Chronic Pain Is Common, Costly, Poorly Treated
Byline: GUEST VIEWPOINT By Jennifer Wagner and Peter Kosek
Jamie was 22 years old when a drunken driver ran a red light and hit the sport utility vehicle in which she was a passenger, breaking her pelvis.
Now just 35, Jamie has endured years of rehabilitation but still suffers from constant pain in her hip and lower back. The chronic pain affects every aspect of her life: her sleep, her emotions and her ability to exercise and to sit or stand for long periods.
Stories such as Jamie's are common. While her original injury has been treated, the pain continues. Despite the high prevalence and cost of pain, our health care system does not effectively assess and treat chronic pain patients.
As a result, both the under-treatment of pain and the misuse of prescription pain medications are major health crises.
In Lane County, approximately 117,000 of our family, friends and neighbors are affected by pain. Chronic pain reduces the quality of life for millions of people - nearly one-third of Americans - and costs society $560 billion to $635 billion each year in lost productivity and medical treatment.
Evaluating and treating pain is complex. The physical, emotional and cognitive effects can become "chronic pain syndrome," a disease in its own right.
Treatment requires attending to biological as well as emotional and cognitive disturbances. Many patients do not receive the comprehensive, interdisciplinary care that is the most effective therapy for treating chronic pain syndrome and restoring function.
For licensure of medical professionals, the Oregon Legislature mandates only seven contact hours of provider education in the evaluation and treatment of pain. So short a time serves only as an introduction to the treatment of patients with chronic pain. To ensure that patients receive the care they need, additional educational programs for health care professionals, such as the upcoming annual conference of the Western Pain Society, are needed.
Compounding the problems of evaluation and treatment is inadequate insurance coverage.
In Lane County, 23 percent of adults younger than 65 have no health insurance. Patients disabled by pain are even more likely to be uninsured. Many insurance plans do not cover care that is proven to greatly improve patients' lives.
For instance, psychological counseling can prevent serious depression and anxiety resulting from persistent pain. Yet many insurance companies, including the Oregon Health Plan, cap this type of therapy or refuse to recognize pain as a valid diagnosis for mental health care.
It is also imperative that the medical community appreciate that we have by no means exhausted the possibilities for identifying effective pain management therapies. …