Approximately 31 percent of Americans suffer from chronic pain. That’s about 100 million people. An independent panel convened by the National Institutes of Health has made some suggestions on how to deal with the present situation.
“We learned that sufficient clinical research doesn’t exist to show physicians how best to treat chronic pain in adults, many of whom suffer from multiple health problems,” said the founding director of the Indiana University Center for Aging Research and Regenstrief Institute investigator Christopher Callahan, M.D., who served on the seven-member panel.
What’s happening right now is that doctors often prescribe opioids as drugs of choice for chronic pains but the panel observed the absence of pain assessment and treatment guidelines. The panel also looked into reports concerning the lack of data on drug characteristics, what are the right doses that really works and when to reduce the required doses.
“Are opioids the appropriate treatment? And, if so, at what dose and for how long? Could other, less dangerous treatments work for some people? The panel found that, in spite of what many clinicians believe, there is no evidence that pain narcotics—with their risks of dependency, addiction and death—are an effective long-term pain-treatment. More research is needed to guide effective care for chronic, often debilitating, pain,” Dr. Callahan said.
Reasons for none implementation of evidence-base, patient-centered care, and other aspects of the treatment which according Dr. Callahan are as important such as the pain related emotional conditions, as well as understanding how the pain, are affecting the patient.
“Ten years ago, the medical community spoke of pain as the fifth vital sign,” Dr. Callahan said. “Even though we know that treatment should be tailored to individual patients, there is no existing algorithm that helps researchers or clinicians determine which patients with which type of pain should be treated with which available approach.”
“We heard information presented that there has been a dramatic increase in opioid overdoses by individuals who illegally obtain and abuse these prescription drugs—often family members or family friends who take the medications from the patient,” Dr. Callahan said.
“The panel did hear suggestions of what providers might do in the face of the limited available evidence. For example, physicians might prescribe smaller quantities of opioids. This could potentially require individuals in pain to travel more frequently for prescription refills, but it would also decrease the amount of drugs potentially available to abusers.”
“In educating their patients, providers might also tip the balance of their cautions about these drugs to highlight that they are important drugs with important dangers to both the patient and those who might obtain them accidentally or illegally. At the same time, the panel heard testimony that patients who responsibly use these medications should not be treated like criminals.”