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Disrupting Addiction


Communication between doctor and patient at the time of treatment may be the best way to help patients manage their pain without becoming addicted to these drugs.


That powerful tool is conversation. Communication between doctor and patient at the time of treatment may be the best way to help patients manage their pain without becoming addicted to these drugs.

An upcoming Cedars-Sinai study looks at ways to reduce pain while curbing overuse of the drugs and explores the most effective ways for doctors to talk about opioid medications with patients who have chronic pain.

"More people die of drug overdoses in the US than car accidents or guns. This sobering statistic reveals a massive, nationwide epidemic of opioid addiction that is costing lives and money," said Dr. Brennan Spiegel, director of Cedars-Sinai Health Services Research, who will lead the team.

More than 33,000 people died of opioid overdose in 2015, according to the Centers for Disease Control and Prevention. Opioid-related deaths have quadrupled since 1999, driven in part by overdoses of prescription pain relievers—drugs common in a nation where more than 100 million people have chronic pain.


"The focus on quality of life means the study will tell us whether the interventions impact health in a way that patients themselves find meaningful."


Cedars-Sinai is conducting a feasibility study at Holman United Methodist Church  in the West Adams district of Los Angeles.  Dr. Bernice Coleman, who helped create the So Help  Program, is testing whether the education and digitally enhanced programming including virtual reality can be a treatment for bringing down high blood pressure.  Dr. Brennan Spiegel created the virtual reality contained along with Applied VR (virtual reality). 

Nancy Newman Photography
NancyNB@earthlink.net

Brennan M. Spiegel, MD

Disrupting Addiction

What makes the Cedars-Sinai project different from similar efforts? In addition to demographic information from prescription claims (data submitted to insurance companies by physicians, pharmacies, hospitals, and other health care providers), the study will use patient feedback, which is critical for managing chronic pain.

"Incorporating patients' perspectives into the study ensures that the findings will be relevant to real people in general medical practices and not just some highly selected sample," said Dr. Itai Danovitch, chair of the Department of Psychiatry and director of Addiction Psychiatry at Cedars-Sinai.

"The focus on assessing quality of life means that the study will extend beyond evaluating symptoms and will tell us whether the interventions impact health in a way that patients themselves find meaningful," he said.



The researchers plan to conduct a follow-up survey one month after their patients' office visits. Spiegel and his team will then gauge each patient's quality of life and overall health (including pain, fatigue, energy, and concentration) and how well communication with their doctors has worked.

They’ll also find out if educational materials given to patients renewing opioid prescriptions were more valuable in preventing overuse than discussions about risks factors.

The study is funded by a grant from the Patient-Centered Outcomes Research Institute.