100 Million Americans Live with Chronic Pain: How are Clinicians Dealing with It?

The National Institutes of Health convened an independent panel, and the panel's findings revealed that individualized care is needed in treating and monitoring the 100 million Americans who are living with chronic pain today.

Patients suffering from chronic pain are usually lumped together and given generalized treatment although little evidence exists to support this kind of practice. Chronic pain is associated with a wide range of conditions and manifests in a number of ways so a specific yet multi-faceted approach is best in addressing it.

Prescription opioids is the treatment of choice for chronic pain but the panel expressed concern over their use, noting the lack of long-term research proving the effectiveness of opioids in banishing pain and improving quality of life on the overall for a patient. Not to mention the serious side effects associated with opioid use, like nausea, respiratory depression, mental clouding, physical dependence and overdose.

"The challenge is to identify the conditions for which opioid use is most appropriate, the alternatives for those who are unlikely to benefit from opioids, and the best approach to ensuring that every patient's individual needs are met by a patient-centered health care system," said Dr. David Reuben, professor at the University of California, Los Angeles' David Geffen School of Medicine and the panel's chair.

Several barriers were identified by the panel that are in the way of implementing patient-centered, evidence-based care, like clinicians not having enough tools for pain assessment, primary care practices not having multi-disciplinary experts at their disposal and insurance plans not covering integrative approaches promoting holistic, comprehensive care.

The panel also recommended that electronic health record vendors be engaged, as well as health systems offering pain management support tools that help clinicians decide on treatment for a patient. Federal agencies, including the NIH, are also advised to organize more conferences for streamlining pain assessment and guidelines for treatment, facilitating consistency which will benefit individuals living with chronic pain.

Pain is the main reason Americans are given disability insurance. Annual societal costs for treating pain are estimated to be from $560 billion to $630 billion, stemming from medical expenses and missed workdays.

The seven-member panel included experts in various fields like epidemiology, biostatistics, health education, nursing, addiction medicine, psychiatry, internal medicine, rheumatology and gerontology. Aside from Dr. Reuben, these include: David Steffens, M.D., M.H.S.; Victoria Ruffing, R.N., CCRC; Christopher Callahan, M.D.; G. Anne Bogat, Ph.D.; Takamaru Ashikaga, Ph.D.; and Anika Alvanzo, M.D., M.S.

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