The National Pain Strategy Is Released

The National Pain Strategy Is Released

A draft of the long awaited National Pain Strategy (NPS) was released today, and the National Institutes of Health want to know what you think.

There are six key areas addressed:

  1. Determine just how big and how severe chronic pain is as public health issue.
  2. Better emphasis on prevention of acute and chronic pain.
  3. Improve the quality of pain care AND reduce barriers to underserved populations at risk for pain.
  4. How to make sure that access to optimal pain management is available to all
  5. More education and training for the people who deliver care.
  6. Create a national pain awareness campaign and promote safe medication use by patients.

“The National Pain Strategy represents the United States first strategic plan for transforming and advancing pain care, education, research and prevention,” Dr. Sean Mackey, Chief of the Division of Pain Medicine at Stanford University’s School of Medicine told the National Pain Report.

Dr. Mackey was one of 80 experts from medical, scientific, public, private, insurance, and patient advocacy groups as well as federal health agencies. He said that the NPS was called for in the 2011 Institute of Medicine report, “Relieving Pain in America” and is a strategic, action-oriented document to transform how we assess and manage pain in our country.

Dr. Mackey stressed that public input is critical.

“It will be important for all of us to work together to promote the goals in the NPS.  We hope you will join us in voicing support for the Strategy by submitting comments. It is our goal to generate as many letters as possible to show HHS the importance of improving pain care for millions of Americans.”

The NPS presents specific short- and long-term goals, identifies key partners and defines tools to measure progress across six important areas including: professional education and training, public education and communication, service delivery and reimbursement, prevention and care, disparities, and population research.

Editor’s Note—At the National Pain Report we know that you have opinions—you express them often and passionately. And, since YOU are the public that truly understands PAIN, it’s important to have your voice heard. Please comment below the story. Thank you.

This is an opportunity for people who are invested in improved pain care to have a voice in shaping the national agenda on pain treatment.  Stakeholders involved include those living with chronic pain, those treating chronic pain, and those who have loved ones with chronic pain..

Read the entire National Pain Strategy here. It is a 72 page document.

Comments must be received by May 20, 2015. Written comments can be emailed to, or addressed to Linda Porter, Ph.D., NINDS/NIH, 31 Center Drive, Room 8A31, Bethesda, MD 20892.

And let us know what you think by writing your comments on this story (if you’d like us to republish your comments, please leave your name)

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Authored by: Ed Coghlan

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Wow! I pointed no fingers at anyone on this thread but simply asked for your opinion. You seemed knowledgeable & I was curious. Sorry to bother you. I’m leaving this thread now. People in pain tend to lash out.

Jeff Irvin

From PT, Chiro, to tender point injections (years of cortisone and nerve ablations in between).
I have pretty much ran the gamut, my lumbar was deemed inoperable years ago.
Three years after a rear ender, now it is neck problems with nerve impingement, I don’t want to hear the same thing.
I don’t really want the meds….. I want my life back, that isn’t possible now.
The meds dull the searing pain, nothing I have ever been prescribed took it all away.
Don’t look down on my like an addict or drug dealer, I want what life I have left to have at least a little quality.
Stuck in bed, staring at 4 walls and the ceiling wasn’t my plan for the future, honestly.
Taking strong medicine wasn’t either, yet on my “good days” give me what I need to enjoy my life under the circumstances.
Teaching my grandchildren new things, maybe catch a fish or 2 together before life is over.
I am under a contract, closely monitored (like a criminal) for something that I had absolutely no choice in.
The records are there, the pain has never been doubted by any doctor that has reviewed them.
The “higher ups” all Preach about “equality”, does chronic pain omit me ?.
Provide the help that I require without treating me like an abscess, or criminal.
Is that really too much to ask ?.


Jess- what will get done is a bunch of the same experts who have done little to transform pain care will have more meetings with their colleagues in medicine and come up with plans and programs much like we have today. Whys should someone from the AAPMS or APS or a doctor break their head open to make pain care much better than it is when they dont have to?
And so the NPS is all about political economy- the same organizations and experts and their front groups who are well fianced with pharmaceutical companies will call for “new and improved” “high quality” effective treatments. They are probably better suited to create beer commercials then transform pain care. The experts on the committee didnt talk about curative or regenerative care, they consider all people in pain to be catastrophizers- just as the 2011 IOM report stated. They could have had a referendum on the NPS, they could have opened up the planning process to all people in pain- but the didnt want to hear from anyone or everyone in pain- all they wanted to do is continue down their narrow path of approach and create a plan that doesnt require much from them and allows them to continue to exert power of the pain care industry.
The pain experts know little about multimodal care- they wouldnt know Manaka acupuncture from Tan acupuncture, they dont care about the role of nutrtition or herbs in pain care, they know little about yoga or qigong or ultrasound or electrotherapies or lifestyle therapy. The NPS is created mostly by people interest in some pharmaceuticals for pain- ask them about orexins or rapamycin or minocycline- and youll see how poorly educated they really are.
Its up to people in pain to revolutionize pain care- the bigshos who control pain care have not made it better- they dont care about the rising prevalence and misery due to apin- all they care about is being in power.


Kate- you like pointing a finger at others- but i didnt happen to see your inspiring vision and energetic plan with regard to pain. Mine includes lowering the prevalence of all painful conditions- which of course is not mentioned in the NPS-as they are not interested in lowering the prevalence of any painful condition. My plan focuses on a bill of rights for people in pain and zero tolerance for discrimination- so mandatory fines and mandatory education and suspension of those health care providers for discriminating against anyone in pain. I wouldnt allow medical boards filled with biased doctors to self regulate medicine- i would call for attorneys with solid record of human rights to police medicine. I would get over the bias toward “treating” painful conditions and call for a bill of rights that includes the right to curative treatment and regenerative treatment for pain. Instead of the low standard of education the AAPM and APS call for in regard to educating physicians in pain care- mine is much more thorough and focuses a lot on nontechnical skills- like listening and empathy. And oh- unlike the bologne the 80 NPS creators called for my bill of rights would require at least one hour for a first visit with a pain provider- thorough assessment of the person in their world and not use PROMIS as an outcome measure- PRMIS is unproven and lacks salience assessment. i would call for NIH having to spend 20% of research on chronic pain with 15% of the money on primary prevention and curative treatments. I would require NIH to gather all the literature past and present on pain and put it through IBM Watson computer. I would require all providers to have adequate education in nutrition. I would require FDA, CDC, NIH staff to go through a debiasing process- as most of them lack critical thinking skills and have lots of anchoring and experiential biases. I would call for developing generative decision based dashboards for people in pain at no cost. I would require the CDC, FDA and NIH to have 20% of the ir advisory boards consist of people in pain with no vested interest in pharmaceuticals, medical facilities or medical devices. My plan is far superior to the NPS- the NPS is essentially about those currently in power continuing the errors of their past and silencing all dissent. The government is ridiculous to conclude- those experts who have gotten pain care wrong in the past will somehow get it right now- or maybe i am silly to believe they really care about pain care being much different or better than it currently is. But my how the government goes to extremes to deny FOIA requests and dialogue with yours truly. Its only to clear the government and the 80 involved in the NPS are incapable of a discussion with someone who sees things very differently then they do when it comes to pain care. But, in the ned- it is clear they… Read more »


1] huge point that is missing everywere,,,why??why are there people in so much chronic pain???,,,jmo,,,,2 wars,,thats kinda obvious,,and the wage gap,,,,we Americans are working harder then ever before,,for less money,less benefits,,less everything,,,but we still gotta pay that crazy mortgage, Back in the 80’s,,I saw my Fathers pay checks,,700.00 a week from Illinios Bell,,His mortgage was on a 30,000 home,,, a nice big home,,,6 kids,,,,Rarely was there ever overtime,,unless a storm came thru,,,bread was 25 cents,,,gas was 1.25,,,,cigs were,,99 cents,,,everything was cheaper,,,,,Now,,the have nots are literally breaking there backs just to feed there families,,working 3 jobs,,2 jobs,,,,our bodies are simply saying NO,,They claim there targeting us 45-55 years old because according to N.I.H,,D.E.A. ,H.H.S,,,,that age group are the ones who need the most medicine,,,well dahhhhh,,when your 50 years old,u gotta pay 1500 in mortgage,another 100,000 to send your kid to college,,,your working 3 jobs to simply provide for your family,,,your body is gonna say no,,,its gonna break,,,and now when we need the MEDICINES,NOT drugs,,,medicines to simple be able too work those 3 jobs because our government has do nothing to get the wage gap fixed,,,they are saying tough,,,suffer in physical pain,,,because we think chronic physical pain is a ,”disorder” not a physical painful condition that needs opiate medicines to help make your physical pain bareable,,,,,and we keep accepting this,,,why????paita

Given myofascial trigger points cause so much pain and dysfunction and they are very treatable, and recent research (Ge et al; Staud et al) has shown that the central sensitization of fibromyalgia is maintained by even a few trigger poitns and that peripheral pain sources are what cause the central sensitization of fibromyalgia, and that a large amount of resources are being needlessly spent due to the inability of care providers to diagnose and treat trigger points, and that John Kennedy asked Janet G. Travell MD to teach trigger points as much as possible while she was White House Physician so that others could learn of this magic, isn’t it about time that myofascial medicine is taught in all kinds of medical and dental schools?


In order to accomplish #1, we need to retrain thousands of physicians. Many of them turn away pain patients because they’re, “not comfortable taking any more pain patients.” This creates an even bigger problem, which I think encourages patients to self-medicate, resulting in a refusal to seek medical care because of prior rejections from doctors. I’d rather try to treat excruciating pain at home than go through all of the effort of finding someone to take me to the ED and then be refused care because I am exhibiting, “drug seeking behavior,” simply because I report being in pain. (I have been accused of this several times over the last decade- even though I have not actually requested medication of any kind. I personally can’t stand narcotics and have no interest in using them to manage pain, either for short or long term. However, I know people who cannot function at all because of pain without them- and it is not my place to try to take that away from them.) We also need PCP’s, urgent care and ED’s to come to a consensus on when someone should seek emergency care for pain management, as many physicians will direct patients to the ED if pain should reach a crisis point. However, once you’re there, it’s common to be turned away because of “drug seeking behavior.” This is bullshit- just because somebody isn’t bleeding profusely doesn’t mean that they are not in crisis. Unfortunately, that can be difficult to understand if you’ve been trained to believe the exact opposite. Quite frankly, that bullshit needs to stop before we’ll be able to get an accurate number of pain patients. I strongly believe that the DEA’s war on drugs is at least partially driving this problem. I believe that problem is also strongly linked to the recent increase in heroin addiction, given how similar heroin is to morphene. Regardless of numbers games, we need to increase funding for pain research immediately. We should have plenty of data on cancer pain, neuropathy and amputees to justify this increase. We don’t even have s good working definition of pain other than, “it hurts.” Many pain patients report dramatic improvements after using medical marihuana regularly, yet it is terribly difficult for many patients to access safely. We can fix that- and we should fix that asap. It is confounding as to why we have it as a Schedule I drug when there is documentation from the Nixon administration (and earlier from the 1930’s as well) that supports cannabis as having KNOWN medical value. I think we also need to work very hard to get multi-modal therapies to patients much more quickly. Most pain patients I know personally suffer for years, despite actively seeking care, before they have access to successful treatments. Drugs alone are not enough. Pain patients need to be able to access physical therapy, heated pools, meditation, alternative therapies, nutrition services (many patients report some level of improvement after increasing fresh fruits and veggies/foods… Read more »

Cynthia Jones

Please understand that after having 5 back surgeries and being diagnosed with Adhesive Arachnoiditis ( A spinal cord trauma ) and Sjogren’s Syndrome along with Osteoarthritis, I am in pain 24/7! I do not need a lot of medication every day, but when I have flare ups, they are so cruel and I have nowhere to turn. I have a Dr. who gives injections more than medications and with AA I cannot have those injections in my spine. I just suffer because he can’t give me a medication to go along with the one I already have or instead of what I already have since it doesn’t work for when it’s excruciating! I feel like that addicts have stripped us of care by abusing the very medications that were made to help people like us. There will always be someone who abuses their medications, alcohol or whatever and those of us who don’t, should not be punished for it! My Dr. knows me, 3 years now he’s been seeing me. He knows I do not abuse any medications and am up front with him about everything. He shouldn’t feel like he will be scrutinized for giving me a medication that will help me. I know the Doctors are scared of the government giving them a hard time. Makes no sense. You cannot stop people from destructive behavior but my pain can be managed better in spite of them, I am tired of paying with pain because the government is trying to save people from themselves.

Jennifer Dolan

There are a number of issues that continue to be unaddressed with regard to chronic pain. The first is the length of time it takes for individuals to get treatment. It can take as long as seven years for someone to get correctly diagnosed with a disorder such as dystonia-something that does not show up on x-rays or MRIs. Patients will typically go from doctor to doctor, often being treated as if the pain is in their head.
Second, pain medication is becoming absorbed into a category that is almost impossible for doctors to prescribe. Vicodin/hydrocodone now needs to be a written prescription, rather than as a call in to a pharmacy. Patients who may have difficulty driving due to pain, need to find ways to get to their doctors offices and then drive to their pharmacies, wait to pick up the script before driving home. Just because there are people who abuse a drug (which there have always been and always will be) doesn’t mean that the people who really need it will). Third, both with regard to work and disability, chronic pain is not seen as a “real” problem. Often the pain is not visible to the naked eye, so the individual is not treated as if they need accommodations from their employer and are faced with double trauma-the trauma of the pain, and the trauma of having to explain over and over why they must modify their work due to their physical etc. condition.

Jeff Irvin

IMHO “concern” has nothing to do with requesting input, they stuck their foot in their mouth by changing hydrocodone to schedule II, now it is more “damage control”.
Feign concern… yet change nothing that will amount to anything.
I went up the “pain med ladder”, all the way to fentanyl 100mkgh patches, little to no relief, messed with my head.
I don’t want a “buzz”, I want pain relief.
By MY CHOICE I came back down to a reasonable schedule II drug at a reasonable dosage.
In 2009 a surprise gall bladder attack wreaked havoc on my body, lost one third of my body weight in about 6 weeks.
The real culprit, a pseudo cyst on my pancreas the size of a softball, it nearly killed me.
My meds were reduced due to weight loss (in the hospital), six months and a heart pik later the cyst was gone.
I regained weight back to 180lbs from about 150lbs., no increase in dosage since it was lowered in 2009.
The auto accident three years ago caused serious damage, little to no “disk space” at one level, instability from damaged facet joints and bilateral narrowing of my neural canal (pinched nerves) to both arms and hands.
Two major spinal area problems…. same dosage as for one.
High dose prednisone for inflammation (with all the side effects), yet no raise in pain meds.
Only time will tell if neck surgery is an option, burning, nearly useless hands, aching shoulders, neck, arms and horrendous headaches, it doesn’t matter to them, they don’t live it.
Quality of life should be a fundamental right, not a doctors choice that is afraid of being “flagged”.
The good book says that you reap what you sow, in their time they may well be rewarded with a bitter harvest.
If they walked a few miles in our shoes, their outlook on chronic pain would undoubtedly be severely changed.

Jennifer Tripoeer

Pain care is so regulated by the government and big Pharmaceutical companies, that those living with chronic pain are often left without relief from its chronic and debilitating effects. Further outreach for other means of achieving pain control is imperative for millions of Americans. Those who suffer every day with debilitating pain are not seeking relief to get high, but to be able to function in their daily tasks of living. It would be my hope that this would not be a years long investigation of the issues of chronic pain, but a broad based investigation of the means to treat it without the ever present stigma of of ‘drug seeking’. It is discrimination when doctors, nurses, and the community look down and judge those whose lives have been dramatically altered by the pain they are forced with every hour of every day.


So DAVID BECKER, what are your suggestions for those who suffer from chronic pain & are being denied medication? Have you formed a Citizen’s group to deal with these issues? I’m all for stem cell research. What solutions do you offer?


It is legal in my state. It’s helpful but may not completely take away the pain for many. Plus parents are concerned about using it if there are children in the home. If you have a job where you are drug tested, you may be fired even if it’s legal in your state.

Bernadette LeRoy

Legalize medical marijuana everywhere.


1.Determine just how big and how severe chronic pain is as public health issue. How Chronic Pain is a health issue…When patients are not believed, sent home without a pain management protocol they end up self medicating. Self medicating with alcohol, over the counter medications or illicit drugs. Even the most outstanding parent might become abusive to their friends, family members, children or pets due to the lack of support. 2.Better emphasis on prevention of acute and chronic pain. Prevention should start at GRADE SCHOOL. I have witnessed kids carrying backpacks overloaded with textbooks, or who are trying to pick up things much too heavy, without a thought to body mechanics - which kids are not taught. 3.Improve the quality of pain care AND reduce barriers to underserved populations at risk for pain. Quality has to start with providers. Providers who are under the gun to get a patient in and out in 15 minutes or less. A car mechanic spends more time diagnosing your vehicle before working on it. Providers are constantly under the pressure of the local D.A. to reduce the number of patients they treat, and the amount of medications they prescribe - this all needs to change. We all know there is a huge difference between dependency and addiction, law enforcement seems convinced dependency will become addiction. Which is not true. The other HUGE issue which is becoming more of a problem is the RIGHT TO DIE States like Oregon, Providers are now refusing to prescribe pain medication to anyone thinking that the patients will want to use the medication to kill themselves, which is of course backwards thinking, much like the protest against returning unused medications back tot he pharmacist - who doled out the meds to begin with…it makes no sense and is forcing people who were once on protocols which allowed patients to have more functional and more active lives. 4.How to make sure that access to optimal pain management is available to all Good Luck with this…. 5.More education and training for the people who deliver care. This is a good start, but appears to me to be more extensive. Providers are severely limited in their ability to provide care, time wise - 15 minutes or less to diagnose or to go over routine protocols is insane, legally (the law enforcement community is going after many of the wrong people, severely limiting or out and out right tying a providers hands in treating pain patients by severely limiting medications. NOTE - I get the issues as I was in law enforcement. 6.Create a national pain awareness campaign and promote safe medication use by patients. To start, the best thing to do is STOP BIG PHARMACY FROM pushing medications which have too many side effects (which often mimic the symptoms of the diseases these patients suffer from) and start giving patients the option of using opiates or medical Marijuana etc. Next, stop limiting providers, give them more time to spend with patients who… Read more »


To Nancy,,could u please explain how exercise,emotional support stops physical pain??I am not sure for me that is correct for all,,for example,,my chronic physical pain is thoracic,,my backbones from T-1-T-9 and all the nerve ending,thus muscles connected to my chest swell everyday from simply using my arms,or standing to long,or siting to long,or leaning over the computer to long,,or breathing,,the muscles actual swell and bruise all along my spine,u can visually see the swelling and the bruises,,soo please explain to me how exercising those damaged muscle more,that already swell w/normal activities like breathing,,how exercise will help them??or someone w/a broken leg,,how exercise will help that leg heal??I truly do not understand your statement about that??Or how talking about my broken back is going to stop the physical pain from a broken back,,,please explain??thank u for your time,,,m


This is a good start, we need regular updates of specific goals reached. I’m surprised at the critical comments. May I ask them to suggest an alternative?

ellen jones

In England ppl with chronic pain are not looked at as drug seekers like so many ppl in america are. I think the changes are much needed and we need to be taken more seriously. I live in chronic pain every single day and still get told by ppl fibromyalgia does not exist or its a fake illness!

Nancy Ribok

4) perfect…!
5) So important, this is a big barrier to optimal treatment.
6) Excellent, patients are often treated like criminals or worse, they need to advocate for themselves as well. This is so important.

Thank you for putting the time to look at this, you will find many barriers in implenting these areas addressed. Very exciting to see NPR and the National Institute of Health and Stanford’s Dr Mackey working together to ensure pain patients get treatment they require and deserve.
Part 2, ran out of space in first message.

Nancy Ribok

This is a good start. To comment on addressed areas;
1) I think this would be difficult to capture. Many patients have been turned away by doctors, sometimes to suffer at home without treatment, also doctors are reluctant to diagnosis patients with chronic pain. Chronic pain is complicated and may span many years, or their entire life.
2) prevention of pain….many patients, have no control over wether they get chronic pain. There are things they can do to diminish pain, such as exercise, diet, emotional support, coaching, etc.
3) This should be number one! There are so many barriers involved
intreating pain, DEA, doctors fear of being reviewed by authorities, time involved in managing these pain patients..documentation, urine tests, doctors and patients are reluctant to try pain managment, costdon’t believe


i think this is a good start…and i think these pain management places should not be the only place we can get meds….i want my family dr to give them to me but most hospitals (they pretty much control the drs) only want pain pts to go through pain management places….i find when i go to them i get so much useless stuff done that charges my insurance that it makes me crazy.

Mark Ibsen

Well this IS good news. The issue is Huge. Acute and chronic pain are both issues to deal with. Acute pain is being under treated, causing more chronic pain which is being neglected.
Let’s make ourselves heard about this.


hmm,,,for me,,talk is cheap,,for me,,I endured physical pain that no-one should of,,w/no medicines for years,,it was literally torture,,forced endurement of physical pain.I couldn’t take a breath of air w/out extreme pain,,soo???Also this is not our D.E.A.,,it is a group of educators from Stanford,,,the same institution that just put out a survey that all our physical pain is in our heads,,sooo?????Talk is cheap,,,,For me, despite all the doctors from the American Academy of Pain telling the D.E.A..NOT to change the law about hydrocodone,,the D.E.A. changed it anyways,,This ,”war of pain patients,” in the new target for the D,E.A’ ,,,its easier and,cheaper,to go after us,,with all the access to ALL are medical records/medicines for the D.E.A. to ,”claim,” there worth,,,by collecting data from us,,,that is a lot easier then going to the jungles of Columbia,,or the fields of Afghanistan,,they can track their worth to our government because the data on us is easier to get ,,then in a field in Afghanistan,,their not allowed in Bolivia anymore,..The D.E.A,,,has done sooo much damage to us,our doctors,and our pharmacist,,via propaganda,made-up statistics, made-up data,,that it has literally created a tortureous ,”witch hunt, on all of us in chronic pain,,Our medicines have been terribly demonized,,,my point being,,I don’ know if 1,,this group at Stanford is just giving us B.S..,,,but a lot of lives/bodies have been forever damaged by the D.E.A’s war on us,,,,Doctors lie,,nurses lie,,our government lies,soo why should these guys be any different???I guess for me,,,when Stanford puts out a survey that actually doesn’t insult us,,,I might start believing them,,,Kinda like the Indians,,or the Black of the 1950’s,,,The government made all kinds of promises,,,to humanbeings who’s lives were destroyed by prejudices,,,,then they never honored 1 of those promises,,These guys may talk the talk,,but do they walk the walk???the proof is in the pudding,,,,for me,,,I don’t believe them,,,


I will oppose this plan that is based on the biopsychosocial interdisciplinary model- for few studies provide clear evidence of the effectiveness of these treatments and there are even fewer studies showing that his model is what people in pain want.
The greatest stakeholders- people in pain were hardly involved in creating this insitutional approach to pain care. It is not based on the needs of any individual, for it is population based. There are no clear goals in terms of outcomes- this plan is focused on creating certain processes in pain care- and so ultimately the public doesnt know what this plan will accomplish.
This plan might have been created back in 2011 in the IOM report on pain care- 4 years later we still dont have a plan that tells us what improvements for any particular individual that can be expected.
This plan is poorly researched and doesnt seem to call for more of the same old Institutional persistence in pain care with little opportunity for people in pain to be heard or for their treatment preferences to be considered.

Jeff Irvin

When a chronic pain patient is treated like a “drug addict” something is absurdly wrong.
Acute, or chronic, pain is pain, I broke my back as a child (was moved without a backboard, at school).
For the past 40 years I have suffered with severe lumbar pain and one numb leg.
For 30 of those years I steered clear of any narcotics (they were offered).
The point eventually came where I had no choice, I am still on “low dose” meds (for the past 10 years).
My doctor is so afraid of being “flagged” he refuses to increase my dosage.
A car accident 3 years ago left me with pinched nerves in my neck…… no help from pain meds, same dose.
What is wrong with this picture ?.
Stacks of MRI’s, EMG’s, etc. proving devastating disability and severe pain…… NOBODY CARES.
They are too afraid of the DEA to even offer any feasible help (they are not nearly bedfast due to it either).
Joint pain, nerve pain, arthritis pain and severe muscle spasms…. all supposedly helped by low dose narcotics.
Back off the DEA, if a patient has authentic, proven pain….. allow them a little bit of quality of life.

David Becker

If Dr Mackey and his colleagues in pain care were sincere about public involvement- they wouldnt have waited to this point to make mention of such-where on the AAPM or the APS web page is a publically available petition file. If truth be told the NPS is the result of coordinated efforts by special interest groups from the IASP to pain specialty organizations and their professionalized lay experts to promote a plan that serves the best interest of these groups and not the public. Their is insufficient evidence to support the biopsychocial or interdisciplinary model they promote- on the evidence pyramid- the evidence for their incompletelt theorized paradigm is at the lowest level of evidence.
Their plan is as byzantine as it is self serving. It doesnt account for the preferences for people in pain- need i mention that people in pain were underrepresented on the task force that created the NPS? Soonce again the pain eperts wish to eclude and constructively silence the voices of people in pain.
As there ar no clear benchmarks are goals- it is clear this ill considered and poorly researched plan isnt much different or better then we have today. Furthermore there is bias against treatments like stem cell therapy that might cure pain-after all the pain specialists indicated in the 2011 IOM pain report- they dont believe in cures. I guess there is more money to be made when the health care indstry treats peoples pain for the rest of their lives.