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The Problem with Treating Pain in America

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A new federal report reveals holes in how we treat chronic pain

Alexandra Sifferlinb93e229a4f87ad18f235baaff90da61f writes: Chronic pain affects an estimated 100 million Americans, and between 5 to 8 million use opioids for long-term pain management. Data shows the number of prescriptions written for opioids as well opioid overdose deaths have skyrocketed in recent years, highlighting a growing addiction problem in the U.S. In response, the National Institutes of Health (NIH) released a report on Monday citing major gaps in the way American clinicians are treating pain.

“The prevalence of chronic pain and the increasing use of opioids have created a ‘silent epidemic’ of distress, disability, and danger to a large percentage of Americans.”

In September, the NIH held a workshop to review chronic pain treatment with a panel of seven experts and more than 20 speakers. The NIH also reviewed relevant research on how pain should be treated in the United States. On Monday the NIH published its findings in the Annals of Internal Medicine, detailing a lack of research into better treatment methods and poor preparedness among physicians. “The prevalence of chronic pain and the increasing use of opioids have created a ‘silent epidemic’ of distress, disability, and danger to a large percentage of Americans,” the report authors write. “The overriding question is: Are we, as a nation, approaching management of chronic pain in the best possible manner that maximizes effectiveness and minimizes harm?”

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“The overriding question is: Are we, as a nation, approaching management of chronic pain in the best possible manner that maximizes effectiveness and minimizes harm?”

The answer is no, the report reveals. The number of opioid prescriptions for pain has gone from 76 million in 1991 to 219 million in 2011, and according to recent Centers for Disease Control and Prevention (CDC) data, the latest figures show around 17,000 opioid-related overdose deaths in 2011. Between 2007 and 2010, the number of hospitalizations for opioid addiction increased four-fold. As TIME recently reported, the growing opioid problem means the nation also has a growing heroin problem, since both drugs offer similar highs, and heroin is cheaper and doesn’t need a prescription.

Past addiction epidemics disproportionally affected non-white, low-income, inner-city citizens, but the current outbreak of prescription painkiller abuse is affecting mainstream white America. “[Past epidemics] made it easier for the public and even healthcare professionals to think about people with addiction as ‘those people,’” says Dr. Andrew Kolodny, the chief medical officer of the rehabilitation nonprofit Phoenix House. “Hopefully that’s changing.”

The NIH says that based on its assessment, healthcare providers in the United States are poorly prepared for managing pain, and many hold stigmas against their own patients seeking relief….(read more)

TIME

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