Researchers Make Breakthrough Toward Developing Blood Test for Pain

Researchers Make Breakthrough Toward Developing Blood Test for Pain

A breakthrough test developed by Indiana University School of Medicine researchers to measure the degree of pain a person experiences.

A study led by psychiatry professor Alexander Niculescu, MD, PhD and published this week in the high impact Nature journal Molecular Psychiatry tracked hundreds of participants at the Richard L. Roudebush VA Medical Center in Indianapolis to identify biomarkers in the blood that can help objectively determine how severe a patient’s pain is. The blood test, the first of its kind, would allow physicians far more accuracy in treating pain–as well as a better long-term look at the patient’s medical future.

“We have developed a prototype for a blood test that can objectively tell doctors if the patient is in pain, and how severe that pain is. It’s very important to have an objective measure of pain, as pain is a subjective sensation. Until now we have had to rely on patients self-reporting or the clinical impression the doctor has,” said Niculescu, who worked with other Department of Psychiatry researchers on the study. “When we started this work it was a farfetched idea. But the idea was to find a way to treat and prescribe things more appropriately to people who are in pain.”

During the study, researchers looked at biomarkers found in the blood–in this case molecules that reflect disease severity. Much like as glucose serves as a biomarker to diabetes, these biomarkers allow doctors to assess the severity of the pain the patient is experiencing, and provide treatment in an objective, quantifiable manner. With an opioid epidemic raging throughout the state and beyond, Niculescu said never has there been a more important time to administer drugs to patients responsibly.

In addition to providing an objective measure of pain, Niculescu’s blood test helps physicians match the biomarkers in the patient’s blood with potential treatment options. Like a scene out of CSI, researchers utilize a prescription database–similar to fingerprint databases employed by the FBI–to match the pain biomarkers with profiles of drugs and natural compounds cataloged in the database.

“The biomarker is like a fingerprint, and we match it against this database and see which compound would normalize the signature,” said Niculescu. “We found some compounds that have been used for decades to treat other things pair the best with the biomarkers. We have been able to match biomarkers with existing medications, or natural compounds, which would reduce the need to use the opioids.”

In keeping with the IU Grand Challenge Precision Health Initiative launched in June 2016, this study opens the door to precision medicine for pain. By treating and prescribing medicine more appropriately to the individual person, this prototype may help alleviate the dilemmas that have contributed to the current opioid epidemic.

“In any field, the goal is to match the patient to the right drug, which hopefully does a lot of good and very little harm,” Niculescu said. “But through precision health, by having lots of options geared toward the needs of specific patients, you prevent larger problems, like the opioid epidemic, from occurring.”

Additionally, study experts discovered biomarkers that not only match with non-addictive drugs that can treat pain, but can also help predict when someone might experience pain in the future–helping to determine if a patient is exhibiting chronic, long-term pain which might result in future emergency room visits.

“Through precision medicine you’re giving the patient treatment that is tailored directly to them and their needs,” Niculescu said. “We wanted first to find some markers for pain that are universal, and we were able to. We know, however, based on our data that there are some markers that work better for men, some that work better for women. It could be that there are some markers that work better for headaches, some markers that work better for fibromyalgia and so on. That is where we hope to go with future larger studies.”

“It’s been a goal of many researchers and a dream to find biomarkers for pain,” Niculescu said. “We have come out of left field with an approach that had worked well in psychiatry for suicide and depression in previous studies. We applied it to pain, and we were successful. I give a lot of credit for that to my team at IU School of Medicine and the Indianapolis VA, as well as the excellent environment and support we have.”

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This is like the Nazi’s also put into the gas chamber and crematorium people who looked different, were disabled, gay, as well as Jewish and gypsies. This idea is ridiculous and scarry. Who is going to monitor patients who have horrible pain syndromes but they vascillate, like peripheral neuropathy. With ice, the burning feeling can calm down for awhile, or with duloxitine which you can take in limited doses during the day (or night) pain can go down, but when it wears off the pain is terrible. Nerve pain has many manifestations and is only one reason why any “test” like this is not worth the time even thinking about it. Ban discussion of this subject NOW.

Mavis Johnson

The Facts tell us that Psychiatrists are publishing decepetive and misleading research. There is no breakthrough here, though the headline indicates there is one, in order to attract readers. Not only is this decepetive but it undermines science. Psychiartists have not found any signoficant Bio Markers, when it comes to identifying suicide or depression, either. They loodly correlated inflamation markers, a few years ago and got a lot of media milage out of that. Of course this did not lead to any blood test or anything else to predict suicidality or depression, or even a bad mood.
It is highly irresponsible to publish this kind of nonsese, when facts, data and statisics tell us that Veterans are commiting suicide, or living with depression, and unrelived chronic pain, along with situational isssues. Universiies hype these findings in order to get grants and research money. Additionally propaganda like this is used to misinform the public, drive invesments or draw attention away from serious issues. In our Post Science world, this looks and is represented as Science, when in fact it is corporate propaganda, and misinformation.

If they had found a real bio marker for any of these disorders, it would make front page news, Instead, this kind of misinformation is taken out of scientific contest, used to give the false appearance that the VA has been dealing with this problem, when in fact they are not. The refusal to evaluate the VAs research by any objective means, or report on the negative impacts, will never make the so called “News.” These same Psychiatrists endorsed millions spent on researching Positive Psychology programs and other kinds of Psuedo Science. They misled the military and the public about “resialince Training” using testiminilas. The problem is that when it doesn’t work, or leads to more deaths, adverse events and expense, we will never hear about it.

Kimberly

I find this very scary. My fear would be that I am suffering in severe pain but it might not show up on this test or it might not accurately reflect my pain. We see this when a patient has all the symptoms of hypothyroidism but remains undiagnosed as there blood tests still lie in the average range. The good physician will still treat the hypothyroidism but the others will stick solidly by the blood work. What about temperatures? I have a resting body temperature of 74.2 degrees F. When I am at 99 degrees, I often feel bad, but it goes dismissed because doctors are so hooked into 98.6 degrees being the normal, average body temperature. Currently, I have never seen a doctor take into his diagnosis my average body temperature and that is less important to me than having my pain controlled.
These tests may be very accurate and work well, but what if???

ANNELLE, I can offer some suggestions. I live near Spartanburg SC where rent is reasonable, lots of sunshine (weather in upstate NY caused me many more 8-9 level pain days… ).
I also have a kind & compassionate Pain Mgmt doc writing my scripts, and he’s quite skilled at procedures like RFA. Is there a way we can communicate with each other directly?

Re: Gabapentin
My former PCP tried Gabapentin after my 2012 back injury & l would fall asleep mid-sentence. In 2013, l was dx will breast cancer (43 y/o) & chemo left me with horrific, constant hot flashes. I’m now on max dose Gabapentin for those, but it took a long time to adjust to it.
Re: blood test markers
I’m on a lot of meds for hot flashes, neuropathy, arthritis, chronic low back pain & very fast pulse (started after my back injury). A friend told me about DME Extended Genotype Panel testing, a genetic test used to help determine how patient’s bodies use different medications. I don’t think this is the same test described in the article, but l am going to look into having the Genotype Panel done. If l can prove that my body consumes current pain meds faster than the prescribed dosing, it would be helpful when discussing options with my PM doc. It could possibly support authorizations & exceptions with my insurance provider. I’m curious to know if anyone else has taken this test. And if so, did they find it helpful.
Thanks

Nicole Armand

Great article “Why Most Published Research Findings Are False”

https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124

Also to “The Insufferable Movement” – You described my life so accurately in your description of what life is like as a pain patient in the hands of pain clinics, I had to copy it to show others so they might understand how easy it is to get so depressed when you become part of this system.

Nicole Armand

The blood test may measure levels of pain but doesn’t measure the brain’s perceived level of pain which is different for everyone. Frankly, this scares me as it can be used to undertreat pain even more than chronic pain is being undertreated today.

Parker

Oh yeah, I really believe that a blood test is going to convey my pain and it’s severity. As we
all know, pain fluctuates. Are there going to be any controls as to when this blood test is administered? I have so little faith in the medical profession I can’t believe that a doctor is going to tell me how much pain I’m experiencing, ever. I recently saw a pain specialist after being struck by a car while walking in a parking lot. I complained of shoulder pain. Because that same shoulder had previously been fractured, the doctor proclaimed that I felt no pain in my shoulder and that the fracture had healed without the benefit of an x-ray or CT scan, nothing. Finally, I went to another pain specialist who did take an x-ray, only to find that, yes indeed, my shoulder was fractured. This is what the pain patient is currently experiencing. Doctors who are so sure that a complaint of pain is just an excuse to receive pain medication that they are overlooking the facts. Gee, it must be nice to be omnipotent. How do these “professionals” stay in business, let alone look themselves in the mirror each day? It wasn’t the pain patient that created this epidemic is was Big Pharma and greedy doctors. Let’s call a spade a spade!

Freda Lovell

I agree, I kept telling my doctors that sure opioids helped me some but when I take them I can’t sleep, they keep me awake and it drives me crazy! And, after not sleeping for days that make the pain worse! So, after a nerve block that wore off my pain came back with a bang and I went into the ER and told the ER doctor that the opioids were not helping me all that much how about trying Toradol, it worked for my headaches from hell! Well, they combined the Toradol and Dilaudid together and for the first time in 4 years, my left foot stopped burning like I was holding that foot over a campfire for a total of 5 hours! It was the best 5 hours of my life and I cried I was so happy for the relief!! But, it did come back and after an MRI of my spine where it showed that I have some kind of arthritis of my Fassett joints at 3, 4, and 5 they sent me home with Gabapentin to take 600 mg. 3 times a day. Well, I started taking them only at night and I wake up like a drunk with a hang over. They help with pain, but I am the Care Giver for my Husband with Dementia and he can’t drive and I can’t take Gabapentin all day long! Really, I need to stop taking them at night. I still need to take 10 mg. of Oxycodone with them, but at least I do sleep now, but the hangover is too much! So, now I am trying to cut 100 mg. tablet and taking 500 mg. at night. I saw a foot specialist and he recommended that I try this! He said the X-rays show that my foot is full of arthritis too! I don’t see how passing out from Bradycardia caused and creating a TBI from two skull fractures caused all this nerve pain, but shows up on MRI and x-rays as arthritis just because I am a Medicare and TriCare Patient!!!

J. C

Oh great. One more way “the man” and “always changing” science is going to control and tell us how we are feeling. Perhaps one day we’ll be robots with the same feelings, pain thresholds, economic situations, histories and genes. Until then, it would be nice to have something besides: people with no point of reference (i.e, never had chronic pain or lived with a loved one with chronic pain); and/or scientific comparisons, allow us (those in the trenches, living a life much different than we want ) to be trusted and believed. With studies like these, we’re getting further and further away from real life.

Of coarse it is, everything is, nerves go to your brain to tell you U R hurting

cindy grossman

What about variations in pain? I posted that the last 2 days have been totally horrific for me, but every day is different, and parts of days are different. Pain is always a moving target, to some degree, and for me can be to huge degrees.

So, this blood test, even if it can work, which I doubt, would only be like a photograph — of that moment.

For me, activitiy spikes pain. So, there could be a day where my pain isn’t off the charts, and I go to an appt, and then do errands on the way home, and those errands cause my pain to spike, and by the time I get home, I’m in total agony, and spend the next couple of days curled up with a heating pad and not moving at all. Actually, this is how it is for me virtually every time I leave the house, and I don’t often leave the house. Any activity spikes my pain, horribly.

Maybe if I had more meds, I could move more, and so my bones wouldn’t be heading towards osteoperosis and my heart and other muscles would get some action — and my house wouldn’t be as chaotic and dirty as it is.

If the war on patients doesn’t end, my forced sedentary lifestyle will force me into assisted living sooner than later. I really think that if I had more meds, I could move more, and then make my body healthier, and live longer.

cindy grossman

I don’t understand how this can work, and I’d like another article to try to explain how objective tests can reveal a patient’s subjective pain.

I’ve had chronic pain for 10 years, and the last 2 days have been truly unbearable — as bad as any; as bad as when I first had my surgery, I”d say. And today seems to be on the way to the same the longer I’m awake.

I don’t want to be told that I shouldn’t be feeling what I feel. That I should be able to take a shower and make a simple meal.That I should be able to unload the dishwasher which I ran 3 or 4 days ago. That I should not be getting hysterical and crying.

Having my opioids arbitrarily reduced hasn’t helped, thanks to the CDC so-called “guidelines”. So I was afraid to take an extra pill in order to conserve my supply. Maybe my pain the last 2 days could have been less if I had confidence that I wouldn’t run out of pills.

I’m grateful that my pain manager is still in business, but the forced taper hurts a lot.

I have no idea how to buy illegal drugs as I never even smoked pot in college etc, and the last thing I want to do is break a law, but I can see being driven in desperation, if I totally run out of meds, to find out how to buy illegal drugs, and be forced then to risk my life with drugs that may be tainted. Either that or suicide. I cannot live with this level of pain. What a great country.

And, I’m absolutely not addicted. I’ve been on my meds for 10 years. On the rare good day, I can skip my pills. And, I haven’t been able to work since the pain began, and I think that maybe I could have if I”d been given higher doses at the beginning — which was before the CDC problem. Maybe I”m better off this way, since my forced taper isn’t as extreme as it otherwise would have been, but I do wonder.

I also wonder at people who have received much higher Rx’s of percocet than I have. My docs always said I couldn’t have more due to risk of liver damage from the tylenol portion.

Annell

I just read how people are trying to move. I have been looking for a place for 4 months. I had no idea how bad things would be I moved home from Dallas was getting $1,200 month for long term disability 4 months they cancelled it along with health care, suppose to be for life. If anyone out there can help or tell me where to go plz let me know I need low income assist living. I live on east coast just off Chincoteague island. I have called from Boston to SC I find 2 to 3 yr wait list!! Or $1,000 to $2,000 which I can not afford only have SSD and no family. Also worried about packing and moving sitting for 2-3 hrs the pain is so bad! And like some of u I just read I need to start giving most away! What golden yrs worked all this time for what I have now I have to let it go! New landlord raised rent $225.00 month! Said it’s my problem he’s in it to make money!! Oh can’t do house work, cook, etc. If anyone can tell me anything I would be most grateful. SC sounds good for weather but don’t know how I would get there if I could find place. After 9/11 airlines changed a lot!! I quit job with piedmont airlines back in 80s to take care of Mom, at that time being in30s didn’t really understand I had house to buy but she would not move. Think I was few months short for retirement benefits. Later worked for American airlines did 401 instead of their retirement think we were pushed that way I do remember that, but had to spend 401 when I’ll over the yrs to pay rent etc took awhile for company disability to start. Wouldn’t have posted this but just read about others trying to move.

Annell

Paul cahan decades ago while trying to find any info that might help, don’t know where but 1 of the 1st things are taught to students, drs to be, is to listen to their patient 1st as usually the patient knows what their problem is. But as we know, well I think that is the 1st thing they forget! Besides chronic pain one day after I got out of bed I had to turn back and I passed out my legs would not hold me. Went to Dr couple days later, when I could drive and the “Dr” tapped my shoulder and said sorry u don’t feel well!! I ordered a blood/ sugar test online, next time I checked and my sugar was 34!! And yes changed drs!! Of course she also believed I was in or had no pain. I use to think if they could be in my body for just 5 mins they would understand, now I want them to feel this for at least 24 hrs!! Without pain pill I’m like all others went to Dr took about 3 hrs or so, was in bed 3 days after. Also Paul I saw ur art how nice, great job. I did have 1 Dr who said never thought I would say this, but down the street u can get pot! He’s upset that he can’t help and he can see me and my pain. 2 yrs later someone brought me some I took 2 Puffs and could hardly walk to bed!! Won’t do that again!! Lol the meds for fibromyalgia I can not take almost same effect, I feel like I have been on ride at fair that goes round and round for several times!! Just can’t take any of that stuff!! Pain pills allow me to get up and go..didn’t mean for this to be so long.

The Insufferable Movement

The Biggest obstacle in medicine preventing the ethical and Humane care of All patients that suffer pain in acute settings, chronic and the intractable pain community is the lack of honoring the autonomy, personhood and whole person’s experience that would be expected in true individualized care. Somehow humanity, compassion and dignity has been stripped from the care model offered to patients on all levels from ERs to PCPs, and the consequences of not believing patients nor honoring their individual personhood and experience has been far-reaching, devastating to doctor-patient trust from both sides, and deadly has we keep hearing more and more story’s of even none chronic pain patients turned away and thrown out of ERs with acute pain events that signaled life threatening injury, but were not believed or doctors and nurses were ‘instructed’ to not believe and refuse care that are leading to many more deaths across this country. The Ethical principles in medicine to do no harm, honor patients autonomy and life alleviate suffering, and even refused to harm when demanded to already have the Oaths and framework of Ethics in the ANA ,AMA,APA oath and Declaration of Geneva to alleviate All of the current tragedies in medicine created by the willful human decision to not adhere to them. And could be fixed if these principles were once again demanded of all practitioners in medicine as a condition of being allowed to care for others. At its core, I believe this is a Human Rights issue, and what should we expect from each other when a fellow member of mankind is suffering in pain, the validation of believing anothers would be the first and most basic to begin with.

The Insufferable Movement

I am noticing from everyone’s comments both patients and doctors, everyone is feeling highly skeptical about this bringing any quintessentially good changes in medical care, and I have to say I am very leary as well how this test may be abused and even used against providing care for legitimate patients as we have seen time after time. It seems, they keep finding ‘new hoops’ they require patients to ‘proform’ to even possess the right to have treatment for their legitimate pain inducing disease, all of which skirt on the air of Bad Medicine, unethical treatment and even discrimination in the form of : drug test, random drug test, drug addiction screening, mental health evaluation, being denied medication from pre-existing mental condition of PTSD anxiety abuse trauma bipolar disorder ADD; Med comorbidity of treating these conditions, creating a situation where doctors say to legitimate patients they can either treat one or the other, their Mental Health or their physical health, un FDA approved steroidal injections/ nerve blocking agents for the spine, off label neuropathy meds use, NSAID overuse, prescription monitoring, HIPAA violations, pass fail requirements from both Insurance government and private practice on off-label medications and anti depressants, being watched urinating for drug test or even bags checked in by nurses in some cases, no family members allowed in office besides patients, monthly visits required, unethically requiring pain contracts, demanding civil liberty relinquishments, pill counts, random pill counts, arbitrarily use of tapers and medication changes without consent of patient, patient abandonment with lack of Continuum of Care provided/plan nor reason for dismissals, abuse of the non science-based CDC guidelines….. These pain management facilities are more a keened to jails, parole office or a type of criminal drug abuse prevention center then they are about helping, healing and treating legitimate patients that suffer from disease.

Lauren Lei

The powers that be need to make morphine legal again as it was in my grandmother’s youth. It was purchased at pharmacies OTC. Just put restrictions on the amount that can be purchased per day, unless your physician approves more.
Anyone can kill themselves with alcohol and do every day. More people die each day from alcohol abuse than those that die from all other drugs combined: street drugs. If regulations are put in place as to age limits and total amounts allowed to purchase per day this would be one tool to curb abuse. People will abuse and will find ways to get around the regulations. The DEA has lost their war on drugs. Turning people in chronic pain into criminals may be what they want. Going after the helpless is so much easier than pursuing the cartels that manufacture methamphetamines, a true scourge on society.
To have some controls on the sale of opioids is so much safer than the free-for-all dangers of street purchases. The demand will always be there. Can we just decriminalize the access and stop clogging our prisons with victims which put a terrible financial burden on taxpayers. Our freedoms are slowly being removed. Our government is becoming militarized and we will soon find ourselves begging for what little crumbs they decide they want us to have. Harassing the chronic pain patients is only the beginning.

Bc my doctors not listening just labeling w/o test almost cost me my life. Recent yrs doctors needed mri to prove ur pain that has help me, but now the new fear created in treating to not treating. I’ve gone in reverse back to docs not listening even though new pains occured & stayed, i ve live w/additoinal pain for yrs .finally i said i tired of the labels to doc & he sent me to orthopedic surgeon. I kn something was wrong, i need two surgeries hip & shoulder. I had to live w/labels for ten yrs not to be taken serious bc i have chronic pain. Like I cannot have or incur additional injuries not to be believed so this blood marker suppose to point out additional injuries( crystal ball) that I may have incurred. when my own doctor won’t listen to me. How many doctors visits does it take to be taken seriously? I have had many in 10 years over the same issues. Blood marker created by psychiatrist but not by one in treating pain? How bizarre? Strange connection of Andrew kolodny psychiatrist who started the so call crisis to lower & discontinued use of opiates. No trust in blood test. Just another doctor trying to sell a product to make millions off of people with intractable pain.

Katie Olmstead

An interesting notion but it sounds fraught with issues. For one thing (as others have said), pain levels can vary from one moment to the next. Which one would the blood test show? How people experience pain (pain tolerance) varies greatly. Acute pain from chronic pain are different things. I may be used to pain after being in pain constantly for 20 years; how would that show up in a blood test? Then there is the matching with remedies. Neurontin may work for many but I nearly died from taking 3 doses. I don’t think there is an easy one-size-fits-all approach that is going to be helpful. I am still waiting for the sophistication of the fictional zapper-thingie from Star Trek. This blood test does not impress me.

Mari-Bess

This sounds like a crock of [edit]. What happens if your pain goes sky high after the blood is drawn? Or goes down? There really are just WAY too many variables to pain for this to really be something to knock out the use of opioids or the “crisis.” My chronic pain conditions basically go in waves….those stupid markers aren’t going to show that I get the feeling. And then guess what that leads to? Doctors telling me I’m lying because the “the biomarkers say……”

cynthia

it would be hard for me to trust that such a test wouldn’t be misused against pain patients. i do believe the govt is determined to all but eradicate opioids. …just today, another pain dr. was busted by the DEA where i live. i think we have two left now. and we have a huge huge population of people in pain. many are homeless. and on it goes….

F.S.T.

Again, an article mentions an opioid “epidemic.” That’s the second clue that this article is way off the mark. The first clue is perhaps the biggest of all, and that is the elephant in the room here:
What happened to listening to a patient’s word? Now we’re going to have “markers” because Dr. Z doesn’t believe Mrs. A. when she’s telling him so let’s do markers! That’ll teach that Mrs. A to try to tell a doctor about her pain again.

Shame that it seems we’re going backward, and picking up steam!

Lee

What good does it do for them to identify pain if they’re not willing to treat it? It feels as if we are living in Nazi Germany with things in this country going the direction they are. I have rods, screws, and cages from C2 to T3 (you can practically SEE my pain on an x-ray) along with other severe comorbidities…as a chronic pain patient, I am horrified at what the very near future holds.

William

Sounds to me like a way to justify taking pain patients medicines away. This story has anti opioids all over it. Kolodny must be involved some where in this.

James Robert De caro

Sorry,I believe it to be junk science just a way for them to read their little charts to explain a reason to take away our pain meds,a battered body with 8 herniated disc in neck and back, a cogential defect of a bifida in my back,hernias,carpal tunnel in both hands, arthritis in both hands ,spondelysis,stenosis,atrophy of the left leg, of which they will not do surgery due to the bifida ,afraid of what they will find once inside
diagnosed in 87 is not an indicator of pain for my doctor and the DEA which has now forced me to taper of which I don’t take a lot of pain meds,but they help me and and give me a half way decent1/2 pain free hours to move about,and by the way I worked another 28 years after initial diagnosis so exactly how is this test supposed to help , when it’s right before their eyes [edit]like I said just another way to take away meds from pain patients,to stop morons from abuseing them with alcohol,and other illicit drugs od,ing then the authority calling it an opioid problem when what it is, is a drug problem which we have been dealing with since the 60’s it is time for patients and organization s to file in all courts ,for the abuse they are doing to us thru these inhumane treatment,and policy’s of the cdc and DEA which their policy states that they do not advocate tapering of people in need,but their liars plan and simple and they talk gobbledygook ,but the doctors are Running Scared and screw the patient they don’t want to go to prison for prescribing ,just my opinion:!

J.D.

I believe this is like many of the papers and studies that get put out. It always shows how great they are doing and how they are on the right track as to get funding from anywhere they can. Why is it that you never hear of the years/decades long studies that take all that funding and fail to accomplish anything aside from giving those researchers another paycheck?
“It’s been a goal of many researchers and a dream to find biomarkers for pain,” Niculescu said. “We have come out of left field with an approach that had worked well in psychiatry for suicide and depression in previous studies. We applied it to pain, and we were successful. How exactly do they define success because people are still depressed and suicide has not been stopped. The only part I believe in that entire statement is when he states it is/has been a “dream”

Kris Aaron

I’ve become a hardened, bitter cynic about pain “treatments,” supposed opioid “alternatives,” and what pain patients “should” experience. I’ve learned not to trust anyone who doesn’t have the specialized medical education and experience necessary to treat chronic pain, especially when addiction specialists like Andrew Kolodny insist no one needs opiates, malpractice insurers jack up their rates for MDs who dare to prescribe them, and our government is fixated on blaming legal opiates for overdoses, rather than illegal fentanyl.
We are already mistaken for addicts and typically combined with recreational drug users in the minds of the media and the public. Now, we’re asked to believe biomarkers in our blood can tell the level of pain we’re experiencing and the medication we “should” be given?
Of course, Big Pharma is currently exploring how such tests can turn a profit, while the anti-opioid contingent is planning how to use the tests to justify denying opioids to everyone.
Meanwhile, pain patients can expect more of the same: The insistence that the lives and well-being of recreational drug users and addicts are more important than treating our pain.
Yet the suggestion of legalizing all recreational drugs is greeted with horror by politicians, law enforcement, and the profitable addiction treatment industry. Government statistics show addicts are dying right now, in record numbers! Taking our legal prescription opioids away has only accelerated the problem and forced users to turn to heroin, which is often cut with deadly fentanyl.
But legalizing drug use is the “third rail” — no politician wants to touch it because no one ever won an election by being soft on drugs. So pain patients suffer the agonies of the damned, addicts continue to overdose, and the people in power continue blithely on, year after year, with the same failed policies.

ElizabethR

I sincerely hope that Dr. Heck is wrong also, but based on the current mindset, “Do no harm” was abandoned by many in the medical community 3 years ago. That was when the all-knowing folks at the CDC, FDA and DEA mandated that suffering and suicide were acceptable “alternatives” to treating long-term pain effectively. Ironically enough, many of the politicians who eagerly jumped on the punish pain bandwagon are small-government Republicans–now the all-time champions of government overreach.

If this research proves out and new ways to actually manage pain effectively are developed (besides chanting “om” and pretending I’m at the beach–neither of which worked for me), I’ll be first in line to admit I was wrong.

I’m skeptical. If their model is how well psychiatry is doing with this kind of thing, it doesn’t inspire confidence. Psychiatry has adopted a model that says emotional distress is due to biochemical imbalances in the brain, a theory that has never been proven. Emotional distress is usually the result of life circumstances, including a history of trauma.Psychiatric meds often are a dismal failure in relieving a patient’s distress. In the same way this model assumes a drug is always the answer to pain when something else may work better for many patients. Also, I tend to believe that a patient’s subjective report of pain should be the primary indicator of whether they need more treatment and whether their treatment is working. I know addicts can lie, but I still think we should listen to pain patients’ reports of their suffering.

Thomas Kidd

About 10 years ago a supposedly new blood test was to show cancer in people, even one cancer cell but it was gone in a poof. Let’s get real man’s knowledge without wisdom is dangerous, and history proves this. But history has been laid aside, just ask any modern day high school student. I have been amazed that many history teachers know very little when questions about our history are brought up. People in pain I urge you all to take these new medical breakthroughs with caution. Television commercials are replete with the new medicines which many times end up killing people and big law suits are the results. Money and lawyers are having great success today. Friends we absolutely must educate ourselves to what is actually going on around us. Professionally trained men and women are being duped by the powers that be to the point of fearing for their licence to practice their trade. Laws are in place to protect them as well as the patients but fear does strange things to people who have one thing on their minds. Material wealth is the downfall of individuals and nations. When compassion, love for one another and common sense are absent from a society nothing works. For years true cancer cures have been suppressed to keep profits high. I know people don’t want to believe these things but a life long study of human nature tells me that mankind has not progressed much. Greed and pleasure still modivates the flesh in preference to actually caring for our neighbors. So I would be very cautious about any research concerning the opiot mess going on now. Opiods have been used for thousands of years to treat pain and nothing has been found to replace it. Lets be honest and true about this one thing, medical practice without love and compassion for those being treated is nothing more than torture in most cases. I would refer you to our history again. I would also encourage all who are capable to learn as much as possible about what is taking place around us.

Rebecca Hollingsworth

Just another fabricated “methodology” by a shrink no less to tell individuals their own level of pain. Ridiculous. Again subscribing to the Socialistic medicinal approach to pain management. The one size fits all approach, or your pain is all in your head [edit] when you have documented proof from MRI’s or scans, or failed surgeties of why you have pain. Biopsychosocial method to treat chronic pain is just more mumbo jumbo garbage.

Dawn

As a long-term, chronic pain sufferer, this sounds so very hopeful. I have often said, “if I could only plug myself into something so the doctors could feel my actual level of pain.” This is almost that. A way for the doctors to better understand MY level of pain. Color me encouraged.

Thomas Kidd

More insane [edit] what will so-called doctors come up with next? Man has become great at making gadgets and test to find ways to avoid treating things. Fake medicine is alive and well. Read awhile back that someone has come up with a way to read our minds. As a child I remember reading this in comic books. We are living in a world swept away with insanity. We chronic pain sufferers are not the problem. But we evidently don’t matter. Money and big profits is behind most research. BEWARE!

do doctors have any training on how to LISTEN to a patient and hear the tone of voice and see the physical manifestations of pain in facial expressions and inflammation in pain areas? You don’t need a weatherman to know which way the wind blows.

William Milot

This is going to end up just like an MRI of the neck or spine. Just like the coil springs in a car, you lay them “FLAT” on the ground they look normal but put the weight of the car on them and it will smash the “weak ones” flat and the cars back end will drag the ground. Depending on what triggers the pain (like positioning) will DRASTICALLY alter test results. If I’m sitting and leaned back the pain is at a 4 but if I stand up and try to walk before I make it to the bathroom it will shoot to a 10 and my legs will buckle up and put me on the floor!

Rosalind Rivera

Well this is indeed wonderful and a long time in coming. As a chronic pain victim this will ensure proper treatment of pain patients as well as taking the decision to enact bias laws without any or very little knowledge of the suffering of people that lead daily life in pain and placing it back where it always has belonged, in the hands of pain doctors and specialists. No longer would all people fall into the same category as in a blank statement that because of the OPIODS crisis of people abusing pain medication as well as self serving and ruthless unethical doctors in prescribing and or selling pain medications to those that literally have no need for them!

Maxwell Morgan

Pseudo-Science in my opinion. Much like the Psychiatrists working for the VA gave us all the “cures” for PTSD. They may be able to measure inflammation etc in the blood, but so many different types of pain, well I’m more than skeptical. Sounds like another one size fits all remedy that the Government uses now. Most of these type “studies” seem to be done to stop opiod use for very minority of us who use pain medication responsibly and ONLY as needed to help cope with 24/7 chronic pain that Doctors have not been able to control with other methods. I had a back injury in Vietnam ( a combat injury ) which for approx. 30 years was intermittent and controlled by things as nsaids and PT. Then it hit hard. Since that time Doctors have prescribed nsaids ( no longer can take because they caused kidney disease ) PT, acupuncture, chiropractor, epidurals, steroid injections, tens unit, pain coping classes, muscle relaxers, surgery, stick on lidocaine patches, braces, adjustable bed, spa, nerve blocks, and I’m sure more I’m missing. None of those work. This new “method” will do nothing for the opiod crisis since it’s a crisis because of those who abuse medication. It sounds as if it’s a backup to the involuntary taper Government program. I hate having to rely on pain medication to just get enough relief to sleep, but no one has given me an alternative that works. My VA PCP told me the goal of the VA was not to alleviate pain only death would do that. She said Studies have shown that objectively pain medication does not relieve pain. That studies show people on pain medication for chronic pain always hurt other people and always seek more and more pain medication, none of this applied to me. I left and went to a private pain clinic and pay for medication to minimally relieve pain from a combat injury. The VA does not care much for wounded veterans.

Marsha

I hope this technology will be used in favor of the patient and not for some anti-opiod agenda. If it will show fibromyalgia pain that’s good. The osteoarthritis can already be seen, and some rheumatoid arthritis. But we don’t always know which is causing the pain.

Voakley

Thank you Judy, my sentiments exactly. People can be addicted to any and everything. Gambling, shopping, shop lifting, sky diving etc. The difference between CPP and an addictive personality is the CPP is trying most importantly must live the best quality of life they can. It’s not a matter of want, it is a matter of necessity.

Deb Liccketto

Does the biomarker in thee blood fluctuate with the level of pain? As a chronic pain patient with multiple lowback conditions, I know from experience as a 100% service connected veteran I am unable to be treated at my local VA for my debilitating pain with pain medication and epidurals which I currently receive as needed separate from VA. From experience the moment I have pain til when I can be seen by a VA spine specialist is so lengthy that my pain has put me in a nearby hospital for a pain shot.
If this biomarker can help point out those with chronic pain, would something also come about like platelet rich plasma (PRP) therapy or stem cell therapy in conjunction with this? I’ve used TENS, physical therapy, accupuncture, massage, lidocaine patches, gels and creams. I can see the use of biomarkers especially with PRP and stemcells which I have not had because neither VA
nor my private insurance will cover. It seems these with the biomarkers would prove to be a true reduction in pain so that the need for opioids would be greatly reduced as would the pain if not completely eradicated.

Judy Dunn

Sorry,. But considering the damage already done but Andrew Kolodny, the “Angel of Death” another Psychiatrist. I would prefer it if an MD actually got involved in this. CPP do not get high on their meds, they are not Addicts, they
Are dependent on them just like diabetic with their insulin to live normal lives.
Until people like you get this through your heads more people will continue to
Die.

Larry Feldman

All the papers coming out on statisticians reporting how they’ve been asked to exclude data, shade it’s importance, or interpret it the ‘necessary’ way. And here I am, some days active at therapy or , some, running between 3 medical appointments, and it might all be the normal pain I’ve gotten used to, while Saturday I might lay around and relax all day, then suddenly wake up at night, with no prompting fr extra activity, with the kind of pain that for 3 hours has me curse my existence. But Dr Niculescu claims he can check my blood and find biomarkers, specific not just to pain, but also to pain & gender, and KNOW that one day I’ll run to the ER, where of course, from those same biomarkers, they’ll know what specific ‘compound’ I should be given, be it mystery medication, vitamins, herbs, or a mudpack. A neurologist once put me on Neurontin for pain. I couldn’t titrate past 600mg daily. The medicine at that point, half of what he wanted me to reach, made me a total zombie He actually had the stones to ask if I wanted to get better. What happens when the biomarker & my pain differ?

Larry Feldman

The article pulls quotes about biomarkers being near equivalent to fingerprints, that they can tell if someone is REALLY IN PAIN & HOW MUCH PAIN THEY’re REALLY FEELING. That’s scary. Especially when combined w- Dr Niculescu stating, “The opioid epidemic occurred because addictive medications were overprescribed due to the fact that there was NO OBJECTIVE MEASURE WHETHER SOMEONE WAS IN PAIN, OR HOW SEVERE their pain was,” & “The biomarker is like a fingerprint, and we match it against this database and see which compound would normalize the signature”, which, according to the study paper might be a giant dose of B-vitamins. Dr Niculescu specifically sees all this as part of the trend into ‘precision medicine’. Devising individual treatment strategies sounds great on paper, but I saw so many explanations for statistical maneuvers in just this one paper alone it was like science 3 card monte.

Not to sound negative, but it still sounds “far-fetched” to me although I suppose something is better than nothing. I don’t understand how a “marker” is going to allow a doctor to prescribe the necessary medication when the government won’t lent them do so now. I also wish they would “come out of left field” with something that would stop people from wanting to commit suicide and being depressed because they can’t obtain their life-saving pain medications NOW instead of when they figure out their research, that is if they ever do….
I don’t understand why people didn’t start on this a long time ago, why they waited until a “crisis” occurred. In doing so, this Injustice to us and crisis for them has fueled new research of several kinds and books by the dozens for and of a cure-all while millions remain to suffer in silence.

Patient advicate

Very interesting and promising study, but I wonder how/if this will affect those few patients who are receiving adequit pain treatment? I do hope this works well for patients. I know there is always room for error in any test. I just hope this works so more CPP can receive the care they truly need.

Larry Feldman

Looking at the actual paper, ‘Towards precision medicine for pain – diagnostic biomarkers and repurposed drugs’ Molecular Psychiatry-Feb 12, 2019 https://www.nature.com/articles/s41380-018-0345-5.pdf the discoverers of thes ‘pain biomarkers’ seem to believe they’ve found the holy grail and are about to solve any future role of prescription medication in the ‘opiod epidemic’.(LOL).
Not quite sure of the whole mishmish of ways they’ve compiled and merged statistics, but one that throws me off is that the subjects all have major psychiatric problems besides their varying pain conditions, and the testing relies on their periodic subjective responses as to pain level despite the end goal of eliminating that opinion in the treatment process.

Subjects adherence to their prescribed medications, and possible use of other legal & illicit substances during the study, doesn’t seem a major concern, YET the authors claim they 1) can predict which patients are likely to have future emergency department visits due to pain and 2) which specific medications, and or nutrients could best alleviate a specific subject’s pain based on their biomarkers. The big kicker: selling this test as a future way to assess actual pain despite ‘unreliable’ patient claims, and finding the substance (for example: ‘The top natural compounds
were pyridoxine (vitamin B6), cyanocobalamin (vitamin B12), and apigenin (a plant flavonoid).’) to prescribe instead of narcotic pain medication.

Barbara Snow

That’s a wonderful thing. Except 8it won’t touch opioid addiction. People want their heroin. Or meth. Or whatever they choose to be their poison. They are only in pain when they are withdrawing.

Jud

nothing to add

Afraid to say my name

This seems very much like pseudo science. Yes there may be markers that show more when pain is present but some folks have very high thresholds for pain and others none at all. As a chronic pain patient, my 3 on a pain scale of 10 may be an 8 for those who do not live with this chronic condition. As a result, medical specialist may incorrectly diagnose people that are used to living in at a constant pain level.