, we are successful,” she said.
About half the clients do not receive Social Security disability, so the
goal is to keep them working longer. Sometimes the savings are minimal, but
as Johnson sees it, helping people feel more useful “is the right thing to
do.” (Lincoln Journal Star, 11/11)
Sharing
the Burden of Chronic Pain
In the
second of
Jane Brody’s articles on pain in The
New York Times, she looks at the way family and friends are affected
by the chronic pain of someone they love. She cites a study by Dennis C.
Turk, a pain management researcher at the University of Washington that
found that “family members [of chronic pain patients] were up to four
times more depressed than the patients.”
Brody says, “Healthy family members are often
overworked from assuming the duties of the person in pain. They have little
time and energy for friends and other diversions, and they may fret over how
to make ends meet when expenses rise and family incomes shrink. It is easy
to see how tempers can flare at the slightest provocation. The combination
of unrelieved suffering on the one hand and constant stress and fatigue on
the other can be highly volatile, even among the most loving couples—whose burdens are often worsened by a decline of intimacy.”
Two factors are important in trying to improve the
situation. One, recognize that chronic pain is not an individual problem.
Support the patient in the fight against it, and try not to take moodiness
and irritability personally. And second, educate yourself about the
condition and its treatments.
The American Chronic Pain Association Family Manual
has several suggestions for families coping with chronic pain.
-
Family members should acknowledge their feelings, whether of guilt about not being able to ease the pain, worry over finances, distress over the reactions of other people or resentment of the patient or the situation.
-
Keep the patient involved, and don’t contribute to the feelings of helplessness. Don’t do for patients the things they can do for themselves, and recognize both the abilities and the limitations of patients.
-
Communicate with each other. Dr. Turk says, “Open, two-way communication is crucial to dealing effectively with chronic pain. Family members need to know how they can be helpful and what might be hurtful.” Family members have the right to be tired, to need and take breaks, to maintain friendships and pursue activities away from home occasionally. Patients have the right to be afraid or disappointed, to be angry about some people’s behavior and the responsibility to be grateful for help provided.
-
Caregivers and family members should care for themselves. “Enlist all the help you can get from family members and friends,” Brody says. Hire someone to help, even if it’s just for a few hours while you get away. Maintain your own physical health, says Brody, because “if you get sick, you won’t be much use to the patient in pain.”
The third article in Brody’s series, on treatments, will appear next week. (The New York Times, 11/13)
SC Office Has Moved
The SC office of TCC (which is also the home of the SCPI)
officially settled into our new space at 1350 Browning Road, Columbia, SC,
29210. We are in the SC Pharmacy
Association Building which is just past the
entrance to Center Point where we have been in the SCHA Building. While our
email, phone and fax numbers remain the same, we are in transition. If you
cannot reach us, please call the NC office at 1 (800) 662-8849 and they will
get us a message. Please note that
the remaining discipline group meetings for this year WILL be held at SCHA.
Meetings in 2008 will be hosted in our new location and the dates for those
meetings will be posted on The Carolinas Center
Web site.
February
20 | 9
a.m.–12 p.m.
Location
102C – Conference Center – Piedmont Technical College – Greenwood, SC
Instructor
Dottie Roberts, MSN, MACI, RN,
CMSRN, OCNS-C
Credit
0.35 CEUs, 3.5 clock hours – This CE activity is approved for 3.5 contact
hours for licensed nurses
Putting
the Pieces Together: Update in Pain Management 2008
February 21 | 1–4:45 p.m.
Location
Small Gym-Harris
Psychiatric Hospital-Anderson, SC
Instructor
Maribeth Kowalski, BS, PharmD
Fee
$55 for non-members, $10 for AHEC members needing ACPE Pharmacy credit; No
fee for AHEC members who do not need ACPE Pharmacy credit
Credit
0.35 CEUs, 3.5 clock hours
This
CE activity is approved for 3.5 contact hours for licensed nurses.
Application for ACPE credit has been submitted for approval.
Target Audience
Licensed Nurses, Pharmacists, Pharmacy Technicians and interested others
Save
the Date!
The Carolinas Center 2008 Annual Clinical Conference
Winston-Salem, NC
April 13-16, 2008
September
25–26,
2008
Charlotte
Marriott Executive Park
Charlotte,
NC
The
Desert
By Charlie's Mom
The
Desert is a poem by a pain sufferer that was a part of American Pain
Foundation’s Pain and Creativity Exhibit. View art, prose, poetry and
video from the honored artists at APF’s first
Pain
and Creativity Exhibit. View the APF video of Pain and Creativity: Voices
of People with Pain.
Again, please check out the SCPI webpage and consider saving this link to your Favorites so that we can keep you updated on the latest news, events and resources in Pain Management.
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