ASIPP Enews

American Society of Interventional Pain Physicians | December 19, 2018

Congressional Concern Questions Vetting Process for HHS Task Force

Numerous members of a new HHS pain management task force formed to address the opioid crisis have taken money from the drug industry in recent years, according to a letter a top Senate Democrat sent to the department.

Senate Finance Committee ranking member Ron Wyden is pressing HHS to explain how it reviewed potential financial conflicts after finding that 10 individuals on the panel — about a third of its membership — received nearly $180,000 in total between 2013 and 2017 from pharmaceutical companies, including opioid firms and medical device manufacturers.

The Pain Management Best Practices Inter-Agency Task Force, which was named earlier this year, aims to develop recommendations for managing chronic and acute pain. Open Payments data, a record of drug and device industry payments to providers, is available for 15 of the task force's 29 task members.

Click HERE to read letter

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Abstract Submission Open!

Abstract submissions are now being accepted for the 2019 ASIPP Annual Meeting Abstract and Poster Contest. The top 10 abstracts selected by our panel will be presented at the annual meeting. The top 25 abstracts will be presented as electronic posters in view for all our attendees.

Click HERE to submit. Deadline is Feb. 18

CDC: Top 10 Drugs Involved in Drug Overdose Deaths

A recent report from the Centers for Disease Control and Prevention (CDC) identified the 10 drugs most frequently mentioned in overdose deaths.

Using data from the 2011 to 2016 National Vital Statistics System-Mortality files, the authors conducted a literal text analysis of death certificates to identify drugs mentioned as contributing to the cause of overdose death . They used this information to calculate which drugs were most frequently involved. “Deaths involving more than 1 drug (eg, a death involving both heroin and cocaine) were counted in all relevant drug categories (eg, the same death was included in counts of heroin deaths and in counts of cocaine deaths),” the authors explained.

Key Findings

In 2016, there were more than 63,600 drug overdose deaths in the United States.
The age-adjusted rate of drug overdose deaths in 2016 (19.8 per 100,000) was 21% higher than the rate in 2015 (16.3).
Among persons aged 15 and over, adults aged 25–34, 35–44, and 45–54 had the highest rates of drug overdose deaths in 2016 at around 35 per 100,000.
West Virginia (52.0 per 100,000), Ohio (39.1), New Hampshire (39.0), the District of Columbia (38.8), and Pennsylvania (37.9) had the highest observed age-adjusted drug overdose death rates in 2016.
The age-adjusted rate of drug overdose deaths involving synthetic opioids other than methadone (drugs such as fentanyl, fentanyl analogs, and tramadol) doubled between 2015 and 2016, from 3.1 to 6.2 per 100,000.

CDC

Chronic Spinal Pain and Depression: Does One Represent a Risk Factor for the Other?

Chronic spinal pain and depressive disorders — particularly chronic depression — may each represent a risk factor for the other condition, according to a study published in the Journal of Pain .

In this study, researchers evaluated interview data from the National Comorbidity Survey (NCS), which used a modified version of a structured psychiatric diagnostic interview, the Composite International Diagnostic Interview (CIDI). Data were collected from a stratified participant sample between 1990 and 1992 (NCS-1; n=8098; ages, 15-54). The participants were tracked and interviewed 10 years later, between 2000 and 2001 (NCS-2; n=5001) using customized interview questions based on responses from the NCS-1. For NCS-2, 5463 of the NCS-1 respondents were traced, with 166 of those respondents reported as deceased.

Clinical Pain Advisor

Opioids offer little chronic pain benefit and wane over time, study says

For adults with chronic pain, opioids offer narrow improvements over a placebo for pain and physical functioning, on average, according to a new analysis published Tuesday. And the majority of patients will experience no meaningful benefit.

Those benefits also tend to decrease over time and come with the risk of side effects such as vomiting and constipation, according to the review of nearly 100 randomized trials published in the Journal of the American Medical Association. Down the line, risks may include physical dependence and overdose.

"The benefits of opioids for managing chronic pain tend to be quite modest," said study author Jason Busse, associate professor in the department of anesthesia at McMaster University's school of medicine in Ontario, Canada.

CNN

Is Chronic Opioid Use Waning in Musculoskeletal Pain Patients?

Patients with low back, multiple-site pain may still be at risk

The risk for chronic opioid use decreased between 2008 and 2014 for patients with newly diagnosed pain in several musculoskeletal areas, indicating efforts to reduce opioid use have had some success, according to researchers.

Across the study period (2008-2014), the overall risk for chronic opioid use was 0.31% (95% CI 0.29%-0.33%). Specifically, patients with neck pain had an annual unadjusted risk for opioid use of 0.43%, while patients with shoulder and knee pain had a risk of 0.3%, those with low back pain had a risk of 1.4%, and those with pain at multiple sites had a risk of 1.5%, reported Eric Sun, MD, PhD, of Stanford University in California, and colleagues.

MedPage Today

Calif. Medical Board Begins Tracking Docs' FDA Warning Letters

The Medical Board of California has begun monitoring warning letters sent by the FDA to physicians engaged in potentially harmful practices, following a Milwaukee Journal Sentinel/MedPage Today report earlier this year about the failure of states to act on allegations raised in the letters.

That investigation found that 73 physicians around the country with active medical licenses had been the subject of FDA warning letters alleging serious problems over a five-year period, but only one had been disciplined.

MedPage Today

Topical Migraine Trigger Point Treatment as Effective as Injection

In patients with frequent migraine attacks , cervical myofascial trigger points, and target areas coinciding with the site of migraine pain, the combination of standard migraine prophylaxis with topical trigger point treatments may be effective in reducing migraine severity and frequency, according to a study published in The Journal of Headache and Pain.

The study authors conducted a retrospective analysis, specifically studying patients with migraine who also had cervical myofascial trigger points and whose target areas coincided with migraine sites. These patients were divided into 3 groups (25 participants per group) and received flunarizine 5 mg per day and on-demand treatments. All participants received monthly evaluations and a headache diary. Evaluations included migraine attack frequency, rescue medication use, and migraine intensity.

Neurology Advisor

Click here to view November issue of IPM Reports

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

Click here to submit

Clarksville physician indicted for unlawful opioid distribution, fraud

A Clarksville doctor has been federally indicted on 45 counts and faces a possible 30-year conviction for unlawfully distributing opioids and committing health care fraud, the U.S. Attorney General’s office said Friday.

Samson Orusa, who is also a pastor for God's Sanctuary Church in Clarksville, was charged with 22 counts of unlawful distribution of a controlled substance outside the bounds of professional medical practice, 13 counts of health care fraud and nine counts of money laundering. Beginning in January 2014, Orusa allegedly opened his medical practice at 261 Stone Crossing Drive with the intent of mass distribution for personal gain.

Nashville Post

Pharmacy Owner Convicted in Medicare Fraud Scheme

A federal jury in Los Angeles, California found a pharmacy owner guilty today for her role in a Medicare fraud scheme involving more than $1.3 million in fraudulent claims for prescription drugs.

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Nicola T. Hanna of the Central District of California, Assistant Director in Charge Paul D. Delacourt of the FBI’s Los Angeles Division and Special Agent in Charge Christian J. Schrank of the U.S. Department of Health and Human Services

Office of Inspector General’s (HHS-OIG) Los Angeles Regional Office made the announcement.

After a two-day trial, Tamar Tatarian, 39, of Pasadena, California, was convicted of one count of health care fraud and two counts of wire fraud. Sentencing has been scheduled for Feb. 25, 2019 before U.S. District Judge John F. Walter of the Central District of California, who presided over the trial. Tatarian was the owner of Akhtamar Pharmacy in Pasadena.

DOJ

Miami-Area Pharmacy Owner Sentenced to Over Seven Years in Prison for Role in $8.4 Million Medicare Fraud Scheme

The owner of a Miami, Florida-area pharmacy who caused Medicare to pay more than $8.4 million over a six-year period for prescription drugs that were never provided to beneficiaries was sentenced today to 87 months in prison.

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Ariana Fajardo Orshan of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office and Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office made the announcement.

Antonio Perez Jr., 48, of Miami Beach, Florida, was sentenced by U.S. District Judge Federico A. Moreno of the Southern District of Florida, who also ordered Perez to pay $8,415,824 in restitution and to forfeit the same amount. Perez was ordered to forfeit four Miami-area properties worth approximately $700,000 and multiple bank accounts totaling over $250,000. Perez previously pleaded guilty to one count of conspiracy to commit health care fraud.

DOJ News