Recent advances in the treatment of chronic pain and substance use disorders.

Among people with substance use disorders (SUDs), chronic pain is among the most common comorbid chronic health conditions. Chronic pain increases risk for poor SUD treatment outcomes, including risk for overdose. Given rising overdose rates across North America, a renewed research focus has emerged to better understand the contribution and treatment of chronic pain in the context of an SUD.

Adoption of methadone take home policy by U.S. state opioid treatment authorities during COVID-19.

Background: Patients face well documented problems accessing methadone from opioid treatment programs (OTPs) in the U.S., yet addressing these barriers has proven difficult due in part to the sheer number of actors governing treatment, including state authorities.

Paths Forward for Clinicians Amidst the Rise of Unregulated Clinical Decision Support Software: Our Perspective on NarxCare.

Amidst the US overdose epidemic, policymakers, law enforcement agencies, and healthcare institutions have contributed to a decrease in opioid prescribing, assuming reduced mortality would result-an assumption we now understand was oversimplified. At this intersection between public health and public safety domains as they relate to opioid prescribing, unregulated and proprietary clinical decision support tools have emerged without rigorous external validation or public data sharing. In the following piece, we discuss challenges facing clinicians practicing medicine amidst unregulated clinical decision support tools, using the case of Bamboo Health's NarxCare-a prescription drug monitoring program-based analytics platform marketed as a clinical decision support tool-that is already positioned to impact over 1 billion patient encounters annually.

Medical Record Documentation About Opioid Tapering: Examining Benefit-to-Harm Framework and Patient Engagement.

Objective: Guidelines recommend that clinicians make decisions about opioid tapering for patients with chronic pain using a benefit-to-harm framework and engaging patients. Studies have not examined clinician documentation about opioid tapering using this framework.

Design And Setting: Thematic and content analysis of clinician documentation about opioid tapering in patients' medical records in a large academic health system.

Opioid Taper Is Associated with Subsequent Termination of Care: a Retrospective Cohort Study.

Background: Opioid tapering is increasingly utilized by providers to decrease risks of chronic opioid therapy, but it is unknown whether tapering is associated with termination of care.

Objective: To determine whether patients taking chronic opioid therapy who experienced opioid tapers were at greater risk of subsequently terminating their care compared with those who were continued on their doses.

Design: Retrospective cohort study of patients in a large, urban health system between 2008 and 2012 with 2 years of follow-up.

Race and Gender Are Associated with Opioid Dose Reduction Among Patients on Chronic Opioid Therapy.

Objective: Among patients with chronic pain, risk of opioid use is elevated with high opioid dose or concurrent benzodiazepine use. This study examined whether these clinical factors, or sociodemographic factors of race and gender, are associated with opioid dose reduction.

Design And Setting: A retrospective cohort study of outpatients prescribed chronic opioid therapy between 2007 and 2012 within a large, academic health care system in Bronx, New York, using electronic medical record data.

"It's Better in a Group Anyway": Patient Experiences of Group and Individual Acupuncture.

Objectives: Chronic pain is prevalent, burdensome, and costly, and there are ethnic and racial disparities in treatment. Acupuncture is effective and safe, but access is limited. Group acupuncture can decrease cost and increase capacity by decreasing clinic space needs and increasing patient volume per acupuncturist; however, the effectiveness and patient acceptability of group and individual session acupuncture have never been directly compared.

"I Felt Like It Was God's Hands Putting the Needles In": A Qualitative Analysis of the Experience of Acupuncture for Chronic Pain in a Low-Income, Ethnically Diverse, and Medically Underserved Patient Population.

Objectives: To examine the experience of patients from a low-income, ethnically diverse medically underserved population receiving acupuncture for chronic pain.

Design: Qualitative analysis using inductive thematic analysis of interviews with participants from an acupuncture trial.

Settings/location: Four community health centers in the Bronx, New York.

Varying perceived social threat modulates pain behavior in male mice.

Unlabelled: We previously demonstrated that male mice display significantly reduced pain behavior on the acetic acid abdominal constriction test when confined in close proximity to a stranger male mouse. We show here the testosterone-dependence (via castration and testosterone propionate replacement) of this phenomenon, likely a form of (social) stress-induced analgesia. However, when similar male dyads are separated by vertical metal bars, allowing only partial physical contact, we find that the mice exhibit hyperalgesia, not analgesia, in response to both acetic acid injection and noxious radiant heat, relative to testing in isolation.