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Iatrogenic opioid dependence is endemic and legal: Genetic addiction risk score (GARS) with electrotherapy a paradigm shift in pain treatment programs

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Health 2013年第11期5卷 16-34页

作者： Kenneth Blum David Han Marlene Oscar-Berman Gary Reinl nicholas dinubile Margaret A. Madigan Anish Bajaj Bernard William Downs John Giordano Wayne Westcott Leonard Smith Eric R. Braverman Kristina Dushaj Mary Hauser Thomas Simpatico Thomas McLaughlin Joan Borsten Debmayla Barh Center for Psychiatric Medicine North Andover USA Centre for Genomics and Applied Gene Technology Institute of Integrative Omics and Applied Biotechnology (IIOAB) Nonakuri Purba Medinipur India Department of Addiction Research & Therapy Malibu Beach Recovery Center Malibu Beach USA Department of Executive Health Path Research Foundation NY New York USA Department of Exercise Science Quincy College Quincy USA Department of Holistic Medicine and Pain Track National Institute for Holistic Addiction Studies North Miami Beach USA Department of Management Science and Statistics The University of Texas at San Antonio San Antonio USA Department of Molecular Nutrition Impact Genomics Inc. Austin USA Igene LLC Austin USA Department of Psychiatry Anatomy & Neurobiology Boston VA and Boston University School of Medicine Boston USA Department of Psychiatry College of Medicine & McKnight Brain Institute University of Florida Gainesville USA Department of Executive Health Path Research Foundation NY New York USA Department of Psychiatry College of Medicine & McKnight Brain Institute University of Florida Gainesville USA Electronic Waveform Lab Department of Pain Research Huntington Beach USA Department of Orthopedic Surgery Hospital of the University of Pennsylvania Philadelphia USA Department of Molecular Nutrition Impact Genomics Inc. Austin USA Department of Executive Health Path Research Foundation NY New York USA Department of Holistic Medicine and Pain Track National Institute for Holistic Addiction Studies North Miami Beach USA Dominion Diagnostics LLC North Kingstown USA Department of Psychiatry Human Integrated Services Unit of Vermont Center for Clinical & Translational Science University of Vermont College of Medicine Burlington USA Department of Addiction Research & Therapy Malibu Beach Recovery Center Malibu Beach USA Centre for Genomics and Applied Gene Technology Institute of Integrative Omics and Applied Biotechnology (IIOAB) Nonakuri Purba Me

The mounting endemic of prescription iatrogenic opioid dependence in pain patients provoked this treatise about an alternative method that can be used to treat pain, improve function and reduce the risk of opioid dependence. It is well known that as well as the side effects reported for chronic opioid therapy, genetically predisposed individuals are at risk for opioid dependence. We propose the use of the Genetic Addiction Risk Score (GARS) assessment to identify patients early in treatment who should avoid narcotic pain medications. Primarily, this review will be an exploration of the mechanisms of action of an electrotherapeutic alternative to narcotic treatment that can be used to augment tissue healing and reduce the pain associated with human injuries and neuropathies. This particular electrotherapeutic device was developed at the Electronic Waveform Laboratory in Huntington Beach, California and is called the H-Wave? device. The primary effect of the H-Wave?device is stimulation (HWDS) of small diameter fibers of “red-slow-twitch” skeletal muscle. Mechanisms of action of HWDS have been investigated in both animal and human studies. They include edema reduction, induction of nitric oxide dependent augmented microcirculation and angiogenesis, small muscle contraction that eliminates transcapillary fluid shifts, reducing the painful effects of tetanizing fatigue and gradual loading of healing injured muscle tissue that helps repair and remodeling. A recent metaanalysis found a moderate-to-strong-positive effect of the HWDS in providing pain relief, reducing the requirement for pain medication, with the most robust effect being increased functionality. We are proposing that GARS can be used to identify those at risk of developing opioid dependence and that the need for opioid analgesia can be reduced by use of this electro therapeutic alternative to opioid analgesia in the treatment of pain and injuries.

关键词： Microcirculation Angiogenesis Analgesic Therapy Electrical Device Stimulation Tissue Loading Remodeling Genetic Addiction Risk Score (GARS) Reward Deficiency Syndrome (RDS)

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