Action planned to discuss and organize medicine’s response to the public health crisis of pain (and opioid addiction)
CHICAGO—A Future of Pain Care resolution, introduced by the American Academy of Pain Medicine (AAPM) to the American Medical Association (AMA) House of Delegates during its June 2017 Annual Meeting, highlights the current challenges to pain management and proposes actions that will positively impact the future treatment of millions of patients suffering from pain.
In keeping with the National Pain Strategy, which was released by the Department of Health and Human Services in March 2016, the AAPM resolution clearly documents the tremendous burden that pain – particularly chronic pain – places on the American public. According to a 2011 Institute of Medicine report, approximately 100 million Americans suffer with chronic pain. The resolution also acknowledges the imbalance that exists regarding the attention paid by governmental and regulatory agencies toward the appropriate treatment of chronic pain versus risks of opioid addiction.
“All of the oxygen in the room is being used to address opioid addiction but not one of the primary causes, which is inadequate pain treatment,” says Robert E. Wailes, MD, AAPM Delegate to the AMA House of Delegates.
While the Centers for Disease Control drafted the Guideline for Prescribing Opioids for Chronic Pain to address the dramatic rise in opioid-related deaths, the document has, in some cases, had the unintended consequence of encouraging under-treatment, marginalization and stigmatization of the patients with chronic pain. Therefore, the Future of Pain Care resolution calls on the AMA to convene a task force to discuss organized medicine’s response to the public health crisis of undertreated and mistreated pain. The task force would bring together the numerous specialties responsible for providing pain care, including primary care and medical and surgical specialties.
A charge of the proposed task force will be to explore and make recommendations for augmenting medical education in order to inform healthcare providers on how to help patients suffering from pain through the use of comprehensive evidence-based pain treatment options (non-opioid medications for treating pain, alternative treatment modalities and the importance of behavioral health support, physical therapy, etc., along with proper prescribing of opioids). For example, ample evidence-based research shows the success of multidisciplinary pain management programs, which typically do not rely heavily on opioids, in treating chronic pain. Furthermore, many mental health techniques for the treatment of pain, such as cognitive behavioral training, meditation, relaxation techniques, biofeedback, self-hypnosis among others, have been shown to be successful in decreasing pain symptoms and reducing the need for opioids.
“We also want to address the challenges of inadequate insurance coverage for treatment alternatives and advocate for changes to allow patients access to more of these potentially lifesaving measures,” adds Dr. Wailes.
The fundamentals of multidisciplinary pain management have been the gold standard for chronic pain care and have been promoted by AAPM since it was established over 30 years ago. The use of multidisciplinary care to treat pain will be the focus of the 2018 AAPM Annual Meeting, which is anticipated to be attended by approximately 1,000 pain medicine clinicians April 25-29, 2018, in Vancouver, Canada.
New concepts, such as that of the Anesthesiology Perioperative Surgical Home, have demonstrated reduction in the burden of post-operative pain and/or acute pain thus resulting in less chronic pain and less need for opioids. Building on these successes, the task force will also discuss strategies that prevent or mitigate acute pain, educate physicians about these strategies, and suggest research to study these strategies prevent the development of chronic pain.
The American Academy of Pain Medicine is the premier medical association for pain physicians and their treatment teams with some 2,000 members. Now in its 35th year of service, the Academy’s mission is to optimize the health of patients in pain and eliminate pain as a major public health problem by advancing the practice and specialty of pain medicine through education, training, advocacy and research. Information is available on the Academy’s website at www.painmed.org