treat chronic pain is gabapentin (Neurontin). Though developed to
mitigate other conditions, these drugs can play a key role in reducing
pain signals — and they're set to get better.
"Currently, some of the main drugs in this category cause fatigue, for-
getfulness and weight gain," says Adam Kramer, MD, MSPT, intervention-
al pain management specialist with Valley Pain Consultants, which has
offices throughout Arizona. "But as they're further developed, we can
expect cleaner side-effect profiles."
Additionally, ketamine infusion centers for treating chronic pain are
popping up around the country. "Payers are not recognizing this as
anything other than experimental," says Matthew McCarty, MD,
founder and president of Balcones Pain Consultants and founder of
Waterleaf Surgery Center in Austin, Texas. "But we pain physicians
know that patients suffering from migraine headaches or complex
regional pain syndrome really do experience a significant benefit."
This doesn't mean that opioids will disappear from the roster entire-
ly — for some cases, it would be inhumane to withhold them, particu-
larly as a last resort. But strategies for monitoring patients in order to
prevent addiction are improving.
The FDA is approving more abuse-deterrent opioids. And urine drug
testing to detect misuse or abuse has improved beyond giving a posi-
tive or negative result for illicit narcotics. Now, these toxicology
reports detect whether a patient is taking drugs from another pre-
scriber, and they're able to distinguish a false positive so that a patient
who may have used, say, a Vicks VapoRub inhaler for allergies won't
be flagged as a methamphetamine user. One validity test developed by
Dr. McCarty called ToxID goes so far as to match a patient's DNA with
the DNA of her urine, to authenticate samples and help disrupt the $1
billion urine adulteration industry. Such improvements help mitigate
issues caused by patient dishonesty or poor memory.
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