According to a new report released by the Institute of Medicine (IOM), an estimated 116 million American adults deal with chronic pain - more than all patients directly affected by cancer, heart disease, and diabetes combined. Medical treatment and lost productivity related to chronic pain costs more 635 billion U.S. dollars each year.
The report, titled Relieving Pain in America: a Blueprint for Transforming Prevention, Care, Education, and Research, presents the results of an IOM study committee investigating chronic pain. Acting under the mandate of the U.S. Department of Health and Human Services (HHS), the Committee on Advancing Pain Research, Care, and Education was chaired by Philip A. Pizzo of Stanford University and Noreen M. Clark of the University of Michigan. In addition to presenting the committee's findings, the report also provides specific recommendations and calls on HHS to implement a plan to:
- heighten awareness about pain and its health consequences
- emphasize the prevention of pain
- improve pain assessment and management in the delivery of health care and financing programs of the federal government
- use public health communication strategies to inform patients on how to manage their own pain, and
- address disparities in the experience of pain among subgroups of Americans
The committee identifies a series of current shortcomings identified in pain treatment including the lack of innovation in the development of new pain medications despite 10% of all written prescriptions being for the treatment of pain. As well, primary care physicians are often the main providers of medical treatment despite their limited formal training in pain management. There are only 3500 pain specialists nationwide and many Americans have no access to comprehensive pain centres. To compound the problem, insurance plans are more likely to pay for invasive surgeries than for physical rehabilitation or psychological counseling which can be more effective in dealing with chronic pain. As a result, "perverse incentives" are established in which costly medical treatments are favoured over less invasive methods which are more cost-effective.
Chronic pain specialists routinely report dealing with patients who have endured years, and at times decades, of chronic pain which has been inadequately treated. Since many surgeons have limited training in dealing with post-operative pain, they often prescribe narcotic medication without addressing the underlying causes of pain. Related issues such as depression, sleep disorders, and cognitive impairments associated with pain are also poorly understood by many medical specialists.
The report concludes by stating that "pain is a major driver for visits to physicians and other healthcare providers, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority."
For the report (pdf)
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