Adequate Pain Care Sorely Lacking for Patients

[Guest guest]

enjoy

Heidi

Adequate pain care sorely lacking for patients

WASHINGTON — Medical science has learned a great deal about the

causes of pain and ways to relieve it, pain experts say, but for a

host of reasons, the treatment of pain and suffering has improved

hardly at all in recent years.

Seffrin, the president of the American Cancer Society, calls

this " a national health-care crisis of under-treated pain.''

" Nearly all cancer pain can be relieved, but fewer than half of our

patients report adequate pain relief,'' Kirch, the society's

associate director of policy, told a pain seminar in Washington last

week.

Hospitals do a little better than that in managing pain for patients

with all kinds of illnesses, according to a survey to be published

Thursday in the New England Journal of Medicine.

The survey of hospitals in 40 metropolitan areas by the Harvard

School of Public Health found that one-third of patients felt that

their pain wasn't well controlled. The percentage of those who were

satisfied by their pain care ranged from 72 percent in Birmingham,

Ala., to 57 percent in New York City hospitals.

At least 76 million Americans suffer chronic pain, including as much

as three-quarters of people who are older than 65, according to Dr.

Ann Berger, the chief of pain and palliative care at the National

Institutes of Health in Bethesda, Md.

" Pain is the most common complaint for which individuals seek medical

attention,'' said Dr. Heit, a chronic-pain specialist at

town University in Washington.

" Considering the available research and medical technology we have

today, it's a travesty that in 2008 so many pain sufferers are

untreated or under-treated because of lack of awareness, education

and misconceptions about pain and pain treatment,'' said

, the president of the land Pain Initiative, a volunteer

organization of state pain experts in Baltimore.

One problem is that medical schools give only a " paltry'' one hour of

training in how to understand and treat pain, " said Will Rowe, the

executive director of the American Pain Foundation, a national

advocacy group that's also based in Baltimore.

As a result, Rowe said, " few physicians are equipped to adequately

assess and treat pain.''

Nevertheless, " pain has a huge impact on society and the quality of

life, " said Dr. Larry Driver, the medical director of the Pain

Management Center at the University of Texas in Austin. " It costs an

estimated $100 billion a year in medical care and lost work.''

Despite the prevalence of pain, Driver estimated that the nation has

only one pain specialist for every 21,000 suffering

patients. ''There's not enough pain care to go around, " he said.

In addition, only 2 percent of NIH research money goes for pain

studies, Rowe said, despite the fact that pain is the " all-time

number one cause for people to seek medical attention. "

Pain experts distinguish between acute pain, as when you break an arm

or hit your thumb with a hammer, and chronic pain, long-lasting

suffering from injury or disease.

Acute pain can be beneficial, prodding the victim to avoid painful

situations in the future, town's Heit said. Chronic pain,

however, is " pain that has outlived its usefulness. "

" If we don't treat acute pain, it moves to chronic pain (by) rewiring

the nervous system, " Berger warned.

The Pain Foundation says that the most common complaints are: back

pain, at 55 million cases; arthritis pain, 43 million; and chronic

headaches, 40 million.

The failure to treat pain adequately is the combined fault of

doctors, patients, the legal system and the health-care system as a

whole, speakers at the seminar said.

In addition to receiving inadequate training in pain management,

doctors are often reluctant to treat patients for pain, Rowe said.

" They are hurried. They don't take time to listen. They're their

least favorite patients to treat,'' he said.

Kirch, of the American Cancer Society, said doctors were concerned

about possible " disciplinary action or criminal prosecution'' for

providing powerful painkillers. Patients and their relatives also

suffer " fear and confusion about possible addiction to pain

medicines,'' she said.

Effective painkillers such as morphine, codeine and other so-

called " opioids'' — derivatives of opium poppies — often are regarded

as narcotics under federal and state regulations.

" The collision between the war on drugs and the war on pain has

created a perfect storm of controversy,'' said Dr. Fishman, the

chief of the division of pain medicine at the University of

California, .

However, Rowe said that " opioids are some of the most effective and

safe medicines when appropriately used.''

" Addiction to opioids in the context of pain treatment has been

reported to be rare in those with no history of addictive

disorders,'' Heit said.

People are often reluctant to tell their doctors they're hurting

because they're embarrassed and they think they should just put up

with it, Driver said.

" Women don't seek pain relief as much as men,'' he said. " They fear

being labeled as complainers.''

Insurance is also a major problem for pain sufferers, the NIH's

Berger said. Medicare doesn't cover most palliative care, and

millions of people have no health insurance.

Besides opioids, pain specialists offer a variety of treatments to

relieve suffering. According to Driver, they include nerve surgery,

rehabilitation, anesthesia, psychological therapy, lifestyle changes

and alternative medicine, including acupuncture, yoga and massage.

[Guest guest]

I found this article very enlightening, Heidi. Some parts of it really annoy me. "...reluctant to treat patients for pain...They're their least favourite patients to treat." Oh, really!

A doctor once said to me, "we're still in the 'dark ages' [meaning the medical establishment] - there is so much we don't understand." It was a moment of sharing between doctor and patient. She was quite friendly. And then she returned her focus to my symptoms of sore throat, burning, itchy eyes, shooting head pains, fatigue, and pain etc. This was early on in my CFS experience. She said..."there are people, we [doctors] don't like to call them hypochondriacs...but they worry about all the problems that are happening in the world."

If she only knew. The fatigue, and the pain were so real. Society's ills were the last thing on my cognitively-disfunctioning mind. Thanks and hugs Carlene

dominie , "heidi" <heidilhlokey@...> wrote:enjoy Heidi

Adequate pain care sorely lacking for patients

[Guest guest]

Grrrr! See

http://www.fms-help.com/doctors.htm

(my good docs/bad docs page). Yes, we who have this illness often

must EDUCATE our doctors about FMS/CFS, and often endure

misunderstanding, scorn, etc. Go to my homepage

http://www.fms-help.com

and look in the yellow box for many great articles that will increase

people's understanding of this illness. We are NOT hypochondriacs!

Dom

>

>

> I found this article very enlightening, Heidi. Some parts of it really

> annoy me. " ...reluctant to treat patients for pain...They're their least

> favourite patients to treat. " Oh, really!