Those who seek relief from chronic pain may find themselves trudging through a maze of different doctors with no end, or relief in sight. This endless cycle includes patient reports of physicians uneducated in pain management and fearful of prescribing stronger medications, like narcotics.
How big an issue is chronic pain? Medical economists estimate that pain costs the U.S. some $100 billion every year, including 515 million workdays lost and 40 million doctor visits.
A recent survey of 805 patients with moderate to severe chronic pain (on a scale of 1-10, pain of 5 or above was considered moderate and pain of 8 or above was considered severe) found that 56% of them had been suffering for 5 years or longer. Of that 56%, only 22% had been referred to a pain specialist. Nearly half who completed the survey said they’d changed doctors at least once; nearly 30% of those who reported severe pain had changed doctors three or more times. Their reasons for changing doctors varied.
Of those who switched doctors, 42 % said they did so because of prolonged suffering, 31% believed their physician was ill-educated or uneducated about pain treatment, and 29% didn’t believe their doctor took their pain seriously. In addition, many physicians who do not specialize in pain management are reluctant to prescribe more effective, narcotic solutions. Fear of patient addiction and scrutiny by the Drug Enforcement Agency (DEA) seem to be two of the main blocks to narcotic prescription. The above-mentioned survey confirms this: only 26% of those with severe pain reported that they were currently taking opioids.
One solution may be to consult those who are trained to treat pain best. So says Russell Portenoy, M.D., president of the American Pain Society: “The input of pain specialists may be helpful when deciding on the best drug therapy for patients with severe chronic pain.”
Medical Tribune, March 18, 1999 and www.businessweek.com