The Chronic Pain Epidemic
What's to Be Done?

Summary

Brief Video Highlight

The Dr. Lawrence H. and Roberta Cohn Forums
THE CHRONIC PAIN EPIDEMIC: What’s to Be Done?
Presented by The Forum at the Harvard T.H. Chan School of Public Health jointly with The Huffington Post

Thursday, November 10, 2016
In association with Harvard Health Publications


More than 100 million Americans struggle with chronic pain, according to one Institute of Medicine estimate, at an annual cost of as much as $635 billion in treatment and lost productivity. Further, the misuse of potent opioid painkillers, while increasing risk of addiction and abuse, can confuse the conversation around appropriate chronic pain management. This Forum brought together a panel of experts to discuss the causes, treatment and impact of chronic pain, exploring the neuroscience behind the pain experience. The panelists examined how clinicians can best serve their patients, highlighting the recommendations of the U.S. Department of Health and Human Services’ recent National Pain Strategy. The Forum also looked at myriad pain management options, including marijuana and mindfulness meditation. And panelists examined relevant pain care policies, including prescription monitoring program regulations, drug development and funding for research.

Part of: , .

Presented jointly with The Huffington Post

Background Articles

Image Credit: iStock.com/ironstealth

  • The Forum Moderator

    Welcome everyone. We will begin in a few minutes.

    • Ernie

      Thank you for showing my video, it is still hard to revisit the past limitations, as I still have them but I don;t let them get me down, Time does heal as we get new tools to relieve the pain. I us wood to alter my pain by trying to keep my mind off the pain. Mind, Body and spirit!!
      Thank you for having this, I am hoping it will help so others to understand you can still have a life with Chronic Pain you just have to adjust your life to your condition, more adaptive tools to getting the task done!!!

  • The Forum Moderator

    We are getting ready to begin.

  • The Forum Moderator

    We have begun. Thanks again for joining us today.

  • The Forum Moderator

    This clip is courtesy of the University of New England: http://www.une.edu/pain. They has a number of video profiles of people who live with chronic pain.

  • The Forum Moderator

    This event is held jointly with The Huffington Post and in association with Harvard Health Publications.

  • The Forum Moderator

    We will have a Q&A at the end of our event. If you have a question for our panelists, you can post it here or email to theforum@hsph.harvard.edu.

  • The Forum Moderator

    The National Pain Strategy is available here: https://iprcc.nih.gov/National_Pain_Strategy/NPS_Main.htm

  • The Forum Moderator

    This clip is courtesy of The Huffington Post. It is from a documentary called Oh, My Aching Back!

  • Carla Cheshire

    What advice do your experts have for those Chronic Pain patients whose doctors will no longer will provide opioid treatment, many have been on these treatments successfully for 10-15 years and are just cut off with a final 30-day supply? If they cannot find a new doctor should they go to the ER? Methadone clinics? What should they do? These people are lost, in pain and don’t know where to turn.

  • Michelle Farrell

    How do you suggest patients receive individualized care when the doctors are scared to do anything? Many of us don’t fit the typical patient. We have different metabolisms, conditions, etc that effects how our bodies handle the meds. Not to mention adverse reactions, allergies. Plus we either don’t have insurance coverage or its not affordable. The push is for the alt treatments, but what about making them affordable?

  • Dr. Stephen Ziegler

    Overwhelming evidence that unintentional overdose stems from poly-pharmacy and poly-substance abuse. Easy to blame pharm industry when illicit substances are playing significant role (e.g., illicit fentanyl)

  • The Forum Moderator

    We will post the video of this event on the website early next week. We also will post it on YouTube.

  • Michelle Farrell

    I’d love to try different treatments. Too bad can’t afford or docs don’t support. Not too mention too many docs will only treat their particular area regardless if another condition impacts it. How do you deal with that?

  • YMI

    I feel that pharmaceutical companies will not support the research because it won’t be profitable to “cure” people of chronic pain. they need people to suffer and be dependent on their products to stay in business. When should the fed. gov step in to stop this? or can they?

  • Dr. Stephen Ziegler

    Pain is individualized, and people in pain often present with complex conditions not capable of resolution by simple interventions like smoking cessation. An integrated, multi-disciplinary approach is certainly indicated, but what is a patient to do when their insurance company does not cover, whole or in part, alternative non-pharmacological therapies?

  • The Forum Moderator

    Thank you all for sharing your questions and comments.

  • Emily Lemiska

    Docs can cut off pts from opioids w/ no warning. Shouldn’t they be required to refer them to other treatments, to taper them appropriately, and if they do suspect abuse, refer them to substance abuse help?

  • The Forum Moderator

    Quick reminder that we will post the video of this event on this website early next week. We also will post it on YouTube, in case you missed anything or wish to watch again.

  • Anne Fuqua

    What do you suggest can be done to ensure patients who DO have long term functional improvement on high dose opioids are able to continue their treatment?

  • The Forum Moderator

    We also want to acknowledge that this event is part of the Dr. Lawrence H. and Roberta Cohn Forums.

  • The Forum Moderator

    Our discussion is ending soon. Thank you again for joining us today.

  • Michelle Farrell

    Psych, PT, specialist…. It’s not affordable to do all. Add in other alt treatments…. How can we do what’s suggested? Unfortunately, scripts are often the most affordable. Multiple visits a week adds up. Ex: psych, PT, & Chiro are $15 each & specialist are $30. Most at the start, if not thru out, want 2-3 visits a week. Do the math… It’s not pretty.

  • Stephen Vasko

    As a long term Chronic Pain Patient I find it irresponsible and harmful to patients labeling us all as drug addicts. We have been being treated badly by our doctors for years now because of the DEA. Your attitudes on this panel are just what I expected to hear. Just because a patient isn’t depressed when they visit their doctor doesn’t mean anything. We have lived for years with our pain and have learned not to show how we truly feel because if we do we are ostracized by family and others. So, we have learned to smile regardless of how we feel. As the one panelist stated let’s talk about your depression because there is medicine for it. Excuse me lady but an antidepressant isn’t going to stop a Chronic Pain Patients pain. The vast majority of us have been through all of the alternative treatments usually more than once. To be slapped across the face by a doctor that knows this to be true and is left with only the option of nothing, now that causes depression. Our doctors are so restricted by the DEA that they can’t truly treat their patients the way they feel they should be. There is no wiggle room in Pain management. You so called learned people just love to sit there and decide between yourselves how we should be treated by our own physicians playing right along with the DEA’s lies. YOU and others like you are doing more harm than good. You are pushing patients into Addiction clinics instead of helping them be able to live as best they are able. Bottom line, I’m in this shape because a Surgeon didn’t do the job correctly. Not one Chronic Pain Patient including myself wants to live this way. Every one of us would gladly stop taking opioids if we didn’t have to deal with pain that is debilitating. You haven’t a clue and until you do Chronic Pain Patients are doomed.

  • The Forum Moderator

    Question from Facebook

    If the culprit in the opioid epidemic is not prescribed medications intended for suffering patients, why has all the focus been on innocent pain patients, their doctors, and their needed medicines?

  • The Forum Moderator

    Questions from Facebook

    Can the panel talk about chronic pain induced by emotional trauma rather than physical trauma, as the underlying trigger?

    Are there any recommended or beneficial exercises for people with fibromyalgia?

  • Kristen Lally

    Question from email

    I would like to see the panel discuss the contribution of acetaminophen to the pain epidemic and opioid crisis. The research on (a-cee-to-min-a-fen) acetaminophen since 2011 has been less than favorable. What are the benefits of including acetaminophen in opioid medications? Should part of the strategy to combat the opioid crisis be a reevaluation of the original recommendations of the 2009 FDA advisory committee recommending elimination of prescription acetaminophen combination products?

  • Kristen Lally

    Question from email

    Why does The National Pain Strategy and the associated research carried out into chronic pain not mention or discuss hydrotherapy as a proven, medicine-free pain-management alternative?

  • Kristen Lally

    Question from email

    Can we not have a little respect for chronic pain without always conflating it with drug addiction? Is this really the most effective way of addressing the chronic pain epidemic?

  • Kristen Lally

    Question from email

    How does one know when a level of pain becomes chronic? How long does pain have to last before it is actually termed and treated as a chronic condition?

  • Kristen Lally

    Question from email

    Can you talk a bit about the emotional impacts of chronic pain – such as depression, anxiety, etc. I have seen psychologists because of my situation and I think it’s important for pain sufferers to know that the emotional toll can be devastating and they should seek help if needed.

  • Kristen Lally

    Question from email

    What would you say is the percentage of pain sufferers who do become addicted to medications? I am scared that I’m going to end up on a lot of them and while I know that there is a conflation around pain suffering and opioid addiction, it is a fact that pain suffers often do become dependent and addicted.

  • Kristen Lally

    Question from email

    How can doctors minimize the risks of their pain patients abusing opioid medications when they prescribe them?

  • Kristen Lally

    Question from email

    What can we do to galvanize research and the pharmaceutical industry to developing new and more effective non-addictive medications?

  • Kristen Lally

    Question from email

    What are the unique set of challenges that come with treating and caring for patients with chronic pain — when there is never a “cured” state or “closed file” — the case is always active, and there is recurrence, and relapse, and ongoing need for care. What aspects of that make your work all the more challenging?

  • Kristen Lally

    Question from email

    How do you feel the health care system functions in ways that help/hinder your chronic patients from accessing it in the ideal manner. Is the US healthcare system still largely geared around short-term treatments and releasing cured patients?

  • Kristen Lally

    Question from email

    Discuss some of the highest risk factors for chronic pain and what strategies can be implemented at the prevention level.

  • Kristen Lally

    Question from email

    What are some of the most pervasive chronic illness/pain issues in the U.S., currently? How are those epidemics different from what we see abroad?

  • Kristen Lally

    Question from email

    Are there any foreign health systems or approaches to dealing with chronic patients which currently serve as examples on how the US could improve its own care for those individuals?

  • Kristen Lally

    Question from email

    In your opinion, what are the most important awareness and advocacy tools that currently exist to speak out on behalf of chronic pain patients?

  • Kristen Lally

    Question from email

    Chronic pain is undoubtedly a huge market for pharmaceutical industries. Can you discuss the role pharma plays in providing drugs that some patients may need over the course of a lifetime, and what pressure pharma receives from the medical establishment or different patient advocacy groups?

  • Kristen Lally

    Question from Facebook

    If the US were to pass a bill making the direct advertisement from pharmaceuticals to patients illegal and instead to doctors, would this decrease the grand amount of unnecessary use of prescription drugs?

  • Kristen Lally

    Question from Facebook

    What can we do to fund preventative care and how would this affect sky-high tertiary care