“50 million people have chronic pain—20 million of those have high impact chronic pain—and there is an absolute need as a medical community and larger society to get educated on what the best treatments are.”
That was the task defined by Dr. Vanila Singh, the Chairperson of the Pain Management Inter-Agency Task Force.
In part one of our recent interview with Dr. Singh, she emphasized the input the Task Force received as over 9000 comments including pain patients, pain professional groups, nursing organizations and pharmacists opined.
“The commentary helped make the case of how alarming this situation is,” she said. “The comments had an effect on us and the report we wrote.”
On the issue of opioids, we asked Dr. Singh about how the opioid controversy is often perceived as binary: opioids are either good (giving chronic pain patients and others palliative relief) or bad (they are highly addictive and are a public health crisis).
She pointed out that federal agencies have begun to course correct noting that the CDC Guideline for Opioid Prescribing was misinterpreted—which the agency acknowledged– and that the FDA and, notably, the American Medical Association both stated the need for a balance in prescribing.
“Those changes began the process of change by addressing the misinterpretation and misapplication,” she said. “The Task Force is helping bring the issue to light.”
Not everyone agrees. Richard Lawhern Ph.D., who manages the Alliance for Treatment of Intractable Pain, congratulates the Task Force on its work, but thinks it doesn’t address the urgency of the opioid crisis
“The HHS Task Force on Pain Management did a tremendous amount of work, some of it highly constructive. But no group which includes such a cross section of professionally self-interested practitioners and Federal Agency representatives can completely avoid politics. I can only imagine the arguments that occurred between Task Force members in private,” Lawhern told the National Pain Report.
Lawhern added, “The Task Force flinched from calling for outright withdrawal of the 2016 CDC guidelines — a truly fundamental error. As long as this fatally flawed document continues to exist, it will be used by Federal and State drug enforcement authorities as an excuse to continue forcing doctors out of practice who dare to prescribe opioids to people in agony.”
Dr. Singh reminded us that the Task Force is an advisory panel that doesn’t have rule make authority. But the report itself—and its emphasis on how to treat chronic pain—may be poised to make a difference.
“The federal agencies have been waiting for this report and are now reviewing it, “she said. “It’s important the people have spoken.”
Dr. Singh, an anesthesiologist who has treated chronic pain patients, uses her Twitter feeds to make the case for better care of pain patients, saying this week “Stigma is a major barrier to the treatment of pain. Education and awareness at multiple levels is key to solving this problem.”
What happens now with the Task Force Report on Pain is that people—the right people (policy makers and elected officials in Washington D.C. and decision makers in state capitals) need to read the report and begin a serious discussion about how we can treat pain better—and do it better quickly.