Wanted to share some personal thoughts today.

I’ve been speaking with pain patients (our readers) a little more often these days, mostly via phone. Didn’t plan it that way. It has sort of happened.

Let me share a couple of conversations that sum the two basic themes I’ve been hearing.

First, there’s a patient—let’s call her Susan—who has a story that we hear way too often. She’s been a chronic pain patient for over a decade and has other issues—in her case diabetes and cardiac issues.

Access to her pain medication is an issue ongoing. She fired her pain physician for indifference. Her primary care physician, she says, is sympathetic but gun shy and when she gets a prescription, it’s often at less the dosage than she has historically been prescribed.

For Susan it’s all about getting her medication—she’s disabled—and her desperation is palpable. She is appealing—she admits often just arguing—with her hospital about her treatment or lack of it. She doesn’t have many alternatives, she’s trying to generate some media coverage to shed some light on pain patients being the collateral damage in the “opioid crackdown”, but has a hard time getting their attention.

“What am I going to do?” she asked.

A second patient—let’s call him Bill—is concerned that the opioid issue is overwhelming the bigger issue for him and others I’ve spoken to—that for many pain patients access to other therapies that insurance covers—from physical therapy to mental health to virtual reality—need to be more actively promoted.

“The public discussion about the treatment of chronic pain has to broaden beyond just opioid prescribing,” he said. “I am very sympathetic to those who are being denied their medicine, but the overall treatment of chronic pain simply has to get better.”

If we have learned one thing in the years that we’ve been here at the National Pain Report is that the treatment of pain is not a one size fits all treatment.

It’s more of an “all of the above” approach.

Do patients need more access to opioid pain medication?

Yes.

Should other therapies beyond opioid medication be promoted and prescribed?

Yes.

Until the pain community (patients, providers, insurers) realizes that these aren’t competing thoughts—but rather go together—I’m afraid we are going to lose more of our people and condemn even more to long-term suffering.

It’s a time for the pain community to speak with one voice.

How do we do that?

That’s the challenge.

Would appreciate your thoughts.

Will share the interesting ones in future columns.

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