A Call For More Chronic Pain Research

A Call For More Chronic Pain Research

U.S. and Afghan soldiers on patrol.

U.S. and Afghan soldiers on patrol.

Over the last week, the controversy on pain management and pain medication has focused on a group that actually is helping to give the issue more attention: our active military and veterans.

The head of the National Pain Foundation thinks that may result in just what is needed in chronic pain–more patient focused research.

“The pain industry and government cannot do what they’ve been doing, which is to pay lip service to chronic pain research and let over 100-million people suffer,” said Dan Bennett, M.D., CEO of the National Pain Foundation.

“If the legitimate concern for our military and vets can amplify a serious national conversation on pain, that’s a very good thing,” said Dr. Bennett who is also a practicing interventional spine/pain medicine physician from Denver Colorado.

Forbes published an article recently that focuses on recommendations from the National Center for Complementary and Integrative Health for assisting military veterans with pain management.

It recommended that large-scale collaborative research into pain management for U.S. veterans should:

  • assess the impact of pain on patient function and quality of life as primary outcome measures, with changes in the use of opioids and other drugs as a secondary outcome;
  • evaluate an integrated package of non-drug treatments, an integrative model of care, or a holistic approach to care rather than focusing on individual complementary health approaches;
  • focus on patients in the early stages of chronic pain; leverage natural experiments and existing resources whenever possible;
  • be pragmatic and embedded in the delivery of care.

“These recommendations are a start and not just for the military and veterans,” Dr. Bennett stressed. “What we can and should learn here should be able to be applied to the general population. We need to transform how  pain is understood, assessed and treated.”

Another story that was published this week, this one by the Washington Post talked about narcotic pain killers specifically and what is happening to thousands of veterans who depend on these prescription drugs to treat a variety of ailments including missing limbs and post-traumatic stress.

The U.S. Drug Enforcement Administration decision last year to put tough new controls on certain pain killers has been topic a for chronic pain patients.

Many doctors have stopped seeing pain patients for fear of scrutiny, pharmacies have been criticized for not filling prescriptions and many patients are very upset because they cannot get what they believe are legitimate prescriptions written or fulfilled.

As National Pain Report columnist Kurt Matthies wrote recently:

“Friends, chronic pain is an epidemic and the sooner we face that fact, the sooner we can do something about it. As Dr. Lynn Webster recently remarked: ‘We need something like a Manhattan Project. We cannot ignore the millions of Americans whose lives are torn apart by pain or accept the large number of people who are harmed from opioids. After all, each reader of this article is likely to experience chronic pain or be close to someone who does. As of now, chronic pain has the power to alter lives forever. We need a societal commitment to find safer and more effective therapies for mankind’s primal enemy – pain.’”

Authored by: Ed Coghlan

There are 17 comments for this article
  1. Mr.Daniel F. Maloney at 9:44 am

    Simply stated,my sports,bodybuilding hobby{No I never used steroids}turned into an obsession and numerous spine surgeries force me to live on my couch.My career as a stockbroker has been ruined.
    Pennsylvania is a state with zero freedom for chronic pain patients.

  2. LouisVA at 8:54 am

    Paul Kemp says: “LouisVA: I don’t wish to take away the help you have found in opioid narcotics. All I am saying is that there are ways that are known to science that will allow the body to heal itself, rather than being placed on long term use of painkillers that — if they contain acetaminophen — are damaging our liver.”

    Paul, I understand what you are saying; however, I do not take anything with acetaminophen and my pain is nearly a life-long problem. My therapy includes Oxycontin, pure oxycodone for breakthrough pain, and a concentrated liquid morphine when the pain gets out of control. When one has had pain for that long (a total of about 50 of my 65 years), the pain becomes centralized (the brain and nervous system are rewired to where pain is the normal state). Please see:

    http://www.practicalpainmanagement.com/critical-necessity-diagnose-pain-centralized

    and

    http://www.practicalpainmanagement.com/centralized-pain-new-consensus-phrase

    Both of these articles were written by my doctor. There is a wealth of information on his website that may be of help to you in explaining why opioids are needed in some cases.

    Next you say: “The pharmaceutical industry has no intention of telling you or your doctor how to cure your arthritis naturally, because they can make more money over the long term by keeping you drugged up, while the breakdown of your joints continues. In fact, they will fib and say that Dr. Wallach’s treatment hasn’t been proven or it doesn’t work. (They have worked for me and many thousands of others. Former Mayor of Atlanta, Andrew Young, was saved from a double knee-replacement by Dr. Wallach’s method. He has a Youtube video about it.)”

    Although I do have some arthritis, that is not my main problem. My first diagnosis was fibrositis (before fibromyalgia was coined as a medical term); thus, joints are not my premier problem. My pain is body-wide and I have tried many, many therapies B4 resorting to opioid therapy. Opioid therapy is a last line of defense when other therapies have proved to be ineffective. There is no known cure for centralized pain; therefore, treating symptoms is the only solution. I am “NOT DRUGGED UP” as you say; in fact, if you met me informally, you would never know that I am on opioid meds. I feel no euphoria whatsoever only relief and I’d also like to mention that I am being treated by one of the foremost pain specialists in the world, Dr. Forest Tennant, who has the oldest, continuous operating pain clinic in the US – operating since 1975. Dr. Tennant specializes in patients with unrelenting pain for which there are few solutions but pain control.

    More than likely, I will be taking these meds for the rest of my life unless a cure is developed, but for almost 5 years now, I’ve been experiencing my highest quality of life in all of my adult years and I am turning 65 on March 28.

    You said: “My hope would be that medical doctors would be trained in solving the cause of the problem (and keeping the cost down for whomever is paying for this), but they are not.”

    I hope so as well, Paul, but since there is no cure for the pain I experience, my hope is that the governmental powers would get off of doctors’ backs and allow them to treat each patient on an individual basis and that includes opioid therapy when it is needed. Any treatment plan should be between a doctor and his/her patient, NOT insurance companies nor the DEA. Insurance companies and the DEA do not have medical licenses and should NOT be in the business of telling doctors how to treat pain.

    Thanks for your concern and input, Paul. Taking on this course of therapy is a difficult decision but, for me, I have no regrets as I am finally living life normally where I used to be housebound.

  3. BL at 2:03 pm

    With so much research that needs to be done in conditions that are the cause of death, I don’t see chronic pain getting much if any money any time soon. Or not enough to make a difference.

  4. Paul Kemp at 11:25 am

    LouisVA: I don’t wish to take away the help you have found in opioid narcotics. All I am saying is that there are ways that are known to science that will allow the body to heal itself, rather than being placed on long term use of painkillers that — if they contain acetaminophen — are damaging our liver.

    My hope would be that medical doctors would be trained in solving the cause of the problem (and keeping the cost down for whomever is paying for this), but they are not.

    The pharmaceutical industry has no intention of telling you or your doctor how to cure your arthritis naturally, because they can make more money over the long term by keeping you drugged up, while the breakdown of your joints continues. In fact, they will fib and say that Dr. Wallach’s treatment hasn’t been proven or it doesn’t work. (They have worked for me and many thousands of others. Former Mayor of Atlanta, Andrew Young, was saved from a double knee-replacement by Dr. Wallach’s method. He has a Youtube video about it.)

    I know many people who have been cut off their prescription medications because of tightened laws on opioid drugs. I’m just glad I don’t have to worry about that happening to me.

    Best of luck to you. I thought you and others might like a safer option than surgery or taking drugs the rest of your life.

    Thanks for your response!

  5. LouisVA at 1:19 pm

    Paul Kemp said: “Dr. Joel Wallach, a long-time NIH researcher, veterinarian, and Naturopathic Doctor, has been helping support & promote the body’s natural ability to heal itself if provided with suitable amounts of all the nutrients it needs. His formulas have worked for me after a forty year battle with acute sciatica and back spasms. The medical industry would prefer to sell you pain pills until you beg for surgery, which they say is the only alternative. It is not.”

    Paul, treatment with opioids is NOT a first line of therapy. After trying everything known to science (not alternative), I could not get out of pain. Now, thanks to those opioids you seem so biased against, I am having the highest quality of life I’ve ever had. Different people respond to different treatments.

  6. Paul Kemp at 1:23 pm

    Dr. Joel Wallach, a long-time NIH researcher, veterinarian, and Naturopathic Doctor, has been helping support & promote the body’s natural ability to heal itself if provided with suitable amounts of all the nutrients it needs. His formulas have worked for me after a forty year battle with acute sciatica and back spasms. The medical industry would prefer to sell you pain pills until you beg for surgery, which they say is the only alternative. It is not.
    When will this country wake up to realize that turning our health over to a rabidly pro-profit industry like Big Pharma was a major mistake? If they can’t patent a natural herb or the nutrients needed to rebuild bone and cartilage, do you think they would lift a finger to inform us?
    It is time to break up Big Pharma’s monopoly on American health care — all they care about is money. There are natural solutions for pain and the repair of our body that they will never tell us about.

  7. Richard Qian, MD at 12:52 pm

    Hi, Everyone:
    I have discovered the first physical mechanism of chronic pain, and have sent it to first rank official for health of Defense Department and hundreds of pain researchers and leaders. However, they just don’t have willing to listen and don’t have ability to listen to me. Finally, it seems no one care. I ask you: Who care this Except me???
    Richard
    The Harvard Medical School.
    Brigham and Women’s Hospital.
    221 Longwood Ave, Boston.

  8. LouisVA at 9:14 am

    Kurt W.G. Matthies said “LouisVA, you have to acknowledge that in perhaps 10% of the pain population treated with COT, addiction is a problem.”

    Kurt, I do not know the percentage of the pain population treated with COT that resulted in addiction. Can you guide me toward where this data was obtained? Even given that a small percentage of pain patients become addicted, is not a good reason to deny legitimate pain patients access to these medications. We have thousands of deadly automobile accidents every year. Does that mean autos should be banned? Of course not! As I explained below, opioid therapy is not a first line therapy. One must try less aggressive solutions first but when those treatments fail, opioid therapy becomes necessary.

    Yes, I agree that a lot of doctors were investigated last year alone for treating pain and some are in prison; however, this is not a new situation as this physician intimidation has been going on for many years. It was back in 2004 that a few pain specialists in Virginia were investigated and one of these specialists, Dr. William Hurwitz, was imprisoned because some of his meds were found on the street. He was a compassionate man that was fooled by some unscrupulous patients. In addition, it was my understanding that his record keeping was less than perfect. After he was imprisoned, pain specialists in Virginia became targets and most all of them closed up shop. This awful situation is why I now have to travel from my Virginia home to California every 90 days to get the medications I need to remain functional. We are in total agreement that THIS HAS TO STOP!

  9. Kurt W.G. Matthies at 7:14 pm

    LouisVA, you have to acknowledge that in perhaps 10% of the pain population treated with COT, addiction is a problem.

    But these are not the only people referred to in Dr. Webster’s statement that have been “harmed.” Over 2,000 physicians were investigated last year alone for treating pain and some are in prison.

    We are imprisoning physicians who use opioids to treat pain.

    This has to stop!

  10. Bill at 5:56 pm

    its not only out military that has its soldiers that suffer from chronic pain. As a retired police with thirty years on the job I deal with chronic pain every day. The injuries are, herniated disc in neck, dislocated elbow, torn tendons in wrist and both elbows, and a low back herniated disc with a sciatica nerve compression. All of these injuries came from the job and most police officers and fire personnel I know all retire with pain issues. Now, I’m required to visit my family phiscan every three months for pain meds after the new law was passed to control substance abuse. Now, legimate patients suffer because of a few who abuse pain meds. My doctor now writes one script for the current visit and two scripts that are post dated. I normally takes two Norco at the end of my days as the pain intensity climbs. Doctors are now refusing to prescribe pain meds because of the new law, and the patient continues to suffer. Great system.

  11. BL at 11:29 am

    Donna M. Harker, it is still up to drs if they prescribe pain meds. Unfortunately, may lie and say it is because of new laws, the government, DEA, etc. It is the drs decision. As far as devices are concerned, that is up to your insurance plan. Even if you have Medicare and/or Medicaid, health insurance plans can choose what they pay for, what they don’t and the hoops you and your dr must go through to see if they will cover it. Ask for a copy of the policy alon with the reference number they are stating is the reason for something with your insurance. With laws, government, etc ask for a copy of the law along with the reference numbers for the state or federal law they are using.

  12. LouisVA at 10:19 am

    Donna and Trudy, I wanted to expand on what you two have said. Using opioid therapy is NEVER a first line of therapy. I tried everything known to science (not alternative) before I realized I was making no progress and I had been in pain for 45 of my then 60 years. After becoming a patient of Dr. Forest Tennant (see http://en.wikipedia.org/wiki/Forest_Tennant), he slowly titrated me up to where I was comfortable and for the last 4.5 years, I have been having my highest quality of life as an adult. Unfortunately, I’m a poor metabolizer so it takes an ultra-high-dose but I feel great and have not had to increase my dose since reaching comfort level.

    I understand your frustrations Donna and Trudy. Dr. Forest Tennant is really a one of a kind ‘maverick.’ My problems are not with him or access to my meds – it is my insurance that paid for my meds for three and a half years, then suddenly they decide to pay for only half, leaving me with out-of-pocket $5000 per month added to a plane flight every 90 days from Virginia to his office in the Los Angeles area. Fortunately, we have family help and an inheritance from the recent death of my mother but if something does not change, we’ll be in debtors prison soon.

  13. Trudy at 5:33 pm

    Frankly-that stuff about opiods harming people is crap-pain pills work-end of story. I am sick of having useless needles jab into my spine, sitting and listening to counselors who tell me to light candles and relax, and being pushed to use a tiny electrical impulse machine which is invasive and cumbersome. I dont want nor can afford that crap-I just want a few pills to stop the pain or bring it below a 4 on a 1-10 scale. I think the patient should have rights to say NO-BUT in my case my doctor makes me do this useless stuff. I pissed off and sick of all things around this issue

  14. Donna M. Harker at 2:41 pm

    I have been a chronic pain sufferer for more than 20 years I recently went to a new doctor and told him what I do to help myself then asked if he had any ideas on how I could do any more to help with my breakthrough pain he said they won’t let us give you pain medicine so don’t ask I had to tell him did you hear me ask for any I mostly use supplements that reduce inflammation and that helps with some pain but not all I use a tens unit and that helps some but I just needed something different that would help with fibro he did give me something that is helping but hey you don’t always need to assume that only pain medicines help.I find it totally unacceptable that the government is able to be our doctors and limit what someone with a medical degree can do for their patients.They have now passed this where pain patients can’t get pain medicine those like me with 100% disability can’t get the tens unit equipment anymore and have to go through 3 fails to even get a new enough medicine to treat pain so the only options are mental health meds that usually do nothing!

  15. Mark Ibsen at 2:24 pm

    Bravo Mr Ed.
    It is past time to do the follow up our active duty soldiers and veterans deserve.

  16. LouisVA at 2:05 pm

    The article states “As Dr. Lynn Webster recently remarked: ‘We need something like a Manhattan Project. We cannot ignore the millions of Americans whose lives are torn apart by pain or accept the large number of people who are harmed from opioids.”

    Opioids are not harmful if used according to Doctor’s orders. They have literally saved my life. I’m experiencing my highest quality of life as an adult and I’ve been around since 1950!

  17. BL at 1:59 pm

    The ACA that was passed in 2010 requires more research and better mangement of chronic pain. Unfortunately, the money hasn’t been allocated. It isn’t a priority.