opiod risk

More Studies Show Opioids’ Risks Outweigh Benefits for Arthritis

Two new studies presented at the 2019 American College of Rheumatology Annual Meeting examine the role of opioid medications in treating rheumatic conditions. The first study found hospitalizations for opioid use disorder in people with osteoarthritis and other musculoskeletal disorders have surged over the past two decades. The second found that these drugs have only a small benefit for pain and function and do not significantly improve people’s quality of life. While these are just two of many studies on the topic, they highlight how complicated the treatment of chronic pain is.

The Centers for Disease Control and Prevention (CDC) has declared the opioid problem in this country an “epidemic.” Nearly 400,000 people died from opioid overdose between 1999 and 2017. Still, doctors continue to prescribe these drugs for patients who are in chronic pain.

Chronic musculoskeletal diseases, like arthritis, are among the top causes of chronic pain, so people with arthritis are at particularly high risk of receiving opioids and potentially developing an opioid use disorder (OUD), says lead study author Jasvinder Singh, MD, professor of medicine and epidemiology at the University of Alabama at Birmingham.

To understand the magnitude of the problem, Dr. Singh and his colleagues analyzed rates of OUD hospitalizations from 1998 to 2016 for five conditions: gout, osteoarthritis (OA), fibromyalgia, rheumatoid arthritis (RA) and low back pain.

Over that 19-year period, OUD-associated hospitalizations surged 24-fold for gout, nine-fold for OA and six-fold for RA. Eventually the rates of OUD leveled out for people with gout and low back pain, but continued to rise for those with OA or RA. “For some conditions, like gout and fibromyalgia and to some extent rheumatoid arthritis, we weren’t aware of how extensive the problem was,” Dr. Singh says.

Given the increasing awareness of the risks linked to opioid use, a drop in those numbers may occur as more recent data becomes available, Dr. Singh says. But until better solutions for chronic pain are available, opioids will likely remain an integral part of arthritis treatment. “We’re talking about diseases that outstrip cancer and heart disease in terms of numbers by several million in the United States. But the progress we’ve made in adequately treating pain in these conditions is somewhat limited,” he adds.

The other research presented at the conference included results from 23 studies on the efficacy of opioids in more than 11,000 people with knee and/or hip OA. The authors analyzed participants’ pain and function after two, four, eight and 12 weeks of opioid use. Although the drugs offered small improvements in pain and function after two to 12 weeks of treatment, they did not improve quality of life or depression.

“Additionally, we found that the magnitude of these effects [on pain and function] remains small and continues to decrease over time,” says lead author Raveendhara R. Bannaru, MD, PhD, director of the Center for Treatment Comparison and Integrative Analysis at Tufts Medical Center in Boston. “In light of dependency concerns and the discomfort that many patients feel while taking the drugs, it would appear that there is no optimal therapeutic window for the use of oral opioids in OA.”

Perhaps surprisingly, the authors found that strong opioids had consistently smaller effect on pain than weak opioids did. Dr. Bannaru says it’s possible that many participants who received strong opioids couldn’t reach a dose high enough to relieve their pain because they couldn’t tolerate the side effects. “Participants receiving strong opioids were twice as likely as participants receiving weak/intermediate opioids to discontinue the study due to adverse events,” he says.

Given the risk of dependency and side effects with opioids, the results of these studies should make people and their doctors more wary of these drugs. “I think that patients need to be fully informed with regard to benefits and risks,” Dr. Singh says. Having more information about opioid risks and their effects on quality of life from future studies should make it easier for patients and their doctors to choose the most appropriate pain reliever.

Author: Stephanie Watson for the Arthritis Foundation.

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January Arthritis News Update

January Arthritis News Update

We consistently learn more about identifying the symptoms of arthritis and how it affects people’s day-to-day lives. Here are a few inspiring developments in the world of arthritis over the past month.

FDA Issues Stern Warning to CBD Industry

The U.S. Food and Drug Administration issued warning letters to 15 companies for selling products containing cannabidiol (CBD) in ways that violate the Federal Food, Drug, and Cosmetic Act (FD&C Act). The FDA also published a revised Consumer Update detailing safety concerns about CBD products more broadly. The FDA warning particularly focuses on ingestibles and products that fall outside of the Arthritis Foundation’s CBD guidelines.

The Arthritis Foundation sent a letter to the FDA regarding the need for more regulation, research and patient education regarding CBD and continues to monitor any legislative action regarding CBD. We have strict guidelines a CBD company must meet in order to associate with us through programs, sponsorship or advertising.  We are not affiliated in any way with any of the 15 firms cited in the FDA letter.

The Arthritis Foundation released the first-ever patient CBD Consumer Guidance for Adults with Arthritis for those considering the use of CBD. You can also learn more about CBD in episode #1 of the Live Yes! With Arthritis Podcast, available now.

Tennis Star Caroline Wozniacki Opens Up About Her Rheumatoid Arthritis Diagnosis

Caroline Wozniacki recently announced her retirement from professional tennis. During her career, which began at age 15, she achieved 30 Women’s Tennis Association (WTA) singles titles, a WTA Finals victory, three Olympic games — carrying the flag for her native Denmark — and a win at the 2018 Australian Open Grand Slam championship. One area of focus she’s planning during her retirement is raising awareness about rheumatoid arthritis (RA). Wozniacki was recently diagnosed with RA but said it didn’t play a factor in her decision to retire.

Rheumatoid arthritis is an autoimmune disease and causes inflammation as the immune system attacks joints by mistake. Treatment of RA includes over-the-counter drugs, like ibuprofen and aspirin, to control pain and inflammation and disease-modifying antirheumatic drugs.

Wozniak plans to use her platform to launch a health education campaign centered around RA. Her goal is let people know anything is possible, regardless of the disease.

Thermal Cameras Detect Rheumatoid Arthritis When Symptoms Are Absent

A recent study performed by Staffordshire University shows thermal imaging could be used to detect rheumatoid arthritis. Researchers wanted to see if RA patients showed different temperatures in their palms when compared to healthy individuals. Patients for this study were chosen because they showed no other signs of RA symptoms.

The researchers found patients with RA showed higher temperatures than the healthy participants, possibly caused by underlying disease activity. Although further studies are required, the research team believes thermal imaging, an emerging technology within medicine, could be an innovative tool for detecting RA compared to current methods.

New Wearable Sensor Detects Gout and Other Medical Conditions

Gout is a complex form of arthritis, characterized by sudden, severe attacks of pain and tenderness in the joints. It can be difficult to diagnose because the symptoms are similar to other conditions.

A Cal Tech team led by Wei Gao, a professor of biomedical engineering, developed a wearable sensor that measures sweat compounds. The research team designed its sensor to measure levels of uric acid, in addition to other metrics. Uric acid was chosen because it is associated with gout, which occurs when high uric acid levels begin crystallizing in the joints, causing irritation and inflammation.

The high sensitivity of the sensors, along with the ease of manufacturing them, means they could eventually be used by patients at home to monitor conditions like gout, diabetes and cardiovascular diseases.

Arthritis can make everyday life difficult for the millions of Americans struggling with its many different forms. But education and scientific developments can make it easier to identify, detect and treat the effects of arthritis. Get the resources you need by joining the Live Yes! Arthritis Network.

Quitting Smoking Helps Improve RA 

Smoking cessation can lower disease activity for RA patients, as well as lowering cardiovascular disease risks according to a new study put out by Oxford Academic.

Additionally, the Mayo Clinic recently released  a study of 74 comorbidities and the timing of their development. The study discovered that comorbidities accumulate in an accelerated fashion after an RA diagnosis. In addition, autoimmune diseases and epilepsy may predispose to RA development, while heart disease, venous thromboembolism and obstructive sleep apnea might develop as a result of RA.

You can find out more about arthritis comorbidities and how RA increases risks for lung and heart diseases on the Arthritis Foundation’s website.

Rural Areas Benefit from State Arthritis Programs

Living in rural areas of the U.S. can provide many challenges for access to care when it comes to managing arthritis. However, state arthritis programs funded by the CDC can make a difference. A recent article released by Xtelligent Healthcare Media highlighted the benefits of providing access to these programs and how they can break down some of the barriers.

The Arthritis Foundation advocates in D.C. each year for continued and increased funding from the CDC to provide these state-funded arthritis programs. You can take action by sending a letter to your lawmakers encouraging them to support this increased funding.

Physical Therapy Before Joint Injections?

Osteoarthritis treatments available are limited, but new research shows that physical therapy may be more effective for knee OA than steroid injections.

The Arthritis Foundation has a Walk with Ease Program & The Better Living Toolkit that can provide guidance in managing OA and staying active. Information on the benefits of physical therapy is available on our website, as well as exercising with OA.

No Itch to Switch: Few Medicare Beneficiaries Switch Plans During the Open Enrollment Period

According to a recent article, only 8-10% of Medicare beneficiaries voluntarily switch plans during open enrollment. Around 1% switch involuntarily. This lends to discussion on whether people understand the differences in their coverage plans available.

The Arthritis Foundation has a toolkit to help you understand your health insurance coverage needs and plan options with the RX for Access – Your Coverage, Your Care.  Also,the Arthritis Foundation Helpline, staffed by licensed, clinical social workers, offers assistance 24/7 to help you understand how to access the care you need.

worst food for gout

New Year, New You Fighting Back When You Have Gout

Now that the holiday feasts are over and the New Year is here, it’s a good time to take stock of your diet and consider healthy changes – especially if you have gout.

Gout is a common form of inflammatory arthritis that can unleash intensely painful flares in individual joints, often in the big toe. An estimated 8 million Americans experience gout attacks, which can last for a few days. The condition can also become chronic and lead to the destruction of joints. Although there’s no cure, there are medications to control gout, as well as lifestyle changes you can make to manage the condition – and reduce or even eliminate attacks.

Gout develops in some people who have high levels of uric acid in the blood; the uric acid can form needle-like crystals in soft tissues and joints. Uric acid is produced when the body breaks down chemicals called purines. Purines occur naturally in your body but are also found in certain foods and beverages. If your body can’t get rid of the uric acid efficiently enough (it’s cleaned out of the blood by your kidneys and eliminated in urine), the uric acid in your blood can build up and reach levels that could cause problems (above 6mg/dl).

One way to minimize the risk of a gout flare is to cut back on high-purine foods. The DASH diet – a low-sodium diet that emphasizes fruits and vegetables over red meats and processed foods – is recommended for people with gout. The Mediterranean diet – which emphasizes fruits, veggies, whole grains and healthy fats – may also help. Find more gout info here.

For specific foods and beverages, keep the following tips in mind:

Worst Foods & Beverages for Gout

  • At the top of the list of what to avoid is booze. Beer and liquor readily convert to uric acid and they slow down its elimination. Studies have shown mixed results about whether wine is OK in moderation.
  • Drinking sugary beverages, such as sodas sweetened with high fructose corn syrup, fruit juices or other sugar-containing drinks, is associated with gout. Notable exception: cherries, especially tart cherries, may be beneficial for gout.
  • Go light on red meats, particularly organ meats like liver, tongue and sweetbreads, which are all high in purines. Also avoid or minimize the amount of bacon, venison and veal you eat.
  • Maybe surprising: Turkey and goose are very high in purines. Chicken and duck are better bets.
  • Some seafoods also are high in purines, including anchovies, sardines, mussels, scallops, crabs, lobsters, oysters and shrimp.
  • Some vegetables are on the watch list, too: Consider cutting back on mushrooms, asparagus and spinach – but veggies of any kind are much less likely to trigger a gout flare than alcohol or organ meats.
  • Learn more about foods to accept or reject here.

What’s Left?

There are also many things you can add to your diet to help avoid or manage gout. Drink plenty of water, milk and tart cherry juice. Drinking coffee seems to help as well. Be sure to talk with your doctor before making any dietary changes.

Get your New Year off to a great start, whether it’s changing your diet, getting in a more positive frame of mind, or embracing a feel-good hobby. Live your best life in 2020! Join the Live Yes! Arthritis Network FOR FREE. Our community is here to help you.

Chicago Area Firefighter Goes All Out to Help Extinguish Arthritis

Matt Pierce, a 45-year-old firefighter in the Chicago area, is on a mission.

After years of participating in the Arthritis Foundation’s Jingle Bell Run with his team, the Red Nosed R-A-ndeers, Matt has set his sights on something quite a bit longer than a 5K: riding his bike 525 miles from San Francisco to Los Angeles this September with the California Coast Classic Bike Tour (CCC). Continue reading Chicago Area Firefighter Goes All Out to Help Extinguish Arthritis

Do It Yourself: A Simple & Satisfying Way to Make Your Mark

 

Our DIY fundraising initiative helps you do it your way with ease.

To raise money for arthritis research and resources, the Arthritis Foundation hosts signature events throughout the year, like Walk to Cure Arthritis, Jingle Bell Run, galas and other fundraisers. Now you’re empowered to fundraise and raise awareness however you want to in the way that works best for you.

Read on to see how Dru did it! Continue reading Do It Yourself: A Simple & Satisfying Way to Make Your Mark

seat belt on white background

Tips to Take the Pain Out of Fastening Seat Belts

Whether you’re strapping yourself in or securing a child in a car seat, arthritis can make one of your car’s most important safety features a pain. Elin Schold Davis, an occupational therapist (OT) and project coordinator for the American Occupational Therapy Association’s Older Driver Initiative, offers these tips to make fastening and unfastening seat belts a cinch. Continue reading Tips to Take the Pain Out of Fastening Seat Belts

Get Ready for Your Day With Less Pain and Hassle

You want to look and feel your best, but painful, stiff joints often get in the way. “When you have arthritis, holding a makeup brush or razor can be difficult,” says Jeanne Harper, an occupational and certified hand therapist in Portas, California. These tips and devices can make looking good easier and less painful.  Continue reading Get Ready for Your Day With Less Pain and Hassle