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Changing the public narrative about chronic pain as a disease

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Reprinted with the permission of the PAINS Project

Sunday night, I watched 60 Minutes on CBS as they interviewed Joe Rannazzisi, former Deputy Director over Diversion at the Drug Enforcement Administration (DEA). Rannazzisi was portrayed as a “whistleblower,” and he blamed drug distributers, unscrupulous physicians, and members of Congress for fueling the opioid crisis. The week before, NBC did a week-long series on the opioid crisis, and the week before PBS did one also.  I could go on—week by week by week—there is not a major news outlet (print, blog, television, radio, or web) that I could not list as well.
Before proceeding, I need to make two disclosures:

  • I have met and worked with Joe Rannazzisi.

  • We have worked with the DEA closely in the past—with Rannazzisi’s predecessor and colleagues at the DEA for whom I have great respect.

In 2008, we worked with the DEA, the National Association of Attorneys General, and the Federation of State Medical Boards to measure the impact of physicians diverting prescription pain medication. That study was published in the journal Pain Medicine (Vol. 9, No.6). I tell readers this to assure you that PAINS is very concerned about the opioid crisis and respects the role of law enforcement in protecting the US population from illicit drugs AND assuring that an adequate supply of medications is available to maintain the health and well-being of all Americans. My concern is about the irrefutable lack of media coverage of a related but separate public health issue, i.e., inappropriate and untreated chronic pain management.
On Friday, October 13, PAINS hosted a roundtable in Washington, DC, that included top officials in the federal government, leading pain care providers, people living with chronic pain and their advocates, academics and a handful of media representatives to discuss the need for more and better reporting on the “chronic pain epidemic” and the unintended consequences that pain sufferers are experiencing related to federal policy attempting to contain the opioid epidemic and the media frenzy around it. This is critically important because it is our view that media shape public perception and public perception leads to votes, which leads to public health policy – interestingly the foundation of the argument made by Joe Rannazzisi in his 60 Minutes interview.
For years, PAINS and others advocating for better chronic pain care have called for “balanced policy.” More than a year ago, PAINS decided to move upstream with our No Longer Silent initiative that led to last week’s meeting in DC. We must have balanced policy—policy that addresses two public health issues—untreated and inappropriately treated chronic pain and the opioid crisis—without unintentionally harming one patient population or the other. To get there, we MUST also have balanced media coverage.
“If it bleeds, it leads!” is an adage often repeated about media coverage. Granted, the chronic pain crisis is not as “sexy” as the opioid epidemic. However, both of these issues are critically important to our society’s health and well-being.
I will be honest that there are many days I feel pretty discouraged about ever accomplishing our goals, then I see a report like this one that appeared on the front page of the Worcester, Massachusetts paper which highlights the plight of Lauren Deluca and quotes PAINS Advisory Committee Member, Cindy Steinberg, who also lives with chronic pain. I encourage you to read this article and ask you to share it with your friends and colleagues via social media, email, carrier pigeon!
We will ask you to do the same with the report from last week’s No Longer Silent meeting when it is published in mid to late November. Until then, let me share just a few “take-aways” from that meeting: 

  • Improving chronic pain care in America will require culture change. More specifically:

  • Changing the public narrative about chronic pain as a disease

  • Removing the stigmatization of those who live with chronic pain and those who care for them

  • Better education of physicians, nurses AND patients

  • Reimbursement models that support comprehensive chronic pain care, not just prescription opioids, interventional procedures and surgeries

  • Better data and more research

It’s a tall order but what one of my colleagues calls “worthy work.”

Comprehensive chronic pain care will improve the lives of millions of Americans, save billions of dollars and reduce opioid prescribing.

Myra Christopher is the Director of the PAINS Project. The PAINS Project is a program of the Center for Practical Bioethics dedicated to transforming the way pain is perceived, judged and treated as called for in the IOM Report, Relieving Pain in America:  A Blueprint for Transforming Prevention, Care, Education, and Research

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One thought on “Changing the public narrative about chronic pain as a disease”

  1. rakiethebird says:

    Thank yo so much, PAINS, for trying your best to relay the collateral damage being inflicted on law-abiding pain patients by unscrupulous politicians, public servants, so-called brown-nosing medical researchers and sensationalistic news media. But, since the information you were conveying didn’t fit their REAL objectives of; making points with voters, supporting political agendas, protecting government finding and selling antacids, it seems to have fallen on deaf ears.

    Chronic pain patients, all 100 million of us have been betrayed by ambition and greed. So long as this continues, there will be no change. People in chronic pain have little energy to go up against perfectly healthy people with a personal stake in the game and they know it. The brave few who have come forward to defend the weak and helpless risk professional disgrace and increased surveillance as a penalty for questioning the official narrative, especially in an escalating totalitarian political environment.

    The question remains, “What must we do to get our perspective acknowledged and taken into consideration?” Short of committing mass suicide on the steps of the Capital building, I am at a loss for an effective solution.

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