By Beth Darnall, Ph.D.
The American Academy of Pain Medicine met in Vancouver last weekend amidst the health crises and pressures being brought on by the pressure on opioid prescribing and pain treatment.
We asked Stanford University’s Beth Darnall Ph.D., a nationally known pain psychologist and author for her observations about the meeting and what it might mean for physicians, psychologists and individuals seeking pain relief.
Here’s what she shared.
We need the National Pain Strategy
“It was recognized that we need implementation of the National Pain Strategy. The NPS is an incredibly well-thought vision created by our nation’s leading experts in the field. Implementation has yet to be realized, but acting HHS CMO Dr. Vanila Singh spoke at AAPM about her co-leadership with Dr. Linda Porter to begin tangible steps forward.
More Mental Health Care Is Needed
“Physicians/prescribers/non-psychologist clinicians are desperately seeking solutions to connect their patients to mental health care – and specifically, to pain psychology experts who can apply evidence-based behavioral pain medicine strategies. As described in our 2016 publication on this issue we have a dearth of pain psychology specialists in the U.S. – meaning those with specialized training and expertise in evidence-based psychological pain management.
“Pain training is needed across all health disciplines. To address the gap, myself and colleagues held a 4-hour behavioral pain medicine workshop on Sunday 4/29 to begin to equip healthcare providers with foundational understanding of the role of psychology in the experience and treatment of pain, and to provide them with a toolkit of resources that they can implement in their clinical care pathways in the absence of psychology providers. Resources include online treatment pathways, books, videos, and other materials. Two online resources are the website for the American Chronic Pain Association and Toolkit.Org Both have free and very low cost downloadable education resources for patients and providers alike.
More Insurance Coverage
“We need better coverage for interdisciplinary and multidisciplinary pain care. This is a perennial problem. This year, a preconference led by the now past-President of AAPM, Dr. Steven Stanos, included insurance payers as key stakeholders in the conversation that was focused on solutions.
“Payers are now mobilizing to create portfolios of behavioral pain medicine treatments to provide patients with immediate access to pain relief tools (Sedgwick is one cutting-edge example focused on helping to connect injured workers to digital care solutions).
“There is a major focus now on integrating or embedding psychological services into primary care. Individuals with pain stand to benefit greatly from this integrated care model, wherein problems are addressed early on, and empowering self-management education and resources offered right away. Multiple federally funded projects are testing these models and methods.
“Many pain physicians are beleaguered by increased authorizations (and rejections for care coverage), DEA policing, and increased documentation. Combined, these pressures are creating unsustainable conditions that may further compromise patient care.
Pain Is Complicated—Let’s Treat It That Way
“The imperative to address the suffering of individuals with chronic pain was a major theme throughout the conference. A one-size-fits-all approach flies in the face of everything we know about pain. Pain is fundamentally individual and requires individual approaches. As such, great concern was expressed for rigid rules and policing around pain treatments.
“We are seeing greater evidence and attention on evidence-based pain treatments, such as pain-CBT (cognitive behavioral therapy), CBT for insomnia (CBTi), and emerging therapies such as virtual reality; these treatments were featured in the conference line-up.”
Look for Dr. Darnall’s editorial titled” “To Treat Pain Address The Whole Person which will be published in Nature Magazine and online this week.