What Can I Do About My Pain?
On a recent episode of the Dr. Oz Show, Dr. Mehmet Oz and his guest, CNN’s Chief Medical Correspondent Dr. Sanjay Gupta, took a hard stance against a new FDA-approved opioid pain medication, Zohydro, claiming that introducing such a powerful new pain medication will increase the epidemic of prescription drug abuse in this country. The episode caused quite a stir within the chronic pain and chronic illness communities for neither including patient voices, nor balancing the discussion about medication abuse with a discussion of “legitimate pain” and pain management.
While doctors, abuse specialists, the news media, and policymakers debate pain medications like Zohydro and whether policies can limit or deter those who abuse these medications, the real question that is missing from these conversations is how do these policies affect patients: the people that need pain medication to manage their daily lives? And what do patients have to say about this?
The social media conversation around the show helped begin to answer some of these questions, and brought the Zohydro controversy into a larger conversation about pain management and the needs of patients. Some of the things patients raised include:
The Invisibility of Chronic Pain
— Judy Sykes (@judeshops) March 26, 2014
Tweets in response to the show highlight how chronic pain (which is distinct from acute pain) is unimaginable until you have it. Patients say it’s hard to explain that you are in pain all of the time, or most of the time, to doctors if they haven’t experienced it themselves.
Lack of Trained Doctors To Treat Chronic Pain
Another issue that came up is the lack of medical professionals to treat pain. Depending on your particular health situation, pain management may be conducted by your primary care doctor, by one of your specialists, or you may be sent to a doctor that solely focuses on pain management, or get pain management as part of palliative care.
However, according to Judy Foreman, a science writer who has recently written a book called “A Nation in Pain”, there are only about 4,000 to 5,000 doctors in the country who really are knowledgeable about pain management out of nearly 850,000 actively practicing physicians. Further, she cited a survey that found that medical students get, on average, only nine hours of training in pain management across their entire medical school curriculum.
The result is that in some cases, doctors don’t feel equipped to treat the pain, or feel that treating a disease is the same as treating pain, and that specific drugs targeting pain are unnecessary.
In my six years of being chronically ill, I have never had a conversation with my doctors about pain management. I know many people in the rheumatoid arthritis community who have had access to this type of care–but having now had four primary care doctors and two rheumatologists and no pain management offered, I am questioning if this is a reflection of my particular doctors, myself, or both. It’s important to emphasize here that pain management is not solely about medication, but can also include physical therapy, as well as alternative therapies such as acupuncture.
The Stigma around Pain Medication for Doctors and Patients
Why I, and I am sure many others have not asked their doctors about pain management is that there is a stigma that exists around pain management, and no one wants to be labeled as a drug seeker when you have a true need for pain relief. Doctors are also impacted by this stigma; in a forum on the site Pop Vox regarding a new bill proposing to ban Zohydro, commenters highlighted having doctors who felt pressured not to prescribe too many painkillers.
And in a facebook conversation on the page of online arthritis community CreakyJoints about the Dr. Oz episode, several comments touched on how patients even feel criminalized by the crackdown on prescription painkillers.
These are just some of the issues raised in these discussions. But if pain, as Judy Foreman suggests, is America’s biggest problem, how do we solve it? Where do we begin? Leave a comment below and let us know what you think!