Millions of Americans in Pain Without Meds

Millions of Americans are showing up at pharmacies, in pain but without prescriptions, as physicians — fearful of drug abuse — hesitate to prescribe pain medications, according to two recent reports.

The issue is reaching "crisis proportions," says Katherine Hahn, a pharmacist and chair of the Oregon Pain Management Commission, who argues that health consumers must be aware of the problem and become more informed, persistent advocates for the care they need.

"Many people suffer needlessly with pain that could be treated, and almost 80 percent of visits to community pharmacies involve pain issues," said Hahn,  lead author of the research articles. "We're in the middle of a storm here, and have to figure out some way to navigate through it."

At least 30 percent of patients with moderate chronic pain and more than 50 percent with severe pain fail to achieve adequate relief, Hahn said. In these and earlier works, Hahn suggests the shortcomings are due to inadequate physician training, personal biases, and doctors' fears of prescription drug abuse.

For instance, people in pain generally visit general practitioners who are not rigorously trained in treating these cases.

"It's daunting if you're given a hammer and a nail to build something that requires a screwdriver," said Dr. Charles Argoff, board certified in neurology and pain management and a practitioner at Albany Medical Center.

Argoff, who was not involved in the current studies, pointed out that there are many different avenues to treat pain, including massage, opioids and behavioral therapy, so a short course can't possibly teach each of them. "Nobody could leave medical school without learning how to read an EKG, so why should they leave without a basic understanding of pain management?"

Not only that, Argoff said that inadequate medical training leads to "irrational fears" that pain meds will be abused, and a bias that all pain patients are drug abusers.  "Any medication can be misused or abused," he told LiveScience. "It doesn't have to be a pain medication."

But abuse of pain meds does seem rampant: Admissions to federally supported treatment programs for prescription opioid abuse more than tripled from 1996 to 2006, costing insurance companies tens of billions of dollars a year, according to Hahn's research, which is published in the Journal of Pain and Palliative Care Pharmacotherapy and The Rx Consultant.

To help safely manage your pain, Hahn suggests finding a doctor that trusts your judgment of your discomfort, and someone who has the knowledge — and is willing — to explore a number of pain relief plans. She also believes it's just as important to select the right pharmacist. Look for one who will negotiate insurance issues and watch out for drug interactions, as well as stay up-to-date on the latest medicines that might treat your condition.

Though keep in mind, says Argoff, that despite the technological advances in therapies over the last decade,  even the best treatment may not rid you of all your pain.

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