Duke Pain Doctor: Surgeon General’s Report Fails To Emphasize The Need For Opioid Alternatives

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Duke Pain Doctor: Surgeon General’s Report Fails To Emphasize The Need For Opioid Alternatives

By Kelly Burch 11/30/16

A pain expert is calling the report to task for not providing specific solutions for millions of pain patients and their doctors.

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Duke Pain Doctor: Surgeon General’s Report Fails To Emphasize The Need For Opioid Alternatives

The Surgeon General’s Report on alcohol, drugs and health, released mid-November, outlines the scope of addiction and calls for much-needed changes in the country’s approach to drug misuse—but according to one pain control expert, it missed one critical step: calling for more research and development of alternative therapies for pain management. 

“There is an inter-relationship between this very overt substance abuse epidemic, which affects more than 20 million people in the U.S. and has a profound impact on the human condition, and the subtler and large covert epidemic of chronic pain,” said Dr. William Maixner, director of the Center for Translational Pain Medicine and Innovative Pain Therapies at Brier Creek, which is part of Duke University’s Department of Anesthesiology.

Maixner continued: “Chronic pain impacts over 100 million Americans, but what it has in common with a huge portion of the substance abuse epidemic is opioids.”

He pointed out that many people start using opioids because they genuinely need to relieve their pain. 

“The exposure that is leading to much of this substance abuse epidemic comes from pain management—well-intended pain management, but pain management where opioids are one of the few outlets many physicians have available,” Maixner said.

Because opioids are so highly addictive, the pharmaceutical and medical industries must seek out new pain management therapies that have a lower risk for abuse and addiction, said Maixner. He was disappointed that the Surgeon General’s report did not specifically mention this. 

“As a pain expert, I had hoped the Surgeon General’s report would present a greater emphasis on the need to develop alternatives to opioids that can be used for pain management, which would eliminate this key pathway to abuse,” he said. “We have a fundamental problem when we are trying to manage pain for the 100 million people who have some form of chronic pain, and opioids are among the few therapies available that work.”

Addiction and drug misuse costs the country about $442 billion a year, according to the Surgeon General’s report. However, pain management is also extremely costly: in fact, the cost of treating chronic pain is higher than the combined costs of treating diabetes, cancer and heart disease. Despite that, research on alternatives to opioids for pain management has been underfunded, Maixner said.

“We spend just 4 cents per pain patient annually on research, while pain patients consume about 15% of health care costs annually," he said. "That’s a big imbalance.”

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.

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