Be the change you wish to see – or walk away. Money at NIH



A Turning Point


$$$$$ MONEY $$$$$


at NIH


May not come this way again


NIH developing

5-year NIH-wide Strategic Plan




Donate to organizations, below

They can provide feedback to NIH via the

RFI Submission site




John C. Liebeskind, 1935 – 1997, distinguished scholar and researcher, past president of the American Pain Society, had the radical idea that pain can affect your health.


Research decades ago by an Israeli team at UCLA and others had shown “that pain can accelerate the growth of tumors and increase mortality after tumor challenge.” Decades ago Professor Liebeskind lectured all over the country: Pain kills.


He wrote an editorial in 1991, summarizing a life’s work:


“Pain and stress can inhibit immune function.”



Quoting John Bonica, the father of modern pain management, he wrote:


“Bonica has long argued that the term ‘chronic benign pain’ (used in distinction to pain associated with cancer) is seriously misleading.  Chronic pain is never benign, he contends; “it is a ‘malefic force’ that can devastate its victims’ lives and even lead to suicide.”



Liebeskind continues, “It appears that the dictum ‘pain does not kill,’ sometimes invoked to justify ignoring pain complaints, may be dangerously wrong.”


Pain mediates immune function




  Opioids mediate the suppressive effect of stress on natural killer cells,


 published in 1984, immune system.


Alcohol increases tumor progression, 1992, immune system.


It used to be news.

He did not live to see change.


People just want to go on doing what they’re doing.

They want business as usual.



After 1991, we saw the great discoveries of neuroinflammation, pioneered by Linda Watkins, PhD, the early understanding of the innate immune system, its involvement in chronic pain and depression, and a few weeks ago, a British team showed neuroinflammation in teens with early signs of schizophrenia and DNA markers.



Major Depression has the same neuro-inflammation found in chronic pain, often responding to same medications, in particular glial modulators – immune modulators. Now, perhaps early schizophrenia will respond to glial modulators, reducing inflammation seen on scan in teens, before they become homeless and burned out by antipsychotic drugs


Inflammation out of control destroys neurons


Fire on the brain



We must be the change we wish to see


It’s not just the Bern. It’s been starting. Forces are finally coming together. We want change. It’s been too much. Too long.


We won’t take it anymore.


I figure if I tell you about it, you might just mention it to someone to pass it on. That is all. One small action may lead to change. Activate inputs to the NIH strategic plan.



~ Action needed ~


Prices of drugs becoming unaffordable

No new drugs for pain or major depression

Research to repurpose existing drugs

Expose the politics destroying our compounding pharmacies


Above all

The #1

Major Priority:

Request NIH to solicit priority call for research on

Glial modulators of the

Innate immune system





Glia modulate

chronic pain, major depression

and almost every known disease


Glia are your innate immune system


Inflammation kills




 Stress kills. Inflammation kills.



Pain kills


In the 1970’s, Professor Liebeskind and an Israeli team at UCLA injected cancer cells to two groups of rats that had sham surgery. Cancer spread much faster and killed far sooner in the group with poor treatment of surgical pain.



~ Pain kills ~


He lectured all over the country


Forty five years ago



I’m gonna be dead before I see this country do anything but unaffordable opioids and the magical ineffective trio of gabapentin, Lyrica, Cymbalta to treat chronic pain. The devastating, blind, nationwide emphasis does nothing to address the cause: inflammation, the innate immune system gone wild.



Innate immune system in action


Untreated pain suppresses the hormone systems too.


Untreated depression – same inflammation kills lives.


Where’s the money?


We are the change we wish to see. It’s pitiful I am so lazy. Suddenly, too late, we may need something, but, aha, no new drugs in the pipeline.




~ Make a joyful cry to NIH ~


They are soliciting input from professional societies


If your condition has failed all known drugs for pain or major depression, then make a joyful cry to NIH, now, before they give away all that nice new $$$$$money$$$$$.



Follow and join


American Pain Society



International Association for Pain

celebrating 40 years of pain research



Reflex Sympathetic Dystrophy Syndrome Association

help for CRPS/RSD  




The key to CRPS/RSD pain will apply to all forms of chronic pain, in particular the most difficult form, neuropathic pain. RSDSA funds research into all forms of chronic pain, not only Complex Regional Pain Syndrome (CRPS/RSD). Their scientific board members are not funded by opioid money.





what is the annual cost of care

as fraction of GDP

for the growing population of Americans on opioids

for one year, for lifetime?



People are dying from prescription opioids and those who need them find they don’t work well enough. Prescriptions opioid costs must be a huge fraction of the medical costs in the United States GDP. You are required  to see a doctor every single month each year, often lifelong, just for one opioid, 12 months a year x 30 years x tens of millions of people and increasing – a growth industry. Not even counting $600 a day for the opioid, what the cost of monthly visits for 30 years? Not counting the army of DEA, FDA, CDC agents watching the opioids like a hawk. We all have to be sharp, addiction is growing. Addiction aside, deaths from prescription opioids are shaking up the CDC forcing urgent change this coming month.




Opioids do not work well for chronic pain

We need better

It’s not just the $600/day price

They just don’t work






Raise a joyful noise at NIH now or write back at us readers with comments and better suggestions. Tell others what you’d like to see. Which politicians do you know would be most interested in this at national levels and organizations?


You may never see this change unless you do it now. Other forces will get this new money.



Turning point now

May not return



We are at a turning point and we will fail to catch the sail that’s coming fast to carry all research money in their shiny big stem cell direction. They never look back.



There is so many medications we can use today, FDA approved drugs that can be re-purposed and applied to recent cutting edge science. Someone must pay to do the work to study this.



Re-purpose old drugs



Stanford just showed a popular generic drug improved recovery of stroke paralysis in mice to begin at 3 days rather than 30. Old drug, new purpose, of course more years of testing to confirm in humans. Brilliant team applying new science.



NIH to solicit a

Special Invitation

for 30 good protocols to

repurpose old drugs



Hundreds of old drugs, already approved, could be involved in mechanisms we have recently learned about. Speak up or money will go to shiny new stem cells. None for chronic pain or major depression. No company will find this profitable – it must be funded by NIH. A popular generic sleeping pill can bring astonishing return from stroke paralysis.



Congress has not opened this new money to NIH in many long years. How often will there be extra money?






Lawrence A. Tabak, D.D.S., Ph.D.
Principal Deputy Director, NIH, solicits you to

Review the NIH Strategic Initiative Plan and their

Request for Information (RFI) and the NIH website

and provide your feedback via the RFI Submission site



This is for “stakeholder organizations (e.g., patient advocacy groups, professional societies) to submit a single response reflective of the views of the organization/membership as a whole. We also will be hosting webinars to gather additional input. These webinars will be held in early to mid-August.




Be the change you wish to see

Donate to those organizations

to solicit the change you wish to be




Happy New Year


There’s money at NIH







The material on this site is for informational purposes only.

It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

Relevant comments are welcome.

If any questions, please schedule an appointment with my office.

This site is not for email.


For My Home Page, click here:  Welcome to my Weblog on Pain Management!





Oxytocin, Astrocytes, Modification of Amygdala Circuits and Pain – IASP Early Research Career Grant Report



As a physician who prescribes Oxytocin [OT] and sees profound relief of many forms of intractable pain and/or relief of treatment refractory Major Depressive Disorder or Anxiety and Panic Disorder, this research on mechanisms is deeply meaningful and long awaited. Oxytocin is a hormone made in the brain, but also in the heart and other organs in women and men. It is rare to find work on glia and oxytocin.


Today the International Association for Study of Pain announced the final report from their 2012 Early Research Career Grant:


“Dr. Alexander Charlet of the Centre National de la Recherche Scientifique (CNRS) in Strasbourg, France, has submitted his final report for his project “Involvement of astrocytes in the endogenous oxytocin modification of amygdala microcircuits….”


“Dr. Charlet’s project focuses on the functional consequences of endogenous OT release in amygdala microcircuits on nociception and pain. In addition, he aims to decipher the precise mechanism, cellular and molecular, by which OT exerts its action. Thus, the purposes of his project are to characterize in vivo and in vitro the effects of endogenous OT in the amygdala on pain-related symptoms….


.….”In addition, he was surprised to discover that perceptions of his project’s importance grew once it was awarded and triggered future collaborations: a Marie Curie European Action Career Integration Grant and the French Initiative d’Excellence Attractivity.”


“As a result, Dr. Charlet also received two major personal prizes: an award from Swiss Society for Biological Psychiatry in 2012 and award from the French Académie nationale de medicine with the prestigious Albert Sézary price in 2013. Finally, he has been recruited as a neurosciences permanent researcher by the CNRS and recently opened his independent lab.”





The material on this site is for informational purposes only.

It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.


Please understand that it is not legal for me

to give medical advice without a consultation.

If you wish an appointment, please telephone my office.


For My Home Page, click here:  Welcome to my Weblog on Pain Management!




PeaPure – Palmitoylethanolamide for Nerve Pain or Migraine


PeaPure is a glial modulator. It is available in Italy and the Netherlands as a food supplement and has been studied in multicenter clinical trials in Europe for several years. It is well tolerated with no side effects and is very helpful for neuropathic pain, headache, and osteoarthritis. It is anti-inflammatory and neuroprotective.


Because it inhibits astrocyte activation and the over-expression of pro-inflammatory molecules and signals, it is being investigated in Alzheimer’s Disease.


The mechanism of action of PEA was discovered in 1993 by Nobel laureate Rita Levi-Montalcini in her work on nerve growth factors. She found it is involved in metabolism of mast cells and published a series of papers on its self-healing effect of the body in response to inflammation and pain. Two recent publications from Jan M Keppel Hesselink, MD, PhD, and his colleagues at the Institute for Neuropathic Pain, Amsterdam, The Netherlands, describe case reports, one of which is the case of a woman with CRPS.


The purpose of this post is to clarify dosing of PeaPure and how to take it for a sudden flare of pain. My apologies for failing to recall the source of these instructions which I believe was from the manufacturer and from here and here. The latter includes an excellent review of its mechanism.


Description of PeaPure® 400 mg capsules
PeaPure® is a food supplement based on a natural and fatty-acid like compound.
The substance palmitoylethanolamide (PEA) is a physiologically active molecule that the body produces naturally.
What the user should know prior to ingestion:
•    There are no known significant side effects.
•    PeaPure® can be taken simultaneously with other medicine. In case of doubt, it is recommended to first consult your doctor or a pharmacist.
•    Use during pregnancy is NOT recommended.
•    PeaPure® does not contain sugar, yeast, allergens, sorbitol, magnesium stearate, povidone or other ingredients.


Dosage and administration – please refer to the manufacturer.




It is with a heavy heart that I report this news:


Palmitoylethanolamide is

now available only from the Netherlands,

sold as PeaPure, a food supplement.

  It is no longer able to be imported by a pharmacy, but we are hoping

that may change if we can interest a supplement manufacturer to make it available for the US.

Patent rights, attorneys are far beyond the resources of my local pharmacy.



I have published this year, 2014, on the treatment of

vulvodynia and proctodynia with PeaPure and a topical cream.


There are no studies to show us how often it may relieve nerve pain, but it is astonishing when it works. No toxicity, no side effects. Your brain makes it, plants make it. There is a growing literature on it and I have posted on some of its mechanisms. And in particular, its Anti-inflammatory, Analgesic, Neuroprotective Mechanisms.



The material on this site is for informational purposes only, and is not a substitute for

medical advice, diagnosis or treatment provided by a qualified health care provider.



Please understand that it is not legal for me to give medical advice without a consultation.

If you wish an appointment, please telephone my office or contact your local psychiatrist.



For My Home Page, click here:  Welcome to my Weblog on Pain Management!


Exercise, a natural pain reliever, can decrease pain, fatigue, stiffness & need for drugs


What you can do

“Moving is the best medicine”


For headache and neck and shoulder pain

As reported in the leading headache journal, Cephalalgia, office workers with headache, neck and shoulder pain took part in an education and relaxation program in an Italian study over eight months. They kept diaries and did posture and relaxation exercises every two to three hours. Compared to a control group, headache and neck and shoulder pain decreased by more than 40% and use of analgesic drugs was cut in half.


For Arthritis Pain

Physical activity is actually a natural pain reliever.
study published in Arthritis Care and Research concluded that regular exercise is effective in significantly improving arthritis pain.
The in-depth study looked at the effectiveness of the Arthritis Foundation Exercise Program – formerly known as the People with Arthritis Can Exercise (PACE) program – to reduce pain and stiffness by keeping joints flexible and muscles strong.
Participants reported a decrease in pain and fatigue, an increase in upper and lower extremity function, and an increase in strength after participating in the basic 8-week exercise program. Also, participants who continued the exercise program independently, beyond 8 weeks, sustained improvement in reduced stiffness.
“The study showed that the exercise program is suitable for every fitness level, even inactive older individuals,” said author of the study Leigh Callahan, PhD, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill. “Many people believe the myth that exercise exacerbates their symptoms. The truth revealed in the study is that symptoms improved with exercise.”
Exercising for joint health is different than exercising for heart health. People living with arthritis don’t have to sweat to achieve success. The basic 8-week Arthritis Foundation Exercise Program consists of low-impact routines with gentle range-of-motion movements that can be done while sitting or standing.
“Even minor lifestyle changes like taking a 10-minute walk 3 times a day can reduce the impact of arthritis on a person’s daily activities and help to prevent developing more painful arthritis,” explains Patience White, MD, chief public health officer of the Arthritis Foundation. “Physical activity can actually reduce pain naturally and decrease dependence on pain medications.”
The Arthritis Foundation Exercise Program is offered at basic and advanced levels and is available throughout the country in many convenient community-based settings. A detailed listing of classes in local areas can be found on the Arthritis Foundation’s Web site at
%d bloggers like this: