A new study from University of Washington

[Forest]

Hi everyone,

A new study from the University of Washington School of Medicine says that 'the missing P' in Pain Management is Psychiatry.

Some quotes from the article:

Psychiatric disorders, especially substance abuse, depression and PTSD (post-traumatic stress disorder) are highly prevalent in patients with CNCP (chronic non-cancer pain). Patients with these substance use and mental health diagnoses are more likely to receive long-term opioid therapy for their pain, at higher doses, and with concurrent sedatives,” Howe and Sullivan wrote, adding that there is “scant evidence” of any long-term benefit from opioid use and that mental health problems may actually make the drugs less effective.

What these patients really need is psychiatric care instead of the de facto treatment of opioids,” Howe explained. “When psychiatric services aren’t available, patients often end up on opioid therapy because the drugs numb the emotional pain as well as providing temporary relief for physical pain.

The complete article can be found here:
http://americannewsreport.com/nationalpainreport/missing-p-pain-management-8822370.html

Thoughts?

 

[yb44]

My first thought is rather cynical. Will this study be disregarded and chucked onto a back shelf? I would like to see opioids used in the same way my GP prescribes antibiotics - with caution, only when absolutely essential and for finite periods of time. I feel anxious when I read about these drugs being used with other drugs and especially for those who are substance abusers. I had a cousin who was constantly running to different doctors, having various surgeries/procedures and taking any drug on offer. She ended up on a drug regime equivalent to someone in the fourth stage of cancer despite there being nothing physically wrong with her. Her parents paid for her to go to a rehab facility at one point but she discharged herself after a week. My cousin always managed to find a doctor that would take her money and give her yet another prescription. At the age of 53 she was prescribed two or possibly more drugs by different doctors. Sadly the combination killed her. So from a less cynical standpoint, I hope the medical establishment takes note of this study and makes some radical changes in the way it cares for people with CNCP.

 

[Ellen]

There are some good conclusions in the report. However, I'm concerned when I see chronic pain referred to as a psychiatric condition that people will immediately assume that this means the pain is "all in their head". Additionally, I worry when pain is linked with inappropriate use of drugs that it perpetuates the concept of people with chronic pain getting some kind of secondary gain (i.e. pain medicine prescriptions) from their pain. Many of us who suffered from TMS for many years found these attitudes rampant among healthcare professionals, as well as family, friends, and the general public. It wasn't until I encountered the concept of TMS from Schubiner and Sarno that I felt validated that my pain was real, that there was a physical mechanism involved in it's creation, and that the pain's purpose was for primary gain and not secondary gain. And finally, I'm concerned that when people with chronic pain are referred to psychiatrists for treatment, that the majority of those psychiatrists don't have a clue how to treat TMS.

I know I just preached to the choir here