Healthsifter by mary desmond pinkowish, since 2003

We Get the Pain We Expect

What is the nocebo effect? No, that's not a typo--NOCEBO, not placebo. Read about it at The Huffington Post and learn what scientist are beginning to understand about pain. Here's something to think about: Pessimism can hurt. In fact, it may hurt more than pain medications help.

And if you're interested, don't miss this week's cover story in Time magazine, Understanding Pain.

Belly Pain in Kids: What Tames Tummies?

Do your kids complain about belly pain? Do you dismiss it as anxiety? Please don't say you tell them they don't have a stomachache--or that it's all in their pretty little heads. Belly pain that can't be linked to a physical disorder is called functional abdominal pain, and writing at the New York Times "18 and Under" blog, Dr. Perri Klass explains what's behind this type of pain in kids and how it might get started:

The problem may start with some initial insult, an infection or inflammation that may affect pain pathways in the child — and may also set up psychological patterns and anxieties in the child and response patterns and anxieties in the parent.

And then the child continues to be extremely aware of sensations coming from the gastrointestinal tract, even when the initial illness is over. The challenge to the parents — passed on to the pediatrician — is how diligently these pains should be investigated, how many tests a child should be subjected to, how much money should be spent.

And while this type of pain isn't "all in the head," one doctor says that "what helps the children is working with the brain more than working with the gut" in trying to fix the problem. 

Great article about a common problem. 

Darvon/Darvocet/Propoxyphene: New FDA Warnings

It's been around since 1957, but propoxyphene, aka Darvon/Darvocet, today is the subject of increased FDA warnings about the potential for fatal overdoses. Here's a Q&A from the agency, which answers most of the important questions about this pain medication. The FDA will require manufacturers to bolster the warnings on the drug label and to produce a Medication Guide that will be given to everyone who gets a prescription or refill. The Agency decided against a phased withdrawal of propoxyphene from the market, as requested by Public Citizen and the European Medicines Agency.   

Pain Relief, Zen Style

"Zen meditation – a centuries-old practice that can provide mental, physical and emotional balance – may reduce pain according to Université de Montréal researchers. A new study in the January edition of Psychosomatic Medicine reports that Zen meditators have lower pain sensitivity both in and out of a meditative state compared to non-meditators."

Read more about this study at ScienceDaily. The study is distinguished from similar ones by the fact that their meditators were highly trained, having practiced for at least 1,000 hours before the testing.

Why Does Morphine Work Better for Guys?

Morphine seems to work better for men overall than women. Some just-published research done in rats may explain why. In guy rats, the areas of the brain involved in pain processing have more receptors for opioids than the corresponding areas in female rat brains. ScienceNow explains how the experiments worked:

...Murphy and colleagues report that male rats have a higher density of μ-opioid receptors in a portion of the periaqueductal gray, a brain region implicated in previous experiments as a likely site of action for opioid drugs like morphine. Injecting morphine directly into this area had a powerful analgesic effect for male, but not female, rats. When the researchers killed neurons with μ-opioid receptors by injecting a toxin bound to a morphine lookalike compound, the drug lost its analgesic effect for males, but not females. Murphy says the findings, taken together, suggest that the difference in μ-opioid receptors in the periaqueductal gray explains the sex difference in morphine sensitivity in rats.

I wonder if men are more easily addicted to opiates than women? Or is it harder for men to recover from opiate addiction? I'm sure someone out there knows the answer to that one. 

And looking at it from the other end of the glass, how can women get better pain control?

The original study is in the current issue of Journal of Neuroscience.

Methadone: Does Your Doctor Know What He's Doing?

Methadone is used increasingly as an alternative to Oxycodone in people with intractable pain. That's all well and good, but not all doctors know how to prescribe this potent drug safely. Another gap: doctors don't always tell people what they need to know to take this drug without accidentally offing themselves. The result is that methadone is now the fastest-growing cause of narcotic deaths in the United States. The New York Times told the story in yesterday's (Aug 17th) paper. Here's what the FDA wants doctors to know about prescribing methadone, and here's additional information for patients. Methadone also goes by the brand name Dolophine, and if you or some you know is taking this medication, be sure you read this information about methadone/Dolophine. Actually, read it twice.

Also read in one of today's Wall Street Journal blogs about what the FDA is trying to do to make narcotic prescribing safer for everyone.