Summary: Chronic pain is challenging to treat. Many people living with chronic pain continue to suffer for months or even years despite medical treatment. Inadequate chronic pain opioid addictionology treatment has contributed to the opioid epidemic. One of the ways to overcome chronic pain is patient education. Teaching patients self-care will help manage pain and prevent its future episodes. However, doctors do not have time and motivation for patient education, as they are not reimbursed for it. The new digital system tries to overcome this gap in patient care by providing an education system to doctors. It is a system that can be integrated into any electronic health record. It uses intelligent algorithms, predictive analytics, and more. It also ensures fair compensation to the healthcare workers for patient education.

Chronic pain is among the leading causes of disability. US data shows that almost one-fifth of adults live with chronic pain, and about 8% have severe pain. In addition, poorly managed chronic pain is one of the reasons for the opioid epidemic in the US. Therefore, doctors need to frequently assess the pain scores of their patients and adjust treatment plans.
Clinicians should prescribe medications and support and coach patients in self-care. However, the problem is that doctors lack time and tools and are not reimbursed for better ongoing patient support.

Patient-centered addiction and chronic pain care

This model of care tries to close the existing gap in patient care. It provides telemedicine coaching to patients to manage chronic pain and reduce its risk. This approach also fulfills the current gap by reimbursing the health professionals for training patients in self-care through telemedicine.
Telemedicine care includes the following:

● Validated pain and risk assessment tools.
● Patient engagement platform containing digital lessons that are readily integrated into any electronic health record system. Based on the EHR, the program can provide personalized training to the patients. It can also help track outcomes remotely.
● Telemedicine coaching encourages patients to make lifestyle changes and thus helps them recover faster from pain.
● Remote monitoring dashboard that helps doctors track the progress being done by the patient.
● It also contains predictive analytics using artificial intelligence to predict long-term health outcomes.

Patient-centered transformative care

The critical thing about the program is that it is highly engaging and thus helps patients to make needed changes. It uses the following strategies:

● Create a well-structured pain management program, and provide tele-coaching to the patients. It focuses on the seven realms of a patient’s life; body, lifestyle, mind, emotions, spirit, environment, and social life.
● The program helps make shifts to patient-centered care, thus facilitating patient empowerment and greater engagement and hence improving the long-term outcomes.
● The program encourages shared decision-making so that the patient develops a better understanding of the condition, and this also results in shared responsibilities.
● It promotes support from family and friends, as they play a crucial role in reducing pain and managing addiction.
● It helps develop interactive content that is easy for patients to remember and thus incorporate into their life.
● Create a simple and doable action plan.

Studies show that more than fifty percent of cases of chronic pain cases still have pain even after a month. Even worse, many of them continue to experience pain for several years. This happens despite the best treatment. It appears that in many cases, the cause of this poorly managed chronic pain is the lack of self-management training for the patients.

Thus, transformative care can provide the right tools to the doctors for shifting to patient-centered care, providing healthcare workers with the necessary digital tools for this transformation, and assisting them with patient education.

Transformative care provides research-based tools that take a minimum time for the clinicians, help in remote monitoring, and have predictive data analytics. It also solves the issue of reimbursement by health plans.

To conclude, managing chronic pain is challenging, and patients continue to experience pain even several months after continued treatment. It appears that the leading cause is poor self-management of painful conditions by the patients, as doctors lack time and tools to educate the patients. Therefore, new transformative care digital tools try to fulfill this gap and thus help with better patient outcomes.

Summary: Opioid epidemic has been ongoing for a long. However, the covid-19 pandemic has made the opioid crisis worse for many reasons. First, it appears that due to social isolation, reduced income, and other reasons, people are seeking relief from opioids. Additionally, the opioid crisis is also being made worse due to reduced attention and allocation of resources, as everyone is focusing more on countering covid-19. However, researchers warn that this would have long-term adverse consequences, causing a prolonged upsurge in opioid misuse or substance abuse disorder (SUD).

 

Opioid overdose is among the major causes of death among young adults and is a highly preventable condition. Even covid-19 epidemic would cause less mortality among healthy adults, which means that one can reduce the risk of contracting the infection through various interventions. However, those living with substance abuse disorder (SUD) are less likely to take these measures.

 

The opioid overdose epidemic has been ongoing in various parts of the US for a long time. However, in early 2020, another epidemic, or rather a pandemic, struck the world, causing millions of deaths. However, covid-19 is far from over. It is subdued but not conquered. It keeps coming back in waves as new strains keep emerging. Moreover, there is no vaccine that can protect people from covid-19 in all cases.

 

The problem is that people are more likely to see drugs during the pandemic and lockdowns. This is evident from the nationwide data. People feel more stressed and isolated, and thus they seek relief from drugs. Hence, looking for a timely opioid addiction treatment becomes a non-negotiable way out.

 

Although, covid-19 is not as significant a threat as it used to be due to mass vaccination. Nonetheless, it remains a significant public health threat. Moreover, current vaccines do not provide complete protection, and even worse, the immunity provided by these vaccines is waning in many, and they need a booster dose.

 

Opioids suppress the respiratory system, worsening covid-19 outcomes

 

Although most people may visualize opioid epidemics and covid-19 as separate disorders, that is not the case. Opioids suppress the respiratory system, harm pulmonary health, and covid-19 mainly causes lung infection.

 

Studies show that those living with SUD are at a 30% greater risk of hospitalization and are much more likely to diet due to severe covid-19 infection. In addition, many studies suggest that opioid use disorder increases the risk of contracting covid-19 by several times.

 

However, the problem is that covid-19 is only making the opioid epidemic worse. Data suggests that since the beginning of covid-19, opioid overdose-related deaths have increased in many parts of the nation.

 

Health experts worry that covid-19 pandemic is laying the grounds for the long-term resurgence of SUD. There are many reasons, including social isolation, increased mental stress, loss of employment, reduced income, and more. In addition, Covid-19 and opiate dependence is causing what researchers call “deaths of despair.”

 

Although we are confident that every covid-19 wave will weaken, this pandemic will end in the long run. However, even if this pandemic tsunami recedes, it is going to leave much damage behind, causing a resurgence in the opioid crisis.

 

These issues are not only due to stress or social isolation. Covid-19 has also disrupted SUD treatment and social support infrastructure, as everyone is focusing on controlling the more severe condition, covid-19. It means that many people living with SUD have discontinued their treatment, and now bringing them back to the clinics would require much effort.

 

Doctors say that people need to understand that the opposite of addiction is not sobriety. The opposite of addiction is connection. Unfortunately, healthcare workers and even family members have lost connection with those living with drug addiction.

 

Thus, the natural way to prevent further worsening of this condition is to start reconnecting with those living with opiate use disorder or SUD. Moreover, it is worth understanding that the opioid crisis may cause more mortalities in the long run than the current covid-19 wave. Of course, an adequate covid-19 response is essential, but it should not come at the expense of reduced attention to drug addiction.

 

Another less discussed reason for the opioid overdose epidemic is that covid-19 response has robbed healthcare workers of certain resources, as most of the sources are now being used to fight covid-19. Many of those affected by the opioid overdose epidemic see those poor policies as the significant causes driving the epidemic.

Summary: 

Opioid addiction has been raging for decades, causing more deaths than street drugs. Using pharmacological drugs to treat addiction to prescription drugs is a way but not the best method. Thus, many researchers are exploring safer treatments. CBD can help counter withdrawal syndrome, alter drug-seeking behavior, and help curb addiction. CBD’s safety is already proven, as it is one of the most commonly used health supplements. Thus, one pharma company is testing CBD to manage opioid addiction. Unlike CBD supplements, it contains a much higher CBD dosage, hence the need to test it extensively.

Opioid misuse epidemics have been raging for over three decades and have become a public health emergency. However, healthcare agencies have been too late to react to this epidemic. They only realized the severity of the issue when deaths caused by prescription drugs exceeded those caused by street drugs. Opioid misuse already causes three times more deaths than a heroin overdose. There are still twice more opioid abusers than those who use heroin.

Doctors have been treating drug addiction for decades. However, managing the addiction to prescription drugs is more challenging. After all, it means managing addiction to one prescription drug with another medication that is relatively safer but not entirely safe. In addition, medicines used to manage opioid addiction are not completely safe and have a range of side effects. Therefore, there is a need to find novel remedies that are safer for prolonged use.

CBD provides hope for managing opioid addiction

Opioid addiction is challenging to manage like any other drug addiction. It is about managing withdrawal syndrome and reducing drug-seeking behavior. For this, doctors use other drugs that help counter withdrawal symptoms and alter the drug-seeking habit. However, a drug used to manage these issues may also be addictive and are not essentially safe.

In recent years, CBD (cannabidiol) has been gaining significant popularity. It is among the most commonly used health supplements. It is safe for prolonged use and has many health benefits. For example, it may relieve pain, reduce stress and anxiety, help sleep better, and more.

CBD is one of the cannabinoids extracted from cannabis plants. However, it does not cause high or euphoria, which occurs due to a substance called THC. CBD products are THC-free or contain it only in traces. CBD is proven safe beyond doubt. Moreover, manufacturers extract CBD from hemp, not from marijuana. Hemp is also a variety of cannabis plants, but it is naturally low in THC and thus safe for regular human consumption.

This is not the first time researchers are testing CBD to manage health conditions. CBD is already approved to address some health conditions. Thus, there are already US FDA-approved CBD-based drugs. For example, a medication called Epidiolex is FDA approved to manage a rare kind of resistant epilepsy in children. Additionally, it appears that CBD is also suitable for conditions like multiple sclerosis and more.

Recently, researchers have started paying much attention to CBD as a remedy for drug addiction. Thus, a company called ANANDA Scientific Inc. has already filed an IND (new drug approval application) for the clinical trial of their unique CBD-based drug to manage opioid addiction. They have already begun the clinical trial, which is in the advanced stages. Moreover, there are significant chances of its approval as pilot studies have already shown the benefits of CBD in managing drug addiction.

Prescription-based CBD can work for managing addiction

Some people here may ask the question: why not simply use CBD-based health supplements that are readily available on the market? Well, CBD-based supplements would not work for many reasons. Firstly, the FDA does not test them. Thus, many of them may not contain much CBD. Many commonly sold health supplements contain hemp oil, which is a different thing and not a CBD product.

But perhaps the dosage is the more significant reason that usual CBD supplements would not work. This is because they contain tiny amounts of CBD. For example, the daily CBD dosage that one can get from usual health supplements is about 20-30 mg a day (usually a max of 70 mg). In contrast, US FDA-approved drugs may contain several hundred milligrams of CBD.

The company, ANANDA Scientific Inc.’s filing shows they are testing 600 to 1200 mg of CBD daily. That is several times higher dosage than one would find in a regular health supplement. That is why, a need for a clinical trial, and this explains why FDA regards it as a CBD-based drug and not a health supplement. Moreover, it is also expected to have better bioavailability and thus efficacy.

To sum up, we are pretty likely to see the introduction of safe, effective, CBD-based drugs to manage opioid addiction. This would be a high-dose CBD product and will be available on a doctor’s prescription.

Summary: Studies show that opioid addiction treatment is crucial in the wake of alarming data revealing a 30% increase in overdose-related deaths between 2019 to 2020 in the US. The data analysis highlights the disproportionate impact on Blacks and Indigenous Americans. Young black people were hit particularly hard by the rise in overdose deaths. Fentanyl and fentanyl-laced drugs are believed to be the leading cause of overdose deaths.

Certain population groups in the US have historically been at a disadvantage. However, new data shows that drug overdose deaths are rising at an alarming and disproportionate rate among Black and Indigenous people in the US.

Analysis of the report published by the Centers for Disease Control and Prevention shows that deaths due to drug overdose rose by 30% between 2019 to 2020, which is a massive increase.

However, as they say, the devil is in the details. On further analyzing the same report, one can see that drug overdose deaths affected Black and Indigenous people more severely. This new report shows a massive jump of 44% in overdose-related deaths among Black people.

Things are also quite bad for American Indians and Alaska Native people. In this population group, the number of drug overdose-related deaths rose by 39%.

Researchers say that deaths among Indigenous people and Blacks outpaced those among white people. Thus, overdose-related deaths among white people rose by about 22% during the same period, which is significantly lower.

Of course, one way to explain these differences is the pattern of substance abuse. Whites choose different kinds of drugs than Blacks or Indigenous Americans. 

However, experts say that there are many reasons for such differences. For example, one of the significant causes of high mortality among specific population groups is treatment biases.

Though a 30% increase in overdose deaths is already a historical landmark, there is more to it. It appears that the overdose issue affected younger Black people (15 to 24 years old) worse, with an almost 86% increase in overdose deaths. It means that in just one year, overdose deaths nearly doubled in this population group.

Not only that, overdose deaths were seven times higher in Black men older than 65 years old compared to white men, which is an unbelievably massive difference.

Like many other reports, the study found that this difference was highest in the counties with the greatest socioeconomic disparities. Thus, for example, if the income gap in any county was less among various ethnic groups, then differences in overdose deaths also was lower.

Researchers say that income inequality between various racial groups seems to have the most significant impact since this leads to poor housing, lack of health insurance, limited access to treatment, and more.

When digging deep into the overdose death reports, experts also found that most of those who die do not get timely treatment for substance abuse or overdose. Thus, for example, data shows quite a low percentage of treatment for substance use among Blacks, with only one in 12 receiving any kind of treatment. Statistics were almost similar for disadvantaged populations like Hispanics and Indigenous people.

In the study, researchers noted a few other trends that may have practical implications. First, they found that most overdose deaths occurred due to illicitly produced fentanyl. Even in those with cocaine or methamphetamine overdose, fentanyl contamination appears to be a significant issue.

Hence, researchers say that tackling the illicit fentanyl supply is important for reducing overdose deaths in the US.

Further, researchers recommend increasing access to substance abuse treatment and better access to medications like naloxone that can reverse opioid overdose. Additionally, better availability of fentanyl test strips would also help in understanding which drug contains fentanyl.

It is our mission to bring real hope and transformational change to patients who would otherwise be consigned to a lifetime of medications, doctor’s visits, and suffering. We expose misaligned incentives and return the power of health to the individual. We believe empowered individuals change their communities. We use a combination of lifestyle intervention, medication management, and emerging scientific research to help our patients.  When you are ready or have questions, reach out.

The content provided herein is not intended to provide assessment, diagnosis, treatment, or medical advice; it also does not constitute provision of healthcare services. No information in this content should ever be considered as a substitute for advice from a healthcare professional, it is provided for thoughtful discussion, informational and educational purposes only.

Summary: Alcohol overuse or alcohol use disorder is associated with higher mortality, especially in young adults. People understand that alcohol increases the risk of health issues like liver disease, pancreatitis, and motor vehicle accidents. However, people do not realize that AUD may also considerably increase cancer risk. Fortunately, new studies also show that quitting alcohol may help reduce this elevated cancer risk.

It is no secret that most adults in the US consume alcohol. However, some may become addicted to alcohol. Few people, about 5% of alcohol users, start consuming alcohol in excessive amounts. Some so-called heavy drinkers frequently engage in binge drinking. These are people living with alcohol addiction or alcohol use disorder (AUD).

Some risks related to AUD are well known to people, like the increased risk of motor vehicle accidents and other kinds of accidents. Unusual aggression and associated trauma. AUD may also cause liver and kidney damage and is associated with a greater risk of pancreatitis. Alcohol addiction is among the leading causes of death in young adults.

However, what many people do not realize is that alcohol also considerably increases the risk of different types of cancers. For some cancer types, alcohol may increase the risk by as much as 30% or even more.

Thus, studies in the US show that high alcohol consumption may increase the risk of cancer anyway between 3-8%. So, on average, high alcohol consumption contributes to about 5% of cases of cancer. Though 5% may not sound significant, but it is worth understanding that cancer is among the top five causes of premature death in the US. Thus, it means that alcohol accounts for 75,000 cancer cases each year and causes more than 18,000 deaths.

Here it is worth understanding that when statistics say that alcohol use disorder kills 140,000 people each year, these statistics do not include deaths caused by cancer that occurs due to AUD. So it means that AUD is causing far more deaths than statistics show.

Studies also suggest that AUD contributes disproportionately to various cancer risks. Thus, it is among the leading causes of oral cavity cancers in the US. However, it also contributes considerably to breast, colon, rectal, and liver cancers.

However, there is good news, too. One of the most extensive studies to date shows that this risk can be significantly reduced. Moreover, this new study shows that this increased risk of cancer is primarily seen in heavy drinkers, people who drink alcohol regularly.

In a new study published in the journal JAMA, researchers analyzed the data of more than four million adults with a follow-up period of more than six years.

The study found that mild alcohol consumption did not increase cancer risk much. Cancer risk increased significantly only in heavy drinkers or those living with AUD.

There were many other encouraging findings in the study. It appears that cancer risk can be reduced by quitting drinking. The study found that once someone stops abusing alcohol, cancer risk still remains high for some time. However, after some time of abstinence, like a year or more, cancer risk is significantly reduced. Thus, those who quit drinking alcohol or drink in small amounts have a reduced cancer risk, and the risk is almost similar to non-drinkers.

Here it is worth understanding that a follow-up period of about six years is not long for understanding the cancer risk associated with AUD. Thus, this risk may be much higher in reality as most people living with AUD continue to abuse alcohol for years or even decades. Another limitation of this study is that it was in Asians.

Despite some limitations, this study highlights one very important and often neglected factor: AUD is also associated with increased cancer risk. Moreover, reducing alcohol intake appears to reduce cancer risk, too.

Summary: Despite a decline in opioid prescriptions, the opioid crisis continues. Opioid use disorder (OUD) and deaths due to opioid overdose continue to increase. Thus, researchers say that there is a need to develop a better understanding of opioid dependence and avoid oversimplification of the problem. So though an increase in opioid prescriptions initially fueled the crisis, later, other factors came into play, like pill mills and an increased supply of illegally produced opioids. 

The opioid crisis is not new, but it is not showing any signs of fading despite the best efforts of regulatory agencies and medical practitioners. What is worrisome is the upward trend of opioid overdose-related deaths, despite a significant decline in opioid prescriptions in the last few years. In addition, it appears that many are now procuring and using prescription opioids produced illicitly. 

Researchers think that if we want to counter this crisis, we need to understand the complex nature of the opioid crisis. Things are not as simple as they might appear. This crisis is not fueled much by opioid prescriptions by doctors to manage chronic pain. Instead, there are other factors like pill mills and “unscrupulous” physicians fueling opioid use disorder (OUD). This pathway that is fueling OUD exists outside the domain of chronic pain management. 

Though there are indeed many faces of the opioid crisis, and it is among the most complex health crisis causing physical and psychiatric health issues. Still, it is also worth understanding that the drug landscape is continually changing. Therefore, what researchers warn is against the oversimplification of the problem. 

For example, saying that the epidemic is solely fueled by opioids prescribed to manage chronic pain is just an oversimplification. On the contrary, studies show that when opioids are prescribed for managing chronic pain, very few patients abuse these drugs. Hence, opioids prescribed by doctors to manage chronic pain do not contribute much to OUD.

Similarly, initially, this factor played a role in OUD development since prescription drugs were cheaper options. However, this factor is not relevant anymore. Though pill mills continue to contribute to the crisis, they are not the only source.

It is true that initially, opioid prescription played a significant role in the opioid epidemic. The epidemic had a humble beginning, as the doctors wanted to help their patients living with chronic pain. Thus, they started prescribing opioids to many patients. However, soon opioid demand rose, and many started procuring these drugs from the illicit market. Due to high demand, the market got filled with illegal drugs. This also affected the market for illicit drugs as it shifted from heroin from Asia to illicitly produced fentanyl in Latin America.

However, researchers say we cannot blame pill mills and unscrupulous physicians alone. Many hospitals continue to prescribe opioids even for conditions with little benefit from opioid prescriptions. 

Since the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain, opioid prescriptions have fallen. Nonetheless, opioid prescriptions remain relatively high in the US compared to other nations worldwide. In addition, studies now confirm that 90% of those living with OUD often use these drugs for non-medical reasons.

Though studies suggest that very few people prescribed opioids for chronic pain will ever develop OUD, this is still a significant number. Moreover, studies show that the number of people older than 50 seeking treatment for OUD has continuously increased. People of this age group are more likely to source opioids from physicians.

Similarly, it is still poorly understood why some individuals are more likely to develop OUD. Nonetheless, researchers think that there is no single explanation. Most of those who develop OUD are individuals who already have other psychiatric comorbidities apart from chronic pain. Thus, this group of people is more likely to develop OUD. Consequently, they not only keep using prescription opioids but are also pretty likely to buy illicit drugs.

To sum up, the researcher says that though specific techniques like using electronic health record notification and motivational interviewing along with opioid dependence treatment  may help reduce the risk of OUD, much work still has to be done to understand the causes of OUD.

It is our mission to bring real hope and transformational change to patients who would otherwise be consigned to a lifetime of medications for opioid addiction treatment, doctor’s visits, and suffering. We expose misaligned incentives and return the power of health to the individual. We believe empowered individuals change their communities. We use a combination of lifestyle intervention, medication management, and emerging scientific research to help our patients.  When you are ready or have questions, reach out.

Medical Disclaimer: Keep in mind that the content provided is not direct medical advice for patient care, but is provided for thoughtful discussion.

Summary: The prevalence of mental health issues has increased significantly in the last few decades. Finding mental health counseling support has been challenging in the US for many years. Psychologists and psychiatrists are not just taking new patients; waiting times are several months long. Moreover, it appears that the mental health care system was ill-prepared for multidimensional stressors like the coronavirus epidemic. The need for mental counseling increased significantly due to coronavirus-related stress. Thus, people are increasingly finding it difficult to find mental counseling support.

Getting timely brain health counseling has never been as difficult as these days. The delays are unbearably long. Thus, many people have to look for alternative ways to manage their health, like practicing yoga or seeking online advice.

Things are especially bad for those living in larger cities, where getting qualified mental health advice may take months. The Internet is full of stories of people who urgently need such support, yet they could not find any. For example, many need mental health counseling to overcome their grief. If they cannot find support immediately, things may become much worse. But it appears that no one is willing to accept new clients.

The coronavirus pandemic has made things worse

Though getting timely mental counseling was never easy in cities like Los Angeles, things have worsened lately. It appears that many more people are seeking help due to coronavirus, and there are just not enough qualified mental health care workers in the US.

Just take an example of Boston Medical Center, which started contacting parents of children who joined the waiting list in April 2021. Unfortunately, they had to wait for more than 10 months to get the help of a child psychiatrist.

The American Psychological Association (APA) recently surveyed and found enormous pressures on the psychologist workforce. The coronavirus pandemic has increased the demand for treating conditions like depressive disorder, anxiety, grief, sleep disorders, and substance abuse by as much as 50% in many instances.

In the survey conducted by APA, 62% of psychologists reported an increase in patient referrals since the beginning of the coronavirus pandemic. In addition, they reported an almost 40% increase in workload. Thus, 65% said that they have no capacity for new patients.

APA, which represents 133,000 psychologists, is not surprised by these issues. They have long predicted these things.

APA long predicted the deficit of mental health care workers

An article was published in the APA’s journal way back in 2020 when the association said that the present system is not ready to handle the upsurge in mental health issues caused by multidimensional stressors like covid-19.

The reason why it is so hard to find a mental health counselor

Mental health counselors could be psychologists or people trained in managing mental health issues. They can generally provide various advice and non-pharmacological means of managing mental health issues like telehealth. However, these people do not prescribe medical drugs. Then there are psychiatrists, who would often prescribe medications to address mental issues. In addition, people seek help from psychiatrists for more severe mental problems like major depression or even schizophrenia.

There appears to be a deficit of psychologists and psychiatrists in the US, which is the main reason why people have to wait so long to get help. The number of people living with mental health has increased significantly during the last few decades. But, the present health system, which was created after World War two, failed to foresee this upsurge in mental health problems.

An even more severe problem is finding narrow specialists. For example, it is highly challenging to find a specialist for mental problems in children. Similarly, very few psychiatrists understand the requirements of ethnic minorities in the US. Thus, finding a psychiatrist with experience in treating black people may be tricky if you are black.

To conclude, the US is in the middle of a mental health epidemic, and there is an urgent need to carry out reforms to the healthcare system. However, it is not something that can be done overnight. Till then, most people are left on their own to find a brain health counselor.