Chronic Pain Management Requires Better Education and Collaboration

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Managing chronic pain requires careful coordination between patients and their providers, especially as the opioid epidemic continues to impact those seeking relief.

About 130 Americans die every day from an opioid overdose, and in 2017, nearly 70 percent of all drug overdose deaths involved an opioid, according to the Centers for Disease Control and Prevention (CDC).

The need to improve pain care has never been more urgent,” Cindy Steinberg, national director of policy and advocacy for the U.S. Pain Foundation, said at a February hearing before the Senate Health, Education, Labor and Pensions Committee. The opioid crisis has only underscored our failure to provide adequate, safe, accessible treatment options for pain relief.”

About 50 million Americans suffer from chronic pain, or pain that lasts most days or every day for six months or more, according to CDC statistics from 2018. Those same statistics show that 20 million Americans suffer from high-impact chronic pain, which interferes with basic functions, including work, sleep, personal hygiene and household chores.

Steinberg, who has suffered from chronic pain for 18 years, told the committee that improving pain management practices means educating both the patient and the provider about best practices.

Those include:

  • Promoting individualized, integrative, multi-modal care plans;
  • Breaking down barriers to accessing a full range of non-pharmacological as well as pharmacological treatments;
  • Investing in vital collection and reporting of epidemiological data on pain;
  • Breaking down stigmas that create barriers to proper care;
  • Committing to ongoing patient support and teaching of self-management skills for living with a chronic illness and pain; and
  • Increasing research into understanding the basic mechanisms of chronic pain in the human body and the development of novel, safe and effective treatments.

A big part of improvement in pain management is removing the stigma of prescription opioids, Steinberg said. While those drugs can be highly addictive, they can also be very effective in treating chronic pain when the doctor and patient adhere to a carefully drafted plan. 

Opioid prescription medications are not the enemy, nor the savior, when it comes to chronic pain,” she said. Opioids are one treatment modality among many pharmacological and nonpharmacological treatments for pain. They should not be a first line treatment for chronic pain and ideally should be used in conjunction other therapies.”

Meanwhile, the Centers for Medicare & Medicaid Services (CMS) in February released an update to its opioid prescribing mapping tool, which the agency developed as a way to use data to better inform local prevention and treatment efforts.

The latest iteration of the tool includes specific data on the rural communities hardest-hit by the opioid crisis, as well as the ability to make geographic comparisons of Medicare Part D opioid-prescribing rates over time for urban and rural communities.

Leveraging data is one of CMS’ key strategies to help target our prevention and treatment efforts to combat the opioid crisis, especially in rural communities,” CMS Principal Deputy Administration for Operations Kimberly Brandt said in a press statement. “[T]his mapping tool gives our state and local partners the data they need to build on their own targeted solutions.”