Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Pain care must be patient-centered, integrated, and individualized

Jianguo Cheng, MD, PhD
Conditions
September 5, 2018
Share
Tweet
Share

Purdue Pharma recently ran a full-page advertisement in the Wall Street Journal and the Washington Post asserting that the company, which manufactures prescription opioids, wants to limit the use of prescription opioids. While this ad may have left some readers confused, one point rang true: “we believe the country needs a new approach to prescribing opioids.”

In its approach to addressing the opioid crisis, Purdue Pharma is encouraging limiting patient access to various treatment options, including limiting exposure to opioids.  The ad stated that Purdue Pharma will no longer promote opioids as an option for pain treatment to prescribers. Instead, the company calls for access to multi-modal and non-pharmacologic options — which are two treatment options that the American Academy of Pain Medicine supports as solutions to addressing this widespread issue.

As the professional society representing the nation’s doctors, nurses, researchers, and other clinicians who are tasked with treating pain, we could not agree more with Purdue Pharma’s statement that we need a new approach to prescribing opioids. To achieve a new approach, however, will require the society to rectify the misconception that treating pain equals prescribing opioids. In fact, there are many treatment modalities in pain management, including non-pharmacological (physical, behavioral, cognitive), pharmacological (non-opioid and opioids), interventional (nerve blocks, ablations, and modulations), surgical, and complementary and alternative treatment. This approach to pain is termed multimodal pain care. In cases where patients have failed to respond to non-opioid therapy but responded well to opioid medications with improved quality of life and better functions, opioid therapy may be appropriate and necessary.

The key is that pain care must be patient-centered, integrated, and individualized. Just as the causes of pain are vastly variable, the ways to treat pain must be tailored to individual patient’s need.  To meet the patients’ need requires accurate assessment and correct diagnosis of each patient’s pain condition, which may be a symptom caused by another disorder or a disease in its own right. Limiting opioid prescription arbitrarily to no more than seven days may not serve the patients’ needs, particularly for those who have severe pain after major surgeries, those with sickle cell disease, those with cancers, and those who have been on chronic opioid therapy for years with significant therapeutic benefit and without adverse effects.

With a sustained national opioid crisis, it is imperative that clinicians are prepared to address and diagnosis proper pain treatment depending on their patient’s needs. There is, however, another critical concern with current approach to pain management, the lack of proper pain management training for medical students. One hundred million people suffer from pain in the U.S., yet, per the Association of American Medical Colleges, there are fewer than 5,000 doctors specializing in pain. The journal Pain Medicine recently covered the gaps in how we train and test our medical students and found that while pain is the most common reason patients seek for care, appropriate management of pain is poorly taught in medical school curriculum and rarely tested in medical licensing examinations. Many students, residents, and educators find the current training landscape for chronic pain management to be inadequate. To begin altering our approach to prescribing opioids, we must start making changes at the foundation of medical training with proper education, certification, courses, and prioritization of pain management.

The future of patient care must be evidence-guided, integrated, and personalized in nature. This is especially true for pain care, and it will require more education options, and physicians, for the public to overcome stigma around pain, opioids, and addiction and for clinicians to help them treat patients smarter and better.

Jianguo Cheng is president, American Academy of Pain Medicine.

Image credit: Shutterstock.com

Prev

It's time for hospitalists to be engaged with opioid use disorders

September 5, 2018 Kevin 1
…
Next

Women in medicine: Are we leading yet?

September 5, 2018 Kevin 1
…

Tagged as: Medications, Pain Management, Public Health & Policy

Post navigation

< Previous Post
It's time for hospitalists to be engaged with opioid use disorders
Next Post >
Women in medicine: Are we leading yet?

ADVERTISEMENT

Related Posts

  • The impact of panels early in medical school on informing patient-centered care

    Sangrag Ganguli and Varun Mehta
  • A radically patient-centered proposal to fix health care in America

    W. Ryan Neuhofel, DO, MPH
  • The patient who reminded this student to care for everyone equally

    Natasha Mathur
  • More physician responsibility for patient care

    Michael R. McGuire
  • The ultimate in patient empowerment: advance care planning

    Patricia McTiernan
  • Blame the pain, not the opioids

    Angelika Byczkowski

More in Conditions

  • How President Biden’s cognitive health shapes political and legal trust

    Muhamad Aly Rifai, MD
  • The emotional first responders of aesthetic medicine

    Sarah White, APRN
  • Why testosterone matters more than you think in women’s health

    Andrea Caamano, MD
  • How veteran health care is being transformed by tech and teamwork

    Deborah Lafer Scher
  • What Elon Musk and Diddy reveal about the price of power

    Osmund Agbo, MD
  • Understanding depression beyond biology: the power of therapy and meaning

    Maire Daugharty, MD
  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 15 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Pain care must be patient-centered, integrated, and individualized
15 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...