It costs more than heart disease, cancer and diabetes.
It may be the most pervasive epidemic in American history – affecting at least 116 million US adults – almost four in 10 – and costing as much as $635 billion a year, an estimate that may be extremely low because it does not include children and members of the US military.
Chronic pain is defined as pain that lasts more than several months. It is a hard-to-diagnose-and-treat but highly common condition that demands a much more comprehensive strategy for dealing with lost productivity and skyrocketing healthcare costs, according to a report from the Institute of Medicine (IOM) release in late June 2011. For many patients, the condition is complicated by the fact that many physicians see it as a less than legitimate condition.
Chronic pain commonly sets in after other illnesses, injuries and medical treatments; remains difficult for physicians to diagnose; is often self-treated and is too often greeted with skepticism (and ridicule) by patients’ physicians and family members.
“Many health care professionals are not adequately prepared to provide the full range of pain care or to guide patients in self-managing chronic pain,” IOM researchers wrote in the report mandated by Congress through the 2010 US healthcare overhaul.
The IOM researchers also excluded costs associated with pain in children and members of the US military – making the estimate conservative; and the federal Medicare program bears approximately one-quarter of the expense, the report said. Lower back pain is the most commonly reported pain in the US, followed by knee pain, severe headaches (migraines) and neck pain. As a result, many sufferers resort to painkillers, including morphine and oxycodone and other opioids. In 2007 more than 33 million people abused opioids, resulting in more overdose deaths than heroin and cocaine combined, according to the latest government data.
“It’s a conundrum of opioids,” according to Noreen Clark, vice chair of the IOM committee that organized the study. “There are people who really need access to pharmaceuticals to manage their pain and there are some who abuse the pharmaceutics, but the abusers are a very, very small proportion of those who need but don’t have access to the treatment.”
According to one study cited in the IOM report, only five of 133 US medical schools have course on pain and 17 have elective courses.
“Chronic pain is real pain and too often can be indescribably debilitating,” notes Francis J. Flynn, Psy.D., clinical director of the Brain Training Centers of Florida. “Ultimately, there are almost as many underlying causes as there are individuals living and dealing with chronic pain. And there is no one-size-fits-all solution. However, we encourage many individuals with chronic pain– especially after significant physical trauma.”
Flynn has special empathy for chronic pain sufferers. An automobile accident resulted in bilateral temporal mandibular joint dislocations, two years of debilitating pain and headaches, and three surgeries before final relief. “I consulted more than a dozen physicians and was repeatedly told it was all in my head. And the problem was all in my head – actually all in my jaw. In my case, the problem was genuinely mechanical – my jaw joints were dislocated. However, for many patients with chronic pain the on-going problem results from the brain’s habituated response to a very real, original problem. By breaking the brain’s habituated response patterns, we can allow patients relief from this kind of pain without the use of medications.
“We encourage chronic pain sufferers to explore every possible avenue of relief. And, before considering radical surgery, we encourage individuals to consider a non-invasive alternative that allows the brain to re-find and re-establish healthier ways of functioning,” notes Flynn.
Chronic pain costs U.S. up to $635 billion a year
By Alina Selyukh | Reuters – Wed, Jun 29, 2011
WASHINGTON (Reuters) – Addressing chronic pain, a hard-to-treat yet highly common condition, costs the United States as much as $635 billion a year and requires a much more comprehensive strategy for curbing lost productivity and healthcare expenses, according to a new government report.
At least 116 million U.S. adults — or about four in 10 — suffer from chronic pain every year, leading to extra sick days, lost wages and productivity, the Institute of Medicine (IOM) said on Wednesday.
Chronic pain is defined as pain that lasts more than several months. It remains hard for doctors to diagnose, is often self-treated by patients and commonly perceived as less than a legitimate condition.
“Many health care professionals are not adequately prepared to provide the full range of pain care or to guide patients in self-managing chronic pain,” IOM researchers wrote in the report mandated by Congress through the 2010 U.S. healthcare overhaul.
The IOM report excluded costs associated with pain in children or members of the U.S. military, making the estimate conservative and yet higher than economic costs of heart disease, cancer and diabetes, according to its researchers. The federal Medicare program takes the brunt of the medical costs of pain, bearing a quarter of expenditures, the report said.
Chronic pain commonly sets in after other illnesses, injuries and medical treatments. Similar to that, acute pain — also addressed in the report — is a sudden, short-lived kind of pain, but can be a recurrent and equally complex problem.
Pain in the lower back is the most commonly reported pain in the United States, followed by knee pain, severe headaches or migraines and neck pain.
Looking for ways to manage pain, many sufferers resort to painkillers, including prescription opioids such as morphine and oxycodone. More than 33 million people abused opioids in 2007, resulting in more overdose deaths than heroin and cocaine combined, according to the latest government data.
“It’s a conundrum of opioids,” said Noreen Clark, vice chair of the IOM committee that organized the study. “There are people who really need access to pharmaceuticals to manage their pain and there are some who abuse the pharmaceuticals, but the abusers are a very-very small proportion of those who need but don’t have access to the treatment.”
Drugmakers including Pfizer Inc have been developing painkillers that are tamper-resistant to prevent abuse, including pills that make it difficult to snort or inject the drugs.
IOM’s report urges more professional education as well as more data collection and research into the phenomenon of chronic pain, in part to get rid of various social stigmas associated with pain as a disease.
The call comes a day after the American Society of Interventional Pain Physicians lobbied Congress to pass a bill that would require physicians to go through special training before prescribing painkillers.
Citing a recent study, IOM said only five of 133 U.S. medical schools have required courses on pain and 17 have elective courses.
The IOM report also calls on federal and state insurance programs, Medicare and Medicaid, together with private health plans and workers’ compensation programs to address lags in pain care coverage.
(Editing by Michele Gershberg, Dave Zimmerman)