Healthcare Providers Poorly Prepared to Manage Pain, NIH Says

Healthcare providers in the United States are poorly prepared to manage pain, according to a new report by the National Institutes of Health (NIH). Some doctors stigmatize patients who seek pain relief, the NIH says.

“[Providers] are sometimes quick to label patients as ‘drug-seeking’ or as ‘addicts’ who overestimate their pain,” the report notes. “Some physicians ‘fire’ patients for increasing their dose or for merely voicing concerns about their pain management.”

The medical community should apply individualized treatment for chronic pain, the report states. More than one medical specialty should be involved in pain management, since pain is both physical and emotional, the authors write. They note there is a lack of data about the effectiveness or safety of long-term opioid use for pain.

“However, there are well-documented potential adverse outcomes, including substantial side effects (e.g., nausea, mental clouding, respiratory depression), physical dependence, and overdose—with approximately 17,000 opioid-related overdose deaths reported in 2011,” the authors wrote.

Other treatments, such as physical therapy and complementary and alternative medicine should be considered, the NIH advises. The report findings come from a NIH workshop held in September. Experts reviewed chronic pain treatment research.

Chronic pain affects an estimated 100 million Americans, according to Time. Between 5 to 8 million Americans use opioids for long-term pain management.

Many doctors do not have tools to assess patient measures of pain, quality of life and adverse outcomes, the report noted. Primary care practices often do not have access to pain management specialists, and insurance plans may not cover team-based approaches to pain treatment. Some plans do not cover effective non-opioid drugs as a first-line treatment for chronic pain. Doctors who do choose to prescribe opioids do not have enough information on dosing and tapering patients off the medicine, according to the NIH.