American Society of Interventional Pain Physicians | September 19, 2018
Interventional Techniques Lab


6.75 A MA PRA Category 1 Credits™

11 AMA PRA Category 1 Credits
Lumbar Endoscopic Spinal Decompression


7 AMA PRA Category 1 Credits™
(Plus Free Online Lectures)
11 AMA PRA Category 1 Credits™
FDA Outlines Plan for New Analgesic Guidance to Combat Opioid Crisis

In a statement addressing the Agency's progress regarding the opioid crisis, the Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, announced plans to withdraw the existing 2014 analgesic guidance document and replace it with something more "streamlined'. 
The 2014 analgesic guidance provides recommendations for sponsors regarding drug development and trial designs. "That guidance [2014] typically called for a large number of studies to get a general chronic pain indication and may have been difficult to implement because it was so broad," said Dr Gottlieb. "Instead, we've determined that a more focused approach would streamline drug development in specific areas."

Daily low-dose aspirin found to have no effect on healthy life span in older people

In a large clinical trial to determine the risks and benefits of daily low-dose aspirin in healthy older adults without previous cardiovascular events, aspirin did not prolong healthy, independent living (life free of dementia or persistent physical disability). Risk of dying from a range of causes, including cancer and heart disease, varied and will require further analysis and additional follow-up of study participants. These initial findings from the ASPirin in Reducing Events in the Elderly (ASPREE) trial, partially supported by the National Institutes of Health, were published online on September 16, 2018 in three papers in The New England Journal of Medicine.
ASPREE is an international, randomized, double-blind, placebo-controlled trial that enrolled 19,114 older people (16,703 in Australia and 2,411 in the United States). The study began in 2010 and enrolled participants aged 70 and older; 65 was the minimum age of entry for African-American and Hispanic individuals in the United States because of their higher risk for dementia and cardiovascular disease. At study enrollment, ASPREE participants could not have dementia or a physical disability and had to be free of medical conditions requiring aspirin use. They were followed for an average of 4.7 years to determine outcomes.

Chronic Pain Affects 20% of Americans, CDC Reports

Of 50 million people with chronic pain, about 20 million have high-impact pain
Chronic pain affected about 20% of U.S. adults in 2016 and high-impact chronic pain -- severe enough to interfere with life or work activities most days -- affected 8%, according to the CDC.
That translates to 50 million people with chronic pain and about 20 million people with high-impact chronic pain, reported James Dahlhamer, PhD, of the CDC's Division of Health Interview Statistics in Hyattsville, Maryland, and colleagues in Morbidity and Mortality Weekly Report.
This is the first-ever CDC assessment of high-impact chronic pain. Population-based estimates of chronic pain among American have ranged from 11% to 40%, with considerable variance among different segments of the population.

Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016

Medicinal Cannabis May Not Have Opioid-Sparing Effects in Chronic Noncancer Pain

Medicinal cannabis may not effectively reduce opioid use or pain interference in individuals with chronic noncancer pain, according to a study to be presented at the 2018 World Congress on Pain, held September 12-16 in Boston, Massachusetts.1
For this prospective study, Pain and Opioids IN Treatment, or POINT, 1514 individuals who were prescribed opioid medications for chronic noncancer pain were recruited between 2012 and 2014.2 Study participants were interviewed at baseline and once a year for 4 years to determine lifetime occurrence and duration of chronic pain, cannabis use (lifetime, last 12 months, and last month), presence of mental health comorbidities (ie, generalized anxiety disorder and depression), and opioid dose (in oral morphine equivalent).

Opinion: Trump administration making progress in fight against opioid epidemic: HHS Secretary

The latest numbers show that more than 72,000 Americans died of a drug overdose in 2017, most of them involving opioids. The tragic statistics are a reminder of why President Trump has made combating the opioid crisis a top priority for his presidency.
But everywhere the crisis has struck, there are signs of hope and resilience. Earlier this year, I visited a clinic in Dayton, Ohio — one of the hardest hit communities in the country — that treats new mothers struggling with addiction and their infants born physically dependent on opioids.

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

Disaster Preparedness 101: Physician Resources for Patients

With hurricane season well underway, the American Heart Association has updated their disaster resources page and released some tips that physicians should keep in mind when counseling their patients prior to the arrival of a storm.
“Heart disease and stroke patients are even more vulnerable to the effects of a disaster,”1said the press release. In addition to patients with cardiovascular conditions, these tips are broadly applicable to patients with a wide range of health conditions.

Click HERE for American Heart Association Disaster Resource Page

Cassipa Approved as Maintenance Treatment for Opioid Dependence

The Food and Drug Administration (FDA) has approved Cassipa (buprenorphine and naloxone; Teva) sublingual film for the maintenance treatment of opioid dependence. 
Cassipa combines buprenorphine, an opioid (partial agonist-antagonist), and naloxone, an opioid antagonist. It is intended for use with a complete plan that includes counseling and psychosocial support. It should only be used after patient induction and stabilization up to a 16mg dose of buprenorphine using another marketed product. The approval of Cassipa was supported by the FDA's finding of safety and efficacy for Suboxone sublingual film in addition to pharmacokinetic data specific to Cassipa. 


Pain Physician
July/August 2018 Issue Features

Health Policy Review
  • Reframing the Prevention Strategies of the Opioid Crisis: Focusing on Prescription Opioids, Fentanyl, and Heroin Epidemic
Systematic Reviews
  • Is Unilateral Percutaneous Kyphoplasty Superior to Bilateral Percutaneous Kyphoplasty for Osteoporotic Vertebral Compression Fractures? Evidence from a Systematic Review of Discordant Meta-Analyses
  • Prevalence of Recurrent Herniation Following Percutaneous Endoscopic Lumbar Discectomy: A Meta-Analysi
Randomized Trials
  • Thermal Versus Super Voltage Pulsed Radiofrequency of Stellate Ganglion in Post-Mastectomy Neuropathic Pain Syndrome: A Prospective Randomized Trial
  • Evaluation of an Experimental Pain Model by Noncompartmental Analysis of Results from a Randomized Placebo Controlled Trial
  • Transforaminal vs Interlaminar Epidural Steroid Injection for Acute-Phase Shingles: A Randomized, Prospective Trial

Do Medical Journals Publish Original Work Anymore?

Suppose you are under pressure to publish in the medical literature. But sadly, you have never done any original research. Yet, you need to put together a paper in a short period of time. How can you solve this problem?
Presto! You can go online, and in a few minutes, you can hire someone to carry out a meta-analysis for you. It is really easy, and if you are willing to pay, they will even write the entire paper for you.
Years ago, those who proposed the existence of a hierarchy of medical evidence made a huge mistake. They placed meta-analysis at the top of the food pyramid. They claimed (mistakenly) that a meta-analysis represented a far stronger level of evidence than a large-scale definitive randomized trial. No one remembers why this happened, and certainly, no one is currently taking responsibility for this egregious error (as far as I know).

Cigna-Express Scripts deal unlikely to harm competition or consumers, DOJ says

The Department of Justice on Tuesday cleared Cigna's $67 billion acquisition of Express Scripts because it said the merger is unlikely to lessen competition in the sale of pharmacy benefit manager services.
Cigna's PBM business nationwide is small, the DOJ said.
At least two other large PBM companies and several smaller ones will remain in the market post-merger, the department said.

Opinion: I'm a Physician and a Gun Owner

Here are my suggestions for gun control
So let's get down to it. Everyone is tired of shooting sprees. If you're a gun owner, you're tired of seeing weapons abused and misused to harm the innocent. If you're a gun opponent, you feel the same way but can't imagine why anyone has these weapons in the first place. I get it. I hope both sides get it.
I've thought about this a lot. I'm a gun owner. I have been since childhood. That was the culture in which I was raised -- guns everywhere. In dad's dresser, in the closet, in the neighbor's truck. It's what I knew. There are about 80 million gun owners in America, many of whom come from a similar background.

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, 2018 @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.

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