Does the National Pain Strategy Still Have a Pulse? Maybe!

Does the National Pain Strategy Still Have a Pulse? Maybe!

One thing that the Obama and Trump Administrations have in common is they have both pretty much ignored the implementation of the HHS/NIH National Pain Strategy.(NPS)

The ambitious multi-faceted approach to treating chronic pain was finished in 2016—and since then has languished in federal bureaucracy. In fact, the three-year anniversary of its release is March 18.

One reason it hasn’t gone very far was that the CDC Guideline for Opioid Prescribing for Chronic Pain was also released in 2016—and it has hijacked the conversation about the best way to treat chronic pain ever since.

There were signs of life about trying to create some momentum to resurrect the plan stirring at the annual meeting of the American Academy of Pain Medicine which was held in Denver last week.

Over the weekend one of the driving forces behind creating the strategy, Sean Mackey, M.D., Ph.D., was on social media promoting the National Pain Strategy.

Mackey, who is Chief of the Division of Pain Medicine and Redlich Professor of Anesthesiology, Perioperative and Pain Medicine, Neurosciences and Neurology at Stanford University, in two separate tweets said:

“Roughly 50-100 million Americans are living with ongoing pain. Over 130 Americans die every day from opioid overdose. Solutions are urgently needed to the conflicting crises in chronic pain and prescription opioid use. We laid out a clear plan to transform our country’s care of the person in pain in the HHS/NIH National Pain Strategy. We need to come together to enact this important plan.”

The strategy recognized six main areas:

  1. Professional education and training—because too many doctors and other providers don’t understand chronic and acute pain nearly well enough.
  2. Public education and communication—if the opioid controversy of the last two years has taught us anything it’s that people don’t understand chronic pain.
  3. Disparities—there are many vulnerable, underserved and stigmatized populations who aren’t treated well enough.
  4. Prevention and Care—three years later there’s still a need to develop methods and metrics to monitor and improve the prevention and management of pain.
  5. Services and Payment—what’s covered by insurance and what it costs
  6. Population Research—how many people live in chronic pain, where they live and what type of care they receive or don’t receive need to be updated and better defined. (see below)

Dr. Mackey is right to promote the NPS again.

And all this reminds us that the April 1st deadline for public comment for the NIH/HHS Pain Management Best Agency Task Force is fast approaching.

Dr. Vanila Singh, who is Chief Medical Officer for the U.S. Department of Health and Human Services chaired the Pain Task Force and is encouraging people to let their voices be heard.

You can do so here.

By the way, one more thing: the largest chronic pain patient survey which we’ve been promoting since late last spring is going to be closed soon.

Terri Lewis, Ph.D., told the National Pain Report that she plans to close it at the end of the month or when they reach 5000 respondents. Over 1000 people have responded in the last month. If you haven’t already done it, please do. We’d like to help Dr. Lewis reach the 5000 mark.

You can take the survey here.

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Authored by: Ed Coghlan

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Please don’t let this extremely important multi faceted approach to chronic pain and chronic pain diseases get buried by the “opioid crisis”. I have a rare and incurable disease which, along with so many others, is dependent on the open communication and interaction between a team of care providers, PCPs, PT, Pharmacists, insurance provers and CBT, to name just a few, in order to allow the chronic pain patient to have a better quality of life. Right now, this approach is not the norm and alternative approaches to treatment are not covered by insurance making them inaccessible to the average patient by cost, lack of any local access and/or uneducated practitioners. There is NEVER going to be a “one size fits all” for chronic pain and without the implementation of The National Pain Strategy there is no hope for the majority of those who suffer from chronic pain.

Thank you for the opportunity to express my feelings.

Roni Walden
Full body CRPS pain warrior

With all due respect this title is a sick choice of words. I think you must realize that at 90 mme a lack of a pulse is what some some CCP paitents a horrible possibility. The CDC either does realize or do realize and that is the whole idea. The mandate certainly will not stop the abuser! PS The comment form is fist hard to download but if can is too hard to manage.


What is wrong with the federal war on opioid use is they are lumping responsible, prescribed meds with illegal street drugs. Overdoses are common with illicit drug use, very rare with responsible medication use. This is insane.


I can’t download java into my laptop but, I Really want to take the survey. Is there an alternative way I can enable it without it? Thanx


C’mon, there is a national pain strategy: refuse to treat pain (chronic & acute) & hope that all CPPs kill themselves off as fast as possible. We’re useless unproductive addicted parasites, after all; getting rid of us can only benefit the United States of Corporations.

I used to not believe in such conspiracy theories, but now that I’m the victim of such a program (or pogrom, maybe), it’s much harder to dismiss. Do I sound bitter? Yoooouuuuu betcha.

Thomas Kidd

I am not, nor will I ever contemplate suicide. I might die in withdrawal but I will not kill myself. I am trusting my Lord Jesus Christ to take care of me and He always has. But I fully understand those who are thinking about it and those who have gone through with it. This nation just keeps heaping judgment upon themselves. The law of sowing and reaping cannot be circumvented it applies to both saint and sinner.

Thomas Kidd

Trump is to busy with his wall. I voted for him but I am sickened by his [edit] concerning the real emergency inside our country with the abuse of people in suffering from chronic pain. That damned wall is his ticket to reelection in 2020. He will not be getting my vote in fact I have decided to not vote again for any these people who don’t give a damn for anyone but themselves.


Also, think about the needless, huge costs, added to Medicare and to other insurers, due to making pain patients go in person each month to get their Rx, and have tox screens so often, etc.

On occasion, I have something I want to discuss with my pain manager, but at the vast majority of my mandated monthly visits, I simply say that I am there for the sole purpose of getting my Rx’s and have nothing to report.

What a waste of their time and of precious health care dollars.

Gail Honadle

I have gone from being fairly functional to being reduced to using electric carts, or sitting in the recliner most of the day. This is NO way to live. Just because I need a Seizure/nerve/muscle med and the only one I can take out of 14 FAILED HORRIBLE REACTIONS ones 1 Failure the first one Valium 10 mg twice a Day which is NOT enough for 5 health conditions it controls. I can’t even have a Lousy 5 mg NORCO twice a day. As I’ve Gastro conditions, Tylenol is all I’m allowed. Doesn’t work well on PAIN at Level 10 or PUKE level. That Enlarged Heart with a Mitral Valve leak can BLOW if Pain goes into stage 3 Hypertension Heart Attack level. I can’t take Hypertension drugs, THEY ALL HAVE GASTRO issues. Besides so many have been recalled due to CANCER warnings. BUT NO GASTRO WARNINGS IN A BLACK BOX even.


Part 2

Ever since 9/11, citizens have been encouraged by the gov’t to keep extra supplies of food, water and other necessities in our homes in case of emergency. But opioid patients can’t keep an extra supply of the Rx’s we need to survive. If something bad were to happen on Day 28, then I fear there would be a spike in suicides for all the people who run out of the Rx’s they need to survive.

It’s not possible for someone who has never experienced it, to understand the toll of endless pain — hour after hour; day after day; week after week; month after month; year after year — and decade after decade. It’s exhausting. It grinds you down. It ruins relationships. It makes basic self-care a major challenge. And for many of us, it is literally impossible to live with if not controlled/managed with opioids as our doctors see fit w/o worry of gov’t persecution.

But, at least officials in charge can listen to those of us who do suffer so much, and try to imagine what it’s like, and be thankful that they don’t experience it first-hand.

For the record, I have tried many non-drug interventions, as well as many non-opioid drug interventions. None of those helped at all, and some of them made me feel worse.

I do not want to be another forced suicide. The U.S gov’t already has more than enough innocent blood on its hands due to treating pain patients like me as criminals. But I do fear that I will run out of pills before action is taken to prevent more suicides, including mine.

Do not delay any longer. Fix this crisis which was so foolishly, and avoidably, created.



Dr Singh –

Due to a recently-imposed forced taper — after being on opioids for over a decade — I considered suicide a few weeks ago. I was on Day 4 of an incredible pain spike, and was terrified to take the extra percocet, or maybe two, that I desperately needed, as I was terrified of running out of pills. And I could not stand the pain any longer.

Finally, I realized that I still had pills left, and the crisis wasn’t upon me that day, and so I took what I needed.

My stress level has been through the roof since the imposition of the forced taper. I can’t stop clenching my jaws and grinding my teeth, among other things. And, instead of passing my last dentist appointment with flying colors, I had lots of bleeding gums and other problems, caused by my newly non-stop clenching/grinding.

Being treated like a criminal instead of like a long-suffering law-abiding American is infuriating. I have never felt such general anger before.

I am not an addict. On a rare good day I can take less than my normal morning dose. I used to occasionally even manage to skip a day entirely, but that hasn’t happened in a few years, as I haven’t had a good enough day to try to skip entirely.

Due to the ridiculous federal and state laws, once a month I have to go to the pain manager’s office to get my monthly pills in person, no matter how horrible I feel, and then on the 29th day after filling my last month’s Rx’s, I have to go to the pharmacy, again, no matter how horrible I feel. If I dont’ go on Day 29, then I lose pills; which I can’t risk.

So far, Walgreens hasn’t imposed quotas and has been happy to fill my Rx’s. Thank goodness for that at least. I’ve been turned away elsewhere due to pharmacy-imposed quotas. I can think of few things more stupid than pharmacies refusing to fill legal Rx’s to suffering patients.


Wanda Hobbs

Chronic Pain Patients finally have a chance to make our voices heard and I hope that everyone responds to the NPR questionnaire, especially in the comment section. It is there that we have an opportunity to tell our unique stories of how our Individual lives as legitimate pain patients are affected by the bill aimed at the masses of addicted Illegal Fentanyl abusers. Without my Legal, Prescribed, Managed and Life-saving Opioids my life would be unbearable as I would be confined to my chair/house. I live alone. I was an RN for over 30 years. I’m in pain all day, every day.. even with my meds but at least I can still take care of my needs-WITH MY OPIOIDS!
The survey has to speak to someone. There has to be a beating heart somewhere. Or is the pulse really missing….Sir, you may be correct.

James McCay

Terri James, I was thinking the exact same thing as I was reading this post!
Regarding the statement that; “130 Americans die every day from opioid overdose.” ALMOST NONE OF THE 130 ARE LONG-TERM CHRONIC INTRACTABLE PAIN PATIENTS! Yet still no medical “professionals” still seem to get this! The CDC certainly has no clue that this IS A FACT!

I capitalize to emphasize because I can only type with one finger, otherwise my fingers/hands go completely dead very quickly.

Chronic Intractable Pain patients KNEW we’d be put in a precarious position once the “War On Opioids” started because we are THE EASIEST TARGETS, and are the most obvious targets. So naturally the lazy bureaucrats went after us first! YET IF THEY TOOK THE TIME TO TALK TO FOCUS GROUPS OF US; THEY’D NEVER FEEL THIS WAY! Because that requires WORK, and all I’ve seen is everyone in this- WITHOUT CHRONIC INTRACTABLE PAIN want fast results, regardless of how horribly it affects THE WORST OF US!

We were ignored, had our life-saving opioids reduced or completely taken away, and WE ARE DYING in record numbers. But by the time the bureaucrats get these death from suicide numbers; IT WILL BE TOO LATE!

I worked as a medical professional for 16-years and very vividly remember many doctors talking about Designer Opioid drugs that only went to the area of the pain and that these drugs were in the FDA testing phase, that was 1991. WHERE ARE THESE DESIGNER OPIOIDS? Because from where I’m lying in bed, that would have prevented any “Opioid Crisis” and “War On Opioids”. Too many people would have lost too much money, I GUARANTEE that was the cause that these designer opioids never came to fruition.

Most people don’t have a clue how much true power BIG PHARMA has in this country, but some of us are learning now the HARDEST WAY possible! This “War On Opioids” was started VERY LATE out of panic when RICH Senator/Congress’ kids started dying from FENTANYL/OXYCONTIN overdoses which has almost nothing to do with us.


I’d like to expound on the respondent commenter “Steven,” below, who asks, and I’m paraphrasing here, why not ask the question: Are you thinking of suicide because your medication was taken away?

I believe that question is the crux of what we’re left to deal with now, because the question could also be asked “… taken away” OR REDUCED? Either way the question is asked, the answer is much the same. Unwarranted reductions can have the same effect of PAIN NOT TREATED APPROPRIATELY any more. Involuntary reductions lead to the treatment of dependency and not pain. In other words, pain patients who have undergone reductions are seeing their pain return to unacceptable levels, while the pittance they receive to stay at or under the 90 mEq endorsed (however wrongfully) by the powers-that-be, only suffices to keep feelings of withdrawal at bay.

So the question remains, are we thinking of suicide? I’ll admit it has crossed my mind — often. But the more powerful heavenly voices speak to my heart as I think of my loving husband, grown children, and especially my youngest grandchildren. And my faith; I don’t want to chance meeting my Lord face-to-face and Him sadly tell me if only I had waited just a little longer, what precious blessing was in store. The last thing I want to do is disappoint my Lord and Savior! He knows the extent of my pain that no one else possibly can.

So I’m continuing on. I’ll turn 63 years old tomorrow. I surely thought I could live out my time in relative comfort, thanks to my pain doctor who wisely and appropriately treated me back in the day before his hands were tied by some random psychiatrist who championed cruelty to pain patients.

Good day, everyone.

Terri James

It’s a shame not to mention a tragedy that it’s been this long and nothing’s been done to help the chronic pain patient, it’s only getting worse and many are taking their own lives. No one can tell me that anybody that takes prescription opioids prescribed by a doctor has overdosed unless they’ve mixed alcohol or illegal drugs with it. I’ve been taking the life-saving opioid medication for 10 plus years now. The only thing it’s done has saved me from a world of pain and let me tell you it has made life much more bearable and worth living! We have pain patients that are committing suicide, it’s the drug addicts that overdose. Major difference there! With a man like Trump you can’t tell me for one second that he has no idea what taking pain medication away from a chronic pain patient can do. He may not be in pain but he’s not stupid either. He may act it but we know he’s not! This whole thing sickens me more and more! We’ve done everything under the sun we can think of to do, I pray this survey works, helps and or wakes the right people up!

Gary Raymond

Thanks, Ed. Perhaps if the NPS program title contained additional consonants, there would be greater exposure. The alphabet people are garnering more legislative and media attention than chronic pain sufferers. Oh, I just figured it out. Alphabet people party acceptably with cocaine.

Why not address the question are you thinking of sucide due to your medicine taken away?