Posts Tagged ‘chronic pain’

Doctors eye deep brain stimulation to treat opioid addiction

 


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Associated Press:

Patient Number One is a thin man, with a scabby face and bouncy knees. His head, shaved in preparation for surgery, is wrapped in a clean, white cloth.

 

Years of drug use cost him his wife, his money and his self-respect, before landing him in this drab yellow room at a Shanghai hospital, facing the surgeon who in 72 hours will drill two small holes in his skull and feed electrodes deep into his brain.

 

The hope is that technology will extinguish his addiction, quite literally, with the flip of a switch.

 

The treatment — deep brain stimulation — has long been used for movement disorders like Parkinson’s. Now, the first clinical trial of DBS for methamphetamine addiction is being conducted at Shanghai’s Ruijin Hospital, along with parallel trials for opioid addiction. And this troubled man is the very first patient.

 


The surgery involves implanting a device that acts as a kind of pacemaker for the brain, electrically stimulating targeted areas. While Western attempts to push forward with human trials of DBS for addiction have foundered, China is emerging as a hub for this research.

 

Scientists in Europe have struggled to recruit patients for their DBS addiction studies, and complex ethical, social and scientific questions have made it hard to push forward with this kind of work in the United States, where the devices can cost $100,000 to implant.

 

China has a long, if troubled, history of brain surgery for drug addiction. Even today, China’s punitive anti-drug laws can force people into years of compulsory treatment, including “rehabilitation” through labor. It has a large patient population, government funding and ambitious medical device companies ready to pay for DBS research.

 

There are eight registered DBS clinical trials for drug addiction being conducted in the world, according to a U.S. National Institutes of Health database. Six are in China.

 

But the suffering wrought by the opioid epidemic may be changing the risk-reward calculus for doctors and regulators in the United States. Now, the experimental surgery Patient Number One is about to undergo is coming to America. In February, the U.S. Food and Drug Administration greenlighted a clinical trial in West Virginia of DBS for opioid addiction.

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HUMAN EXPERIMENTS

 

Patient Number One insisted that only his surname, Yan, be published; he fears losing his job if he is identified.

 

He said doctors told him the surgery wasn’t risky. “But I still get nervous,” he said. “It’s my first time to go on the operating table.”

 

Three of Yan’s friends introduced him to meth in a hotel room shortly after the birth of his son in 2011. They told him: Just do it once, you’ve had your kid, you won’t have problems.

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THE PAIN PARADOX from “Trauma Sensitive Mindfulness”.


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There is one more idea in Buddhism and MBSR that shapes our orientation to mindfulness: the notion that our avoidance of suffering can exacerbate it.

 

Mindfulness experts John Briere and Catherine Scott referred to this as the pain paradox—the observation that our natural tendency to escape, deny, or withdraw from pain only intensifies and prolongs the distress.
What we resist, the saying goes, persists.

 

This paradox was key to Kabat-Zinn’s introduction of MBSR to the medical community.

 

When he originally approached doctors with the idea of having patients meditate, Kabat-Zinn was advocating for a fundamentally different approach to suffering—one that lay at the heart of the Buddhist tradition he’d trained in.


“From the perspective of mindfulness,” he wrote, “nothing needs fixing.


Nothing needs to be forced to stop, or change, or go away.”

 

Perhaps not surprisingly, this idea raised eyebrows.

 

Western medicine was built largely on helping alleviate people’s pain, offering interventions such as medication or surgery.

 

Mindfulness ran completely counter to this paradigm. How could paying closer attention to one’s pain alleviate it?


Yet doctors were also open to the idea. Each of them had patients they couldn’t cure and who were resistant to conventional treatment approaches. Doctors and their patients had little to lose.

 

The first MBSR studies thus began with those who were suffering from chronic pain.

 

Kabat-Zinn wanted to see whether they could mobilize their own internal responses to the suffering they were experiencing. “We invited them, paradoxically,” he said, “to put the welcome mat out for whatever sensations they were experiencing, just to see if they could attend to them moment by moment and ‘befriend’ the actuality of their experience, even briefly.”

 

The results were successful. Patients found that their relationship to pain shifted positively when they practiced mindfulness.

 

At times, their pain even disappeared. Patients also reported discovering that the vexing sensations that lived inside them were transient and shifting.

 

Rather than being constant throughout their day, the pain was shifting over time—a huge realization for those who felt perpetually burdened by their bodies.


Mindfulness was helping people relate to their pain differently.


For some, it was even opening a door to a freedom they had forgotten or had previously not known.
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An incredible feat!

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“May your choices reflect your hopes not your fears.”

– Nelson Mandela
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Think it is to difficult letting thoughts go?

 

 

Think enduring a mundane existence is difficult?

 

Examine this incredible life, one of sacrifice and service.

 

 

Remember chasing pleasure is not the road to happiness.

 

Mandela sure did not chase pleasure but his life changed a country!

 

Mandela spent 27 years in prison, upon returning to society, released his hate and forgave his abusers.

 

Beside this monumental compassion, he had the wisdom to unite his country.
Hard to find a more amazing feat in our generation, in my opinion.
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Why is change so difficult???????????

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Where does all the resistance come from? Why do we isolate, avoid unpleasant situations and people. Why do we chase and covet pleasant situations, people who approve of us, accomplishment, power, status and security?

 

Seems a decent strategy to avoid pain and soak up accomplishment in the short-term. Counterintuitive, knowing this strategy leads to suffering.

 

We have practiced habits, patterns of behavior, some subconscious in origin. We have created an “Ego” to mirror our habitual patterns. Our identity is wrapped around this “Ego”. Be it a banker, athlete, monk, priest, accountant, home maker, actor, philanthropist, etc.

 

 

Inside this cocoon, we judge ourself, find a place where we believe we fit, belong. When we enter a room, our “Ego” scans the occupants and decides if we are superior or inferior, then ranks our status.

 

 

Yes, this is superficial and kind of crazy. First, the “Ego” is a mirage, we are not what we think or judge. Second those occupations are what we do, not who we are.

 

 

Our mind is the issue, also the solution.

 

 

Fear of the unknown and this “Ego” are the main culprits keeping us from changing. We would rather suffer a known situation than risk changing, even when there is a possibility of success.

 

 

The “Ego” covets complete control. Healing means the “Ego” loses more and more control. In reality the “Ego” does not know what is good or bad for us. The “Ego” only, desires complete control.

 

 

Remember he/she generates 60,000 thoughts daily to influence where we place our attention.

 

 

You will definitely encounter your own “Ego” if you take this healing journey. He/She is not evil, he/she is only a follower not our captain.

 

 

Training the mind to empty and focus takes power from the “Ego”.
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Opioid lawsuit targets rich family behind drug that fueled US crisis Sackler family, which owns Purdue Pharma, the maker of OxyContin, accused of fueling addiction while boosting profits

73473615-1842-4E00-8F31-5065EB9A653CPhotograph: George Frey/Reuters
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The Guardian:
Joanna Walters and agencies
Tue 12 Jun 2018

 

The prescription painkiller OxyContin at a pharmacy. The lawsuit takes the unusual step of personally naming the company executives.
The prescription painkiller OxyContin at a pharmacy. The lawsuit takes the unusual step of personally naming the company executives.

 

The state of Massachusetts on Tuesday sued the maker of the prescription painkiller OxyContin, which has been blamed for spawning America’s opioids crisis, naming leading executives and members of the multibillionaire Sackler family that owns the pharmaceutical company.

The lawsuit accuses the company, Purdue Pharma, of spinning a “web of illegal deceit” to fuel the deadly drug abuse crisis while boosting profits.

Their strategy was simple: the more drugs they sold, the more money they made, and the more people died
Maura Healey, state attorney general
Purdue Pharma is already defending lawsuits from several states and local governments, but Massachusetts is the first state to take the unusual step of personally naming the company’s executives in a complaint, the state attorney general, Maura Healey, said. It names 16 current and former executives and board members, including the chief executive, Craig Landau, and eight members across three generations of the Sackler family that wholly owns Purdue.

The lawsuit alleges Purdue deceived patients and doctors about the risks of opioids, pushed prescribers to keep patients on the drugs longer and aggressively targeted vulnerable populations, such as the elderly and veterans.

“Their strategy was simple: the more drugs they sold, the more money they made, and the more people died,” Healey said on Tuesday.

Purdue, based in Stamford, Connecticut, issued a statement saying it vigorously denied all the allegations and looked forward to presenting “substantial defenses” to the claims in the lawsuit.

“We share the attorney general’s concern about the opioid crisis. We are disappointed, however, that in the midst of good faith negotiations with many states, the commonwealth [of Massachusetts] has decided to pursue a costly and protracted litigation process. We will continue to work collaboratively with the states toward bringing meaningful solutions,” it stated.

Maura Healey, the Massachusetts attorney general, has sued the maker of OxyContin over the deadly opioid crisis.
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Maura Healey, the Massachusetts attorney general, has sued the maker of OxyContin over the deadly opioid crisis.

 

Purdue, along with some other painkiller makers and drug distributors, is currently facing more than 300 lawsuits from city and county authorities across the country. The lawsuits have been corralled into one multi-district case in a federal court in Ohio. The judge in that case has been pushing for a huge, quick settlement to compensate victims and assist in what the government has admitted is a public health crisis, in the way the so-called “Big Tobacco settlement” happened against cigarette companies in the 1990s. But some experts are calling for the case to go to trial in order to oblige the pharmaceutical companies to produce more evidence in the discovery process.

 

 

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THE PAIN PARADOX from “Trauma Sensitive Mindfulness”. Part 2

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Yet doctors were also open to the idea. Each of them had patients they couldn’t cure and who were resistant to conventional treatment approaches. Doctors and their patients had little to lose.

 

The first MBSR studies thus began with those who were suffering from chronic pain.

 

Kabat-Zinn wanted to see whether they could mobilize their own internal responses to the suffering they were experiencing.

 

 

We invited them, paradoxically,” he said, “to put the welcome mat out for whatever sensations they were experiencing,

 

 

just to see if they could attend to them moment by moment and ‘befriend’ the actuality of their experience, even briefly.”

 

 

The results were successful. Patients found that their relationship to pain shifted positively when they practiced mindfulness.

 

At times, their pain even disappeared.

 

 

Patients also reported discovering that the vexing sensations that lived inside them were transient and shifting.

 

Rather than being constant throughout their day, the pain was shifting over time—a huge realization for those who felt perpetually burdened by their bodies.

 

 

Mindfulness was helping people relate to their pain differently.

 

 

For some, it was even opening a door to a freedom they had forgotten or had previously not known.
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THE PAIN PARADOX from “Trauma Sensitive Mindfulness”. Part 1

6AED47A3-A91F-45F2-9B38-9CF55C710AC1.
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There is one more idea in Buddhism and MBSR that shapes our orientation to mindfulness: the notion that our avoidance of suffering can exacerbate it.

 

Mindfulness experts John Briere and Catherine Scott referred to this as the pain paradox—the observation that our natural tendency to escape, deny, or withdraw from pain only intensifies and prolongs the distress.

 

 

What we resist, the saying goes, persists.

 

 

This paradox was key to Kabat-Zinn’s introduction of MBSR to the medical community.

 

When he originally approached doctors with the idea of having patients meditate, Kabat-Zinn was advocating for a fundamentally different approach to suffering—one that lay at the heart of the Buddhist tradition he’d trained in.

 

From the perspective of mindfulness,” he wrote, “nothing needs fixing.

 

Nothing needs to be forced to stop, or change, or go away.”

 

 Perhaps not surprisingly, this idea raised eyebrows.

 

Western medicine was built largely on helping alleviate people’s pain, offering interventions such as medication or surgery.

 

Mindfulness ran completely counter to this paradigm. How could paying closer attention to one’s pain alleviate it?

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