Benzodiazepines might be a 'hidden element' of the US' overdose epidemic -- and doctor visits for prescriptions
are increasing
(CNN) Doctors have been increasingly prescribing  benzodiazepines , also known as "benzos," in recent years. Looking at data from 2014 to 2016, new research found this class of central nervous system depressants was prescribed at about 65.9 million office-based doctor visits. That's a rate of 27 annual visits per 100 adults.
The research, which analyzed data from the National Ambulatory Medical Care Survey, was published on Friday by the US Centers for Disease Control and Prevention.

Benzodiazepines  such as alprazolam, diazepam and lorazepam can be helpful when taken on a short-term basis. Doctors often prescribe them to relieve acute anxiety, agitation or to help someone sleep. Taken over the long term, they can become addictive. In older adults, the drugs have been shown to increase the risk of falls, cloud judgment and impair memory. There is an increased risk of hospitalization and death for people who take benzos,  particularly  if they are taken with an opioid.
Robert Laszewski, Health Policy and Strategy Associates, LLC, President, is giving a keynote titled 'Evolving Concepts for Future Health Care Reform: Beyond ACA' during the Manchikanti Distinguished Lecture Series
ASIPP® Annual Meeting 2020 Has Two Highly Respected Distinguished Lecture Series
There are two highly respected Distinguished Lecture Series at the American Society of Interventional Pain Physicians’ (ASIPP®) Annual Meeting 2020.

The Raj-Racz Distinguished Lecture Series has keynotes from Laxmaiah Manchikanti, MD on excellence in IPM and Konstantin Slavin, MD, PhD on advances in Neuromodulation.

The Manchikanti Distinguished Lecture Series is pleased to have keynotes from Robert Laszewski speaking on evolving concepts for the future of health care reform and several representatives from Farragut Partners , one of Washington’s top government relations firms, will speak about the importance of legislative advocacy for our specialty.

Joshua Hirsch, MD will do the introduction to the Manchikanti Distinguished Lecture Series . Dr Hirsch is Vice Chief of Interventional Care, Massachusetts General Hospital and Associate Professor, Harvard Medical School.

This will be the 22nd annual meeting for ASIPP ® and is being held in conjunction with the Texas Pain Society . The Annual Meeting will be tailored to physicians, mid-level providers, and staff. You can register in several ways. By phone contact Cindy at 270-554-9412. Online click here . In addition, the Exhibitor Prospectus is available to prospective sponsors and vendors. Click here to access the Exhibitor Prospectus.

Reserve your hotel room at discounted rates. The ASIPP ® meeting room block is now open for reservations. You may book online or by phone. Discounted rates include date of March 31-April 5 and will be available until March 17. Reserve by phone: 1-877-803-7534. Use the Group Discount Code: G-SIPP. Click here to reserve your room online.

If you have questions about the room block or the meeting, contact Karen Avery at / 270-554-9412 x 4210
Tylenol a cancer risk? California considers warning on common
painkiller acetaminophen
One of the most commonly used drugs on the market may be deemed a carcinogen by California.

Acetaminophen, an active ingredient in popular pain-relief medications like Tylenol, Excedrin and Midol, has been on the state’s list of drugs under review for years because of tenuous links to cancer.

In the spring, a panel of scientists appointed by the governor will conduct a public hearing to determine whether acetaminophen – known in other countries as paracetamol – will be added to a list of about 900 chemicals the state considers a cancer risk. A California law called Proposition 65 requires the state to warn its residents about chemicals that may cause cancer or reproductive toxicity.
Two Excedrin products are temporarily discontinued,
company says
(CNN) Pharmaceutical company GlaxoSmithKline says it has temporarily discontinued two types of Excedrin items as a precautionary measure.

The company has suspended production and distribution of its Excedrin Extra Strength and Excedrin Migraine products, it said.
"Through routine quality control and assurance measures, we discovered inconsistencies in how we transfer and weigh ingredients for Excedrin Extra Strength Caplets and Geltabs, and Excedrin Migraine Caplets and Geltabs," it said in a statement to CNN.
The company does not believe that the product poses a safety risk to consumers but has voluntarily implemented the measure as a precaution, it said.
CDC to screen at three US airports for signs of new virus from China
More than 100 staffers from the US Centers for Disease Control and Prevention are being deployed to three US airports to check passengers arriving from Wuhan, China, for fever and other symptoms of a  mysterious new virus   that's killed two and infected dozens in China, the CDC announced Friday.

t's a highly unusual step. The last time the CDC did routine passenger health screening was during the 2014 Ebola outbreak, according to  Dr. Martin Cetron , director of the CDC's division of global migration and quarantine.

"I've been here since 1996, and that's the only other time we've ever done this -- for Ebola," Cetron said.

The screenings at New York City's John F. Kennedy International Airport will start tonight, and screenings at San Francisco International Airport and Los Angeles International Airport will begin Saturday. The CDC will look for symptoms such as coughing and difficulty breathing and check temperatures of each passenger with an infrared thermometer.
Opinion: Following massacre of Americans, we need a new strategy to defeat drug cartels

By Senator Bill Cassidy, MD, (R-LA) and Vanila M. Singh, MD, Opinion Contributors
Members of a Mexican drug cartel recently massacred American women and children in broad daylight. The attack was a tragic reminder that cartels continue to run rampant, leaving a trail of violence, sorrow and death. Traditional methods of eliminating these criminal organizations have not solved the problem. We need a new strategy that targets how these dangerous organizations fund their illegal activities. In the meantime, these cartels continue to fuel a public health crisis with 60,000 Americans dying each year to overdose and many more losing their livelihood to violence and addiction-related to illicit drugs.

Criminals use a practice known as trade-based money laundering (TBML) to move illegal goods and money funding their operation. It’s how drug cartels traffic both drugs and people. It is how rogue nations get around international sanctions and how the black market continues to thrive under our noses, and it’s why people keep dying.
ABIPP Recognizes Your Knowledge and Expertise

The American Board of Interventional Pain Physicians ( ABIPP ) has developed certification programs that recognize accepted levels of knowledge and expertise in the interventional pain management profession, with the goal of improved patient care. Hundreds of qualified physicians have made the commitment to become ABIPP certified.

ABIPP now offers the only competency certification program for regenerative medicine.
For complete information about the examination requirements and to obtain an application packet, visit or call 270-554-9412 x4217 or by email at .
ABIPP Part I  
  • Combined CSM/CCPM Exam for ABIPP Path
  • Competency Exam in Controlled Substance Management
  • Competency Exam in Coding, Compliance, and Practice Management
JUNE 27-28
  • ABIPP Competency Exam
  • Regenerative Medicine Competency Exam
  • Endoscopic Lumbar Decompression Competency Exam
939 Ridge Lake Blvd.,
Memphis, Tennessee 38120

June 27 - June 28, 2020 | Hilton Memphis
What Does an Influenza B Dominant Flu Season Mean?

B viruses hit one age group harder than others, experts say
Every flu season is predictably unpredictable, with the current one a prime example thanks to an unexpected virus strain becoming predominant early on.

According to the CDC's most recent  FluView data , the agency's weekly influenza surveillance report, the influenza B/Victoria strain is currently the most common flu strain in the U.S. An early edition of the CDC's  Morbidity and Mortality Weekly Report  noted that the last time  influenza B viruses were the predominant U.S. flu virus  was the 1992-1993 flu season. They added that B/Victoria viruses account for 60% of circulating U.S. viruses this year, whereas in the last 3 years, this strain accounted for less than 10% of circulating viruses.

Influenza B viruses circulate every year, but they are generally seen more often at the end of the flu season, towards the spring.
A Novel Surveillance Tool for Flu: Fitbit
Heart rate, activity, and sleep data hold promise for population-level influenza tracking

Fitbits, wearable devices that measure resting heart rate and sleep time, hold promise in measuring flu at the state level, researchers found.

Weeks during which deidentified Fitbit users in five states had elevated heart rates and more sleep time tended to be those when influenza-like illnesses (ILI) were most common in those states, reported Jennifer Radin, PhD, of Scripps Research in La Jolla, California, and colleagues, writing in  The Lancet Digital Health .

When the Fitbit data were included in flu-intensity prediction models, Pearson correlations increased by an average 0.12 points (SD 0.07) over the original models, they said, adding, "Correlations of the final models with the CDC ILI rates ranged from 0.84 to 0.97."
Essentials of Regenerative Medicine in Interventional
Pain Management
Essentials of Regenerative Medicine in Interventional Pain Management is a book to bring concise, collective, and comprehensive information to interventional pain physicians practicing regenerative medicine in managing chronic pain. Regenerative medicine is an integral part of interventional pain management within the definitions of interventional pain management and interventional techniques.

Each chapter contains an introduction of the subject, historical context,pathophysiology, applicability of regenerative medicine with its evidence base, indications, anatomy, technical aspects, complications, and precautions for each topic when available and applicable. This comprehensive book consists of 35 chapters, more than 350 figures, and 50 tables.
Essentials of Regenerative Medicine in Interventional Pain Management
Informed Consent: Docs Should Ask Permission to Touch
It's 2020, and no, it's not implied by patient's mere presence in exam room

Not that long ago, I was discussing with a group of physicians why I support the use of scribes in the medical office. It decreases the documentation burden on physicians. Scribes, in person or virtual, allow clinicians to look patients in the face. And in-person scribes help to reduce patient nervousness about being alone in a room with a physician.
The lead physician in this small, all-male physician group meeting with their female administrative staff and me (the consultant) was incredulous at my last statement. How could any patient, female or male, be uncomfortable by being alone with a healthcare professional?

Enter the elephant in the room. Many physicians, especially those trained before the turn of the century, are unaware of one simple fact: even though the patient has walked into an exam room, and may even have requested to have a female practitioner, that does not mean that you have informed consent to touch the patient.
Submit Your Abstract To The ASIPP ® 2020 Annual Meeting Abstract/Poster Presentation

The 2020 Annual Meeting Abstract Submission form is now available!

Abstracts Deadline February 17, 2020
FDA Panels Show Little Love for New Painkillers
Two drugs get thumbs-down; two get split decisions

FDA advisory committees had little love for investigational painkillers this week, soundly rejecting two proposed drugs and deadlocking decisions on two others.

Thumbs-down went to Nektar's  oxycodegol  for chronic low back pain -- which earned a stunning 27-0 rejection -- and Intellipharmaceutics'  oxycodone extended-release tablets  known as Aximris XR, which was slammed down 24-2.

Split decisions went to Durect's  bupivacaine depot   (Posimir), a post-surgical non-opioid painkiller that would be injected directly into a surgical incision, in a 6-6 vote, and Esteve Pharmaceuticals' combination of the  mild opiate tramadol and the anti-inflammatory drug celecoxib  (Celebrex), which earned a 13-13 tie.
Pain Physician November/December
2019 Articles Available Online Now
The November/December issue of Pain Physician features a Health Policy article on the changes in utilization of interventional techniques in the Medicare population, a look at opioid prescribing in Switzerland, and opioid prescribing training in fellowship programs in the US, as well as several systematic reviews, randomized trials and original research.

Update on Reversal and Decline of Growth of Utilization of
Interventional Techniques In Managing Chronic Pain in the
Medicare Population from 2000 to 2018
Laxmaiah Manchikanti, MD; Mahendra Sanapati, MD; Vidyasagar Pampati, MS; Mark V. Boswell, MD, PhD; Alan D. Kaye, MD, PhD; Joshua A. Hirsch, MD


Opioid Prescription in Switzerland:
Appropriate Comedication use in Cancer and Noncancer Pain
Maria M. Wertli, MD, PhD; Ulrike Held, PhD; Andri Signorell, MSC; Johann Steurer, MD; Eva Blozik, MD; Jakob M. Burgstaller, MD, PhD

What are Future Pain Physicians Learning? A Survey of
Opioid Prescribing Practices Among US Pain Fellowship Programs
Ferdinand Iannaccone, DO; Peter Nielson, MD; Hazeez Adigun, MD; Andrew Kaufman, MD
Patients with newly diagnosed musculoskeletal pain are prescribed opioids more often than recommended

NIH study shows treatment recommendations impacted by patient and physician factors.
During their first physician visit, patients experiencing newly diagnosed chronic musculoskeletal pain are prescribed opioids more often than physical therapy, counseling, and other nonpharmacologic approaches, according to a  new study  published in the Journal of Pain. The use of opioids over other approaches stands in contrast with clinical recommendations for the use of nonopioid pain approaches and nonpharmacologic approaches. The study included authors from the National Center for Complementary and Integrative Health (NCCIH), part of the National Institutes of Health; the University of Montreal; and McMaster University in Hamilton, Ontario, Canada.

“Particularly when the patient is experiencing pain that may become chronic, that first clinical encounter can set the course for patient care moving forward,” said Helene Langevin, M.D., director of NCCIH. “This study was designed to assess the ways in which real-world practice compares and contrasts with practice guidelines for these initial patient encounters.”

Study authors analyzed data from the National Ambulatory Medical Care Survey (NAMCS), conducted between 2007 and 2015. The survey data are collected by the Centers for Disease Control and Prevention’s National Center for Health Statistics and represent how medical care services are used in the United States. The results concur with the high prevalence of chronic musculoskeletal pain in the United States, with an average of 36.8 million initial visits (for a new chronic pain problem) per year or approximately 11.8% of the population.
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.  

So submit today your:
  • Case Reports
  • Technical Reports
  • Editorials
  • Short Perspectives
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Customized waiting room TV exclusively for ASIPP ® members. Create your own ad-free television broadcasts using our videos, custom informational slides and your own YouTube videos. Even add local weather reports, news and live messages.
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