American Society of Interventional Pain Physicians | October 10, 2018
Effects of Overdose Risk Reduction Initiatives for Patients Receiving Chronic Opioid Therapy

Reducing opioid dose — but not risk stratification or monitoring initiatives — may be effective in  reducing overdose rates  in patients on chronic opioid therapy, although this observed reduction was not significant compared with the group receiving a control intervention, according to a study published in  The Journal of Pain .
Risk stratification and risk-based monitoring, 2 measures that are recommended as part of guidelines on chronic opioid therapy, are thought to be broadly adapted in the clinic. Previous studies have shown that prescription opioid overdose risk increases with opioid dosage. This is the first controlled study to examine the effects on opioid overdose rates of dose reduction initiatives during chronic opioid therapy. 

Opioid Analgesics Linked With Higher Rates of Unemployment in Chronic Pain

Patients taking  opioid analgesics  for chronic noncancer pain may have a risk for unemployment 3-fold higher compared with individuals not taking opioids, according to a study published in  Pain Medicine.
This cross-sectional, observational study included 604 participants with chronic back, osteoarthritis, or neck pain. The Acupuncture Approaches to Decrease Disparities in Pain Treatment 2-arm trial was used to collect survey data. Data on employment, use of opioids to treat pain, quality of life, pain, patient health, and demographics were collected through a survey administered at baseline. The relationship between unemployment and  opioid use  was analyzed through multivariable logistic regression.

February 22-24, 2019
Orlando, FL

Most Physicians Disenchanted With Their Profession: Survey

Seven out of 10 physicians would not recommend their profession to their children or other family members, and more than half are thinking about retiring within the next 5 years, including one-third of those under the age of 50, according to a new national survey by The Doctors Company, a physician-owned medical malpractice insurer.   
The survey of more than 3400 US physicians uncovered a "complex picture" of the attitudes of physicians nationwide toward the important issues facing the industry, with physicians reporting feeling disenchanted with the practice of medicine, the authors note in their report.

Access to this article may be limited.
Docs in Urban Settings Favor Brand-Name Drugs

Prescription rates of nearly 600 commonly used drugs appear to be influenced by a county's racial composition, state healthcare laws, and wealth, according to a national survey of medical claims data.
Urban areas, particularly in the Northeast Corridor between New York and Washington, D.C., tended to prescribe more expensive, brand-name drugs even when these drugs have not demonstrated a higher effectiveness ( P =8.7 × 10 -37 ), reported Rachel Melamed, PhD, and Andrey Rzhetsky, PhD, both of the University of Chicago.

Interventional Pain Management Reports is an Open Access online journal, a peer-reviews journal dedicated to the publication of case reports, brief commentaries and reviews and letters to the editor. It is a peer-reviewed journal written by and directed to an audience of interventional pain physicians, clinicians and basic scientists with an interest in interventional pain management and pain medicine. 

Interventional Pain Management Reports is an official publication of the American Society of Interventional Pain Physicians (ASIPP) and is a sister publication of Pain Physician . Interventional Pain Management Reports Interventional Pain Management Reports is an open access journal, available online with free full manuscripts.  

The benefits of publishing in an open access journal that has a corresponding
print edition journal are:  
  • Your article will have the potential to obtain more citations.
  • Your article will be peer-reviewed and published faster than other journals.
  • Your article can be read by a potentially much larger audience compared with traditional subscription-only journals.  
  • Open Access journals are FREE to view, download and to print.

So submit today your:
  • Case Reports
  • Technical Reports
  • Editorials
  • Short Perspectives

FDA recalls Liveyon stem cell product: blow to big clinic supplier?

The FDA has issued  a recall  of the main stem cell product of a California firm called Liveyon that is linked to unproven stem cell clinics. The recall seems to have been due to “adverse reactions.”
An emerging big player in the birth-related stem cell clinic area?
I’ve been hearing the name Liveyon pop up more often in the unproven stem cell clinic industry recently. More specifically, they seem to be a supplier and marketer of birth-related products to clinics. The clinics then in turn inject the non-FDA-approved offerings into customers for profit. I have only mentioned this particular company  once on this blog  before. It was in a post about a clinic that apparently used their product for neuropathy, which was not a recommended indication.

Opioid-Benzo Overlap Higher in Patients Using Multiple Health Systems

Receiving drugs from more than one healthcare system was tied to a greater risk of overlapping prescriptions for opioids and benzodiazepines, a cross-sectional study showed.
Receiving prescriptions from both the U.S. Department of Veterans Affairs (VA) and Medicare Part D in 2013 carried a 27% increased risk for overlapping opioids and benzodiazepines, compared with receiving prescriptions from the VA alone, according to Walid Gellad, MD, MPH, of the VA Pittsburgh Healthcare System, and colleagues .

Pain Physician
September/October 2018 Issue Features

Health Policy Review
  • Reframing Medicare Physician Payment Policy for 2019: A Look at Proposed Policy     
Systematic Reviews
  • Efficacy Assessment of Radiofrequency Ablation as a Palliative Pain Treatment in Patients with Painful Metastatic Spinal Lesions: A Systematic Review
  • Comparison of Clinical Efficacy Between Transforaminal and Interlaminar Epidural Injections in Lumbosacral Disc Herniation: A Systematic Review and Meta-Analysis
  • Comparison of Clinical Efficacy of Epidural Injection With or Without Steroid in Lumbosacral Disc Herniation: A Systematic Review and Meta-analysis
Randomized Trials
  • Effectiveness and Safety of High-Voltage Pulsed Radiofrequency to Treat Patients with Primary Trigeminal Neuralgia: A Multicenter, Randomized, Double-Blind, Controlled Study Protocol
  • Preemptive Analgesia with Parecoxib in Total Hip Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial
  • Comparison of Efficacy of Lateral Branch Pulsed Radiofrequency Denervation and Intraarticular Depot Methylprednisolone Injection for Sacroiliac Joint Pain

FDA Fast-Tracks Non-Opioid Treatment for Neuropathic Pain

The Food and Drug Administration (FDA) has granted Fast Track designation to AV-101 (VistaGen Therapeutics), an investigational non-opioid treatment for neuropathic pain.
AV-101 is an orally bioavailable, small molecule N-methyl-D-aspartate (NMDA) receptor glycine B antagonist. According to the Company, AV-101 has the potential to achieve ketamine-like antidepressant effects, but without the side effects and safety concerns. The treatment is currently being evaluated in a Phase 2 study (ELEVATE) in patients with major depressive disorder who have had an inadequate response to standard antidepressant therapy (ie, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors).  

Former pain physician sentenced to 20 years in prison after allegedly causing multiple overdoses: 5 details

Former pain management physician Howard Gregg Diamond, MD, pleaded guilty Oct. 5 to federal drug distribution charges, KATC News reports.
Here's what you should know:
1. Dr. Diamond pleaded guilty to conspiracy to possess with intent to distribute controlled substances, in addition to other charges.
2. He will serve 20 years in federal prison.
3. In 2017, a federal grand jury alleged Dr. Diamond conspired with others to unnecessarily prescribe drugs such as fentanyl, hydrocodone and morphine. The prescriptions allegedly contributed to the deaths of seven people in Texas and Oklahoma from 2012 to 2016.
4. Dr. Diamond acknowledged responsibility for one patient overdose, his attorney told the Dallas Morning News.
5. Dr. Diamond practiced at Diamondback Pain and Wellness Center in Sherman, Texas, Dallas News reports. The Texas Medical Board suspended him in 2017.

DOJ News

Miami-Area Pharmacy Owner Pleads Guilty for Role in $8.4 Million Medicare Fraud Scheme
The owner of a Miami-area pharmacy pleaded guilty for his role in Medicare prescription fraud scheme involving approximately $8.4 million in fraudulent billings.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division; U.S. Attorney Ariana Fajardo Orshan for the Southern District of Florida; Special Agent in Charge Robert Lasky of the FBI’s Miami Field Office; Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG); Special Agent in Charge Brian Swain of the U.S. Secret Service (USSS), and Special Agent in Charge Adolphus P. Wright of the U.S. Drug Enforcement Administration (DEA) Miami Field Division made the announcement. 
Antonio Perez Jr., 48, of Miami Beach, Florida, pleaded guilty today before U.S. District Judge Federico A. Moreno to one count of conspiracy to commit health care fraud.

Texas Hospital Administrator Convicted of Health Care Fraud for Role in $16 Million Medicare Fraud Scheme
A federal jury convicted a Houston-area hospital administrator on Friday for his role in a $16 million Medicare fraud scheme.  
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Ryan K. Patrick of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office, Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) Dallas Region, Special Agent in Charge D. Richard Goss of IRS Criminal Investigation’s (IRS-CI) Houston Field Office, and Unit Division Chief Stormy Kelly of the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) made the announcement.
Starsky D. Bomer, 45, of Harris County, Texas, was convicted of one count of conspiracy to pay and receive healthcare kickbacks, two counts of violating the Anti-Kickback Statute, and one count of conspiracy to commit health care fraud following a five-day trial. Sentencing has been scheduled for Jan. 28, 2019 before U.S. District Judge Vanessa D. Gilmore of the Southern District of Texas, who presided over the trial. 

State Society News 
November 8-11, 2018
NY/NJSIPP Pain Medicine Symposium 2018 
Hyatt Regency Jersey City.
CLICK HERE for more details

November 12 and 14, 2018
FSIPP Regional Meetings: 
November 12, 2 018 @6:30pm
Carrabba's Italian Grill
2370 SW College Road, Ocala, FL 34471
November 14, 2018 @6:30pm
Carrabba's Italian Grill
5820 Red Bug Lake Road, Winter Springs, FL 32708
CLICK HERE to register for either meeting

July 12-14, 2019
GSIPP 2019 - 15th Annual Meeting & Pain Summit
The Cloister Hotel at Sea Island
Sea Island, GA
For more information, contact Karrie Kirwan at or Tara Morrison at or 770-613-0932.

July 26-28, 2019
PAIN 2019
West Virginia Society of Pain Physicians
Loews Miami Beach, FL

Send in your state society meeting news to Holly Long,
ASIPP | Pain Physician Journal | Phone | Fax | Email