I’ve only had this blog up and running for a couple of weeks now, but there are times when I already get frustrated trying to think up something to write about on a given day. I’ll go take a look at the day’s health news hoping some sort of inspiration will strike, but this past week it felt as though most of the week all I was finding was story after story about prescription drug abuse. I mean, we all understand, don’t we by now? I mean, don’t we? What’s odd is that we rarely hear about illicit drug abuse anymore. It seems that way to me at least. It feels very odd to me. I think it really skews our perceptions as to what’s actually happening out there :/

The ratio of drug abuse stories to health(y) news was so unbalanced the other day that I remarked to friends that I might just write about that instead of a “real” subject, but that is the real subject, isn’t it really? When I really think about it, it isn’t only the DEA coming down hard on the Doctors that’s causing them to refuse to treat patients’ chronic pain needs–it’s also what these Doctors themselves perceive, and if they also read all of these stories about rx drug abuse, well, the math tells me they get suspicious. Add that suspicion to the sorts of things they are taught and is it really any wonder that the emergency room is a migraineur’s worst nightmare? (and the Doctors think they dislike us.)

Sadly after contemplating all of that, I came across several fellow patients this weekend with horrible ER stories void of pain relief and full of feelings of being treated like drug-seekers even though they are not.

It’s not just patients who are treated as nefarious criminals these days though.

Treating Doctors as Drug Dealers

The Drug Enforcement Administration’s War On Prescription Painkillers

This is an excellent piece I found just as I was about to go to bed on Saturday night. This piece is about 30 pages long, and looks at why things have become so ridiculous with the DEA and pain meds. It delves into everything from why there aren’t more pain specialists to begin with, to just how the DEA’s focus from “the war on drugs” morphed into the war against legitimate pain medication (and subsequently against chronic pain patients and doctors).

In 1999, the DEA came under heavy criticism from Congress on the grounds that no “measurable proof” existed to show that it had reduced the country’s illegal drug supply […] The DEA now needed to find a new front for the war on drugs on which it could produce tangible, measurable results.

The Controlled Substances Act empowered the DEA to regulate all pharmaceutical drugs. […] In 2001, the DEA had already announced a major new antidrug campaign, the OxyContin Action Plan

This is apparently after much prompting from the Justice Department, with claims that the prescription drug ‘problem’ in the United States was equal to that of Cocaine. The OxyContin propaganda campaign that followed was incredibly successful as you’ll see in the piece. The author points out that theft is actually a major source of diversion of opioids, and not patients, yet the DEA and even the makers of OxyContin dispute this and continue to insist that Doctors and patients are the main source of diversion of these drugs and so, the investigations continue.

The DEA has also set up a hotline to report doctors whom patients suspect of over-prescribing, an odd move that further complicates the doctor-patient relationship

I never really considered the informant angle before, but now the paranoia and reluctance of some Doctors makes far more sense. It’s hard to believe things have gotten this bad. 😦 Please do take the time to read this piece. It’s long, but well worth it if pain impacts your life or the life of someone you love. And if you disagree with what’s happening, please write to your representatives.


Medtronic’s RestorePRIME Neurostimulation System was approved yesterday March 24 by the FDA for the treatment of chronic pain. More specifically, it is indicated in patients with intractable pain of the trunk or limbs, and works by blocking pain by sending electrical pulses to the spine.

“The RestorePRIME System is a significant advancement in the field of neurostimulation,” said Joshua Prager, pain specialist and director of the Center for Rehabilitation of Pain Syndromes at University of California at Los Angeles School of Medicine.

The neurostimulator “allows physicians to customize the treatment to treat their patients’ chronic pain more accurately, potentially reducing the number of return visits and improving pain relief,” he said. [link]

The device is non-rechargeable and about the size of a stopwatch. Medtronic will begin launching it as soon as the end of March and into April, and it should be fully available by May. Patients can go to www.TameThePain.com for more information on the RestorePRIME.

Merck will be collaborating with Neuromed to develop new treatments for chronic pain. The deal includes Neuromed’s leading compound NMED-160, currently mid-way through testing.

These do sound quite hopeful, as Christopher Gallun, the CEO of Neuromed told the New York Times in an interview “We think these have the potential to become very powerful agents for chronic pain, on the level of morphine,”. The mechanism of action of this painkiller is not new, but the side-effect profile should be significantly lower than what’s available now from that class of medication.

The deal is being described as one of the richest collaborations ever in this country. Neuromed is a biotech spin-off from the University of British Columbia, set up by UBC Professor Terrance Snutch in 1998. See stories from The Vancouver Sun and The New York Times for further details.

comorbid condition: a disease or disorder that is not directly caused by another disorder but occurs at the same time.

I not only deal with chronic migraines, but I also have Bipolar Type II disorder. There are days it doesn’t really affect me all that much, and then there are the days when it really throws a wrench into my migraine management.

Bipolar Type II disorder is characterized by periods of depression and hypomanic episodes. It’s considered generally less severe than Bipolar Type I disorder (manic depression) but can be just as disruptive.

The main problem I’ve had lately is sleep disruption and insomnia, which directly affects my migraines. As most migraineurs know, a regular sleep schedule is incredibly important. Add hypomania into the mix and your sleep goes right out the window. I don’t like sleeping pills so I’ve resisted using them so far. Sometimes during the day I can tell if I’m becoming hypomanic, but not always (the onset can sometimes be subtle). Often it’s not until evening rolls around that I’ll realize that I am far too wide awake to fall asleep. I might make an attempt at sleeping on those nights, but it’s always unsuccessful. So far this month I have been unable to sleep on the 9th, 12th, 13th and 17th. There is always a strong and stubborn migraine to deal with by the next morning.

Obviously things aren’t under optimal control. I’m currently undergoing a medication change to try and balance things out better. Hopefully that will put an end to losing several nights of sleep per month.

Is tonight one of those nights? Honestly it’s hard to tell so far. I’m usually in bed by now, but there’s still hope yet!

In the latest issue of the National Headache Foundation’s Newsletter, Headlines, the future in migraine treatments are discussed. Some of these have made headlines recently, but this piece is packed full of news. Included are the steps a drug goes through before it can be sold to give us an idea of just why it takes so long. One of these drugs is so early in its development that it hasn’t even been assigned a name. Some are in final stages before approval, and others are everywhere inbetween.


You’ll find an emphasis on faster-acting medications. New delivery systems for these drugs are also being developed alongside the drugs themselves. Pharmaceutical companies are collaborating to bring drugs and new delivery systems together for more powerful pain relief.

Alexza Molecular Delivery Corporation is developing a device called Stacatto. Essentially, medication is vaporized, it is then inhaled and delivered immediately into the bloodstream. This device is being used with PCZ (Prochlorpromazine). PCZ is used often in the ER for the treatment of acute migraine and nausea and vomiting. Clinical trials have gone well so far.

Brittania Pharmaceuticals ia collaborating with Novartis Pharmaceuticals and developing a DHE (dihydroxyergotamine) nasal powder. They hope that a nasal powder will be easier to take than the current methods (subcutaneously, or by nasal spray) and that the body will absorb it much faster.

You’ll also find a lot of old drugs being studied for new uses, combinations of existing drugs and there are also brand new medicines being developed as well. Check out the entire story in the online excerpt of the January/February edition of the NHF’s newsletter Headlines