…approximately a third of adults suffer from multiple chronic conditions, wreaking untold havoc on healthcare systems and economies across the globe. …as a clinical psychologist, I see many people trying to navigate the daily vagaries of chronic afflictions.
The underlying factor for all of them, however, is that, in the absence of a cure, people want to live the best life they possibly can, regardless of their affliction or disability. Continue reading
AMA: Get rid of market barriers to appropriate pain management – by Andis Robeznieks – Senior News Writer – American Medical Association
This article makes a critical point and describes what should be the goal when treating pain: “appropriate analgesic prescribing and pain management.”
Ending the nation’s opioid epidemic requires eliminating obstacles to treatment and appropriate analgesic prescribing and pain management.
New policies adopted at the 2019 AMA Annual Meeting took aim at barriers established by health plans and other players in the medical system. Continue reading
Coincidentally, the month of September is “Pain Awareness Month” and its 2nd week is also “Suicide Prevention Week”. I believe pain awareness *is* suicide prevention, so here is my yearly post about the unintended serendipity of these two awareness campaigns going on at the same time.
By now we have direct evidence that a lack of pain awareness, as demonstrated by all the politicians and healthcare “experts” enshrining the CDC “guideline” prescription opioid restrictions as law, is leading to suicides of patients with uncontrolled pain.
Can the connection become any more obvious? Continue reading
Preventing Opioid Abuse Shouldn’t Mean Ignoring Patients’ Pain – by Subhash Jain – Aug 2019
I’m surprised and delighted that this article was published in the respected “Harvard Business Review” so that it reaches the people making the rules from their seats in the executive suites of medical corporations.
From lawsuits by several states against the manufacturers of opioids to criminal prosecutions against pharmaceutical executives, much has been made about pain medications and their misuse. Unfortunately, if you just pay attention to these headlines, you’re likely to miss an important fact:
Pain medications are an important and medically necessary part of many patients’ treatment.
Hurrah, another doctor pushing back against the widespread policies of reducing long term opioid use to almost zero. Continue reading
Since childhood, I have suffered from severe stabbing headaches.
Thus, my first lesson in pain management. Getting accurate, effective, pain treatment is a lengthy and difficult process.
Actually, it’s usually impossible to find truly effective pain relief, especially when the most effective medication (opioids) is being withheld. Pain treatment is still handled with the same old standbys: NSAIDs, Tylenol, and opioids.
Throughout medical school, I learned about pain receptors and pathways, but little about how to treat pain. Continue reading
The Global Burden of Musculoskeletal Pain—Where to From Here? – free full-text /PMC6301413/ – Am J Public Health. 2019 January
This article makes it clear that our chronic musculoskeletal pain is a serious burden, not just for us, but for all of society too. It itemizes reasons why chronic pain is so often regarded as a mere nuisance and isn’t taken as seriously as other health concerns.
In the 2010 Global Burden of Disease Study (GBD), which broadened the scope of musculoskeletal conditions that were included over previous rounds, low back pain imposed the highest disability burden of all specific conditions assessed, and subsequent GBD reports further reinforce the size of this burden.
Over the past decade, the GBD has produced compelling evidence of the leading contribution of musculoskeletal pain conditions to the global burden of disability, but this has not translated into global health policy initiatives. Continue reading
The two PubMed articles in this post are from the early 2000s, over 16 years ago, yet they describe the same situation we’re stuck in today, with doctors being squeezed, harrassed, and sued from both sides of the opioid controversy.
Sometimes they are successfully sued for refusing to administer necessary pain relief when a jury decides that “insufficient pain management in a dying patient constituted abuse by a physician.” (which seems obviously right to me)
Other times they are successfully sued when a doctor who “provided comfort care to terminally ill patients was accused of performing euthanasia.” (luckily, the conviction was later overturned)
I’m very glad I’m not a doctor who has to make such potentially career-ending decisions these days. Continue reading
Access to Primary Care Clinics for Patients With Chronic Pain Receiving Opioids – Jama Network Open – July 2019
This JAMA study shows that 40% of doctors refuse a new patient if they are using opioids. Many refuse not just to manage their pain, but to manage any other aspect of their general health.
Findings In this survey study of Michigan primary care clinics, 79 clinics contacted (40.7%) stated that their practitioners would not accept new patients receiving opioid therapy for pain. There was no difference based on insurance type.
Meaning The findings suggest that access to primary care may be reduced for patients taking prescription opioids, which could lead to unintended consequences, such as conversion to illicit substances or poor management of other mental and physical comorbidities. Continue reading
Pain was once viewed only as a symptom, the consequence of another condition. It was often ignored as doctors focused on treating its underlying medical cause.
But for almost everyone, pain is what matters. “It’s pain that brings people into the doctor’s office,” says Penney Cowan, executive director of the American Chronic Pain Association. “It’s pain that they want treated.”
“The costs are incalculable,” says Christopher L. Edwards, PhD, assistant professor of psychiatry at Duke University School of Medicine. “How do you estimate the value of lost self-worth? How do you estimate the loss of family, friends, and a sense of accomplishment?” Continue reading
How Did We Come to Abandon America’s Pain Patients? – Filter Magazine – by Alison Knopf – July 2019
This is an excellent article pointing out exactly how pain patients have been neglected and dismissed by the medical system. Kudos to Alison Knopf for her exemplary work.
- Pain patients are untreated and suffering.
- Pharmaceutical companies are being sued and settling.
- Law enforcement is cracking down on providers.