Difference between revisions of "Expand & Enhance Chronic Pain Prevention & Management"
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| − | + | Brief Description | |
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| − | = | + | = Introductory Paragraph = |
| − | + | Chronic pain occurs when pain last for longer than 3 months.<ref>Pain Management: Treatment Overview. (n.d.). Retrieved November 24, 2019, from WebMD website: https://www.webmd.com/pain-management/guide/pain-management-treatment-overview</ref><br/> Pain affects more Americans than diabetes, heart disease and cancer combined.<ref>Yesterday, Today & Tomorrow: NIH Research Timelines. (n.d.). Retrieved November 24, 2019, from https://archives.nih.gov/asites/report/09-09-2019/report.nih.gov/nihfactsheets/index.html</ref><br/> 25.3 million American adults suffer from daily pain.<ref>Nahin, Richard L. “Estimates of Pain Prevalence and Severity in Adults: United States, 2012.” The journal of pain : official journal of the American Pain Society 16.8 (2015): 769–780. PMC. Web. 27 Jan. 2017</ref><br/> 23.4 million American adults report a lot of pain.<ref> Nahin, Richard L. “Estimates of Pain Prevalence and Severity in Adults: United States, 2012.” The journal of pain : official journal of the American Pain Society 16.8 (2015): 769–780. PMC. Web. 27 Jan. 2017. | |
| + | </ref><br/> 14.4 million American adults suffer the highest level of pain, category 4.<ref> Nahin, Richard L. “Estimates of Pain Prevalence and Severity in Adults: United States, 2012.” The journal of pain : official journal of the American Pain Society 16.8 (2015): 769–780. PMC. Web. 27 Jan. 2017 | ||
| + | </ref><br/> Today, chronic pain is the most common cause of long-term disability in the U.S.<ref>Yesterday, Today & Tomorrow: NIH Research Timelines. (n.d.). Retrieved November 24, 2019, from https://archives.nih.gov/asites/report/09-09-2019/report.nih.gov/nihfactsheets/index.html</ref><br/> Chronic Pain and Opioid Use Among Seniors | ||
| − | = | + | = Key Information = |
| − | + | Chronic pain is the primary reason seniors are prescribed opioids -- and use of opioids has many negatives for seniors.<ref>How the Opioid Crisis Affects the Elderly | Updated for 2019. (2018, September 4). Retrieved November 24, 2019, from AgingInPlace.org website: https://www.aginginplace.org/how-the-opioid-crisis-affects-the-elderly/</ref> | |
| − | + | '''Risk factors'''<br/> for chronic pain include: | |
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| − | < | + | *genetics - heritability accounts for 38.4% of the variation in chronic pain risks.<ref>Genetic and environmental risk factors for chronic pain. (n.d.). Retrieved November 24, 2019, from ScienceDaily website: https://www.sciencedaily.com/releases/2016/08/160816151850.htm</ref> |
| + | *female gender<ref>Hecke, O. van, Torrance, N., & Smith, B. H. (2013). Chronic pain epidemiology and its clinical relevance. British Journal of Anaesthesia, 111(1), 13–18. https://doi.org/10.1093/bja/aet123</ref> | ||
| + | *older age<ref>https://www.ncbi.nlm.nih.gov/books/NBK92516/</ref> | ||
| + | *race and ethnicity<ref>Institute of Medicine (US) Committee on Advancing Pain Research, C. (2011). Pain as a Public Health Challenge. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK92516/</ref> | ||
| + | *being a military veteran<ref>]O. van Hecke, N. Torrance, B. H. Smith; Chronic pain epidemiology and its clinical relevance. Br J Anaesth 2013; 111 (1): 13-18. doi: 10.1093/bja/aet123</ref> | ||
| + | *low socioeconomic status<ref>O. van Hecke, N. Torrance, B. H. Smith; Chronic pain epidemiology and its clinical relevance. Br J Anaesth 2013; 111 (1): 13-18. doi: 10.1093/bja/aet123</ref> | ||
| + | *employment status and occupational factors<ref>O. van Hecke, N. Torrance, B. H. Smith; Chronic pain epidemiology and its clinical relevance. Br J Anaesth 2013; 111 (1): 13-18. doi: 10.1093/bja/aet123</ref> | ||
| + | *history of abuse or interpersonal violence | ||
| + | *anxiety and depression<ref>Pain Management: Treatment Overview. (n.d.). Retrieved November 24, 2019, from WebMD website: https://www.webmd.com/pain-management/guide/pain-management-treatment-overview</ref> | ||
| + | *existing health problems - fibromyalgia, shingles, arthritis, a weakened immune system<ref>https://www.webmd.com/pain-management/guide/pain-management-treatment-overview</ref> | ||
| + | *lifestyle - not eating health, not exercising regularly, smoking, or having a drug or alcohol problem<ref>McGreevy, Kai, Michael M. Bottros, and Srinivasa N. Raja. “Preventing Chronic Pain Following Acute Pain: Risk Factors, Preventive Strategies, and Their Efficacy.” European journal of pain supplements 5.2 (2011): 365–372. PMC. Web. 27 Jan. 2017.</ref> | ||
| + | *previous surgery<ref>Millions of Patients Face Pain and Withdrawal as Opioid Prescriptions Plummet. (2017, November 21). Bloomberg.Com. Retrieved from https://www.bloomberg.com/news/articles/2017-11-21/millions-of-patients-face-pain-and-withdrawal-as-opioid-prescriptions-plummet</ref><br/> | ||
| − | + | '''Managing Chronic Pain'''<br/> 8 Million Americans are on long-term opioid therapy for chronic pain<ref>Millions of Patients Face Pain and Withdrawal as Opioid Prescriptions Plummet. (2017, November 21). Bloomberg.Com. Retrieved from https://www.bloomberg.com/news/articles/2017-11-21/millions-of-patients-face-pain-and-withdrawal-as-opioid-prescriptions-plummet</ref><br/> 1 million are taking dangerously high doses<ref>Genetic study defies “one-size-fits-all” approach to prescribing opioids for chronic pain. (n.d.). Retrieved November 24, 2019, from https://medicalxpress.com/news/2017-12-genetic-defies-one-size-fits-all-approach-opioids.html</ref><br/> <br/> The dilemma: how to provide the most effective pain treatment for 80 percent of pain patients who are at least risk for opioid addiction while causing the least harm to the remaining 20 percent who are at most risk of developing OUD<ref>Millions of Patients Face Pain and Withdrawal as Opioid Prescriptions Plummet. (2017, November 21). Bloomberg.Com. Retrieved from https://www.bloomberg.com/news/articles/2017-11-21/millions-of-patients-face-pain-and-withdrawal-as-opioid-prescriptions-plummet</ref><br/> <br/> Experts say chronic pain sufferers on high doses aren’t necessarily addicts, at least not the sort who would resort to buying drugs on the street. With most medical and government resources focused on treatment for more obvious drug abusers, few formal programs exist to help patients dependent on opioids. | |
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| − | + | Experts who have studied opioid dependence say that, in some cases, it’s too risky to reduce doses until complex psychological problems are under control.<ref>National Pain Strategy Overview | Interagency Pain Research Coordinating Committee. (n.d.). Retrieved November 24, 2019, from https://www.iprcc.nih.gov/National-Pain-Strategy/Overview</ref><br/> <br/> '''Current Status'''<br/> Expanding and improving pain prevention programs is a hot topic among public health officials. In March 2016, the National Institute of Health released its National Pain Strategy that outlines the federal government's first coordinated plan to address America's pain crisis.[26] One of the cornerstones of the strategy is the prevention of chronic pain.<ref>Injury and Illness Prevention Programs—Frequently Asked Questions. (n.d.). Retrieved November 24, 2019, from https://www.osha.gov/dsg/InjuryIllnessPreventionProgramsWhitePaper.html</ref> | |
| − | + | = Relevant Research = | |
| − | < | + | The DiscovEHR Project<br/> A researcher from Florida Atlantic University's Charles E. Schmidt College of Medicine has received a five-year, $4 million grant from the National Institutes of Health to help solve the "one-size-fits-all" approach to prescribing opioids for chronic pain. Because of the high heritability, finding the genetic predictors of prescription opioid use disorder is more critical than ever. Currently, little data exists on clinical characteristics and genetic variants that confer risk for opioid use disorder. |
| − | + | In the novel study, researchers will assess clinical and genetic characteristics of a large patient cohort suffering from chronic musculoskeletal pain and receiving prescription opioids. As part of the project, researchers will leverage data from Geisinger's central biorepository and electronic health record (EHR) database to conduct large-scale genomics research and phenotype development. | |
| − | + | With the genetic information, the multidisciplinary team will derive a clinical and genetic profile of prescription opioid-use disorder and apply the knowledge to develop an "addiction risk score." Researchers hope the findings from this study will enable clinicians to identify those who are at low-risk for opioid use disorder from those who are at high-risk and require additional counseling and access to alternative treatment options. | |
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| − | + | The genome-wide association study will help the researchers determine if there is a particular subset of genes and genetic variants that are influencing susceptibility to becoming addicted to prescription opioids. Once they are able to generate the hypothesis that a genetic variant is responsible for increasing risk, the next steps will involve proving causation. Ultimately, the researchers hope their work will be used to help empower patients so that they understand their susceptibility to risks and can make informed health care decisions.[32] | |
| − | + | = Impactful Federal, State, and Local Policies = | |
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| − | + | Please list any federal, state, or local laws, policies, or regulations that support this topic or ones that could be a possible barrier. Are there laws or policies other states should know about and replicate for success? | |
| − | + | = Available Tools and Resources = | |
| − | + | Oftentimes, there are already great resources in the field that have been developed, but they are not housed in a single place. Please use this section to share information about those resources and drive the reader to that resource. It may be a worksheet, toolkit, fact sheet, framework/model, infographic, new technology, etc. I suggest no more than 5 really good links and a corresponding description for the reader. We also can use this section to highlight some of the great resources and programs at SAFE Project. | |
| − | + | = Promising Practices = | |
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| − | + | Please link to any best practice models or case studies that highlight creative/innovative or successful efforts in support of this strategy. Is there a community that does a really good job in this area that other communities should replicate? Please write a brief description and provide a link. | |
= Sources = | = Sources = | ||
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Revision as of 16:30, 20 September 2021
Return to ...
Brief Description
Contents
Introductory Paragraph
Chronic pain occurs when pain last for longer than 3 months.[1]
Pain affects more Americans than diabetes, heart disease and cancer combined.[2]
25.3 million American adults suffer from daily pain.[3]
23.4 million American adults report a lot of pain.[4]
14.4 million American adults suffer the highest level of pain, category 4.[5]
Today, chronic pain is the most common cause of long-term disability in the U.S.[6]
Chronic Pain and Opioid Use Among Seniors
Key Information
Chronic pain is the primary reason seniors are prescribed opioids -- and use of opioids has many negatives for seniors.[7]
Risk factors
for chronic pain include:
- genetics - heritability accounts for 38.4% of the variation in chronic pain risks.[8]
- female gender[9]
- older age[10]
- race and ethnicity[11]
- being a military veteran[12]
- low socioeconomic status[13]
- employment status and occupational factors[14]
- history of abuse or interpersonal violence
- anxiety and depression[15]
- existing health problems - fibromyalgia, shingles, arthritis, a weakened immune system[16]
- lifestyle - not eating health, not exercising regularly, smoking, or having a drug or alcohol problem[17]
- previous surgery[18]
Managing Chronic Pain
8 Million Americans are on long-term opioid therapy for chronic pain[19]
1 million are taking dangerously high doses[20]
The dilemma: how to provide the most effective pain treatment for 80 percent of pain patients who are at least risk for opioid addiction while causing the least harm to the remaining 20 percent who are at most risk of developing OUD[21]
Experts say chronic pain sufferers on high doses aren’t necessarily addicts, at least not the sort who would resort to buying drugs on the street. With most medical and government resources focused on treatment for more obvious drug abusers, few formal programs exist to help patients dependent on opioids.
Experts who have studied opioid dependence say that, in some cases, it’s too risky to reduce doses until complex psychological problems are under control.[22]
Current Status
Expanding and improving pain prevention programs is a hot topic among public health officials. In March 2016, the National Institute of Health released its National Pain Strategy that outlines the federal government's first coordinated plan to address America's pain crisis.[26] One of the cornerstones of the strategy is the prevention of chronic pain.[23]
Relevant Research
The DiscovEHR Project
A researcher from Florida Atlantic University's Charles E. Schmidt College of Medicine has received a five-year, $4 million grant from the National Institutes of Health to help solve the "one-size-fits-all" approach to prescribing opioids for chronic pain. Because of the high heritability, finding the genetic predictors of prescription opioid use disorder is more critical than ever. Currently, little data exists on clinical characteristics and genetic variants that confer risk for opioid use disorder.
In the novel study, researchers will assess clinical and genetic characteristics of a large patient cohort suffering from chronic musculoskeletal pain and receiving prescription opioids. As part of the project, researchers will leverage data from Geisinger's central biorepository and electronic health record (EHR) database to conduct large-scale genomics research and phenotype development.
With the genetic information, the multidisciplinary team will derive a clinical and genetic profile of prescription opioid-use disorder and apply the knowledge to develop an "addiction risk score." Researchers hope the findings from this study will enable clinicians to identify those who are at low-risk for opioid use disorder from those who are at high-risk and require additional counseling and access to alternative treatment options.
The genome-wide association study will help the researchers determine if there is a particular subset of genes and genetic variants that are influencing susceptibility to becoming addicted to prescription opioids. Once they are able to generate the hypothesis that a genetic variant is responsible for increasing risk, the next steps will involve proving causation. Ultimately, the researchers hope their work will be used to help empower patients so that they understand their susceptibility to risks and can make informed health care decisions.[32]
Impactful Federal, State, and Local Policies
Please list any federal, state, or local laws, policies, or regulations that support this topic or ones that could be a possible barrier. Are there laws or policies other states should know about and replicate for success?
Available Tools and Resources
Oftentimes, there are already great resources in the field that have been developed, but they are not housed in a single place. Please use this section to share information about those resources and drive the reader to that resource. It may be a worksheet, toolkit, fact sheet, framework/model, infographic, new technology, etc. I suggest no more than 5 really good links and a corresponding description for the reader. We also can use this section to highlight some of the great resources and programs at SAFE Project.
Promising Practices
Please link to any best practice models or case studies that highlight creative/innovative or successful efforts in support of this strategy. Is there a community that does a really good job in this area that other communities should replicate? Please write a brief description and provide a link.
Sources
- ^ Pain Management: Treatment Overview. (n.d.). Retrieved November 24, 2019, from WebMD website: https://www.webmd.com/pain-management/guide/pain-management-treatment-overview
- ^ Yesterday, Today & Tomorrow: NIH Research Timelines. (n.d.). Retrieved November 24, 2019, from https://archives.nih.gov/asites/report/09-09-2019/report.nih.gov/nihfactsheets/index.html
- ^ Nahin, Richard L. “Estimates of Pain Prevalence and Severity in Adults: United States, 2012.” The journal of pain : official journal of the American Pain Society 16.8 (2015): 769–780. PMC. Web. 27 Jan. 2017
- ^ Nahin, Richard L. “Estimates of Pain Prevalence and Severity in Adults: United States, 2012.” The journal of pain : official journal of the American Pain Society 16.8 (2015): 769–780. PMC. Web. 27 Jan. 2017.
- ^ Nahin, Richard L. “Estimates of Pain Prevalence and Severity in Adults: United States, 2012.” The journal of pain : official journal of the American Pain Society 16.8 (2015): 769–780. PMC. Web. 27 Jan. 2017
- ^ Yesterday, Today & Tomorrow: NIH Research Timelines. (n.d.). Retrieved November 24, 2019, from https://archives.nih.gov/asites/report/09-09-2019/report.nih.gov/nihfactsheets/index.html
- ^ How the Opioid Crisis Affects the Elderly | Updated for 2019. (2018, September 4). Retrieved November 24, 2019, from AgingInPlace.org website: https://www.aginginplace.org/how-the-opioid-crisis-affects-the-elderly/
- ^ Genetic and environmental risk factors for chronic pain. (n.d.). Retrieved November 24, 2019, from ScienceDaily website: https://www.sciencedaily.com/releases/2016/08/160816151850.htm
- ^ Hecke, O. van, Torrance, N., & Smith, B. H. (2013). Chronic pain epidemiology and its clinical relevance. British Journal of Anaesthesia, 111(1), 13–18. https://doi.org/10.1093/bja/aet123
- ^ https://www.ncbi.nlm.nih.gov/books/NBK92516/
- ^ Institute of Medicine (US) Committee on Advancing Pain Research, C. (2011). Pain as a Public Health Challenge. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK92516/
- ^ ]O. van Hecke, N. Torrance, B. H. Smith; Chronic pain epidemiology and its clinical relevance. Br J Anaesth 2013; 111 (1): 13-18. doi: 10.1093/bja/aet123
- ^ O. van Hecke, N. Torrance, B. H. Smith; Chronic pain epidemiology and its clinical relevance. Br J Anaesth 2013; 111 (1): 13-18. doi: 10.1093/bja/aet123
- ^ O. van Hecke, N. Torrance, B. H. Smith; Chronic pain epidemiology and its clinical relevance. Br J Anaesth 2013; 111 (1): 13-18. doi: 10.1093/bja/aet123
- ^ Pain Management: Treatment Overview. (n.d.). Retrieved November 24, 2019, from WebMD website: https://www.webmd.com/pain-management/guide/pain-management-treatment-overview
- ^ https://www.webmd.com/pain-management/guide/pain-management-treatment-overview
- ^ McGreevy, Kai, Michael M. Bottros, and Srinivasa N. Raja. “Preventing Chronic Pain Following Acute Pain: Risk Factors, Preventive Strategies, and Their Efficacy.” European journal of pain supplements 5.2 (2011): 365–372. PMC. Web. 27 Jan. 2017.
- ^ Millions of Patients Face Pain and Withdrawal as Opioid Prescriptions Plummet. (2017, November 21). Bloomberg.Com. Retrieved from https://www.bloomberg.com/news/articles/2017-11-21/millions-of-patients-face-pain-and-withdrawal-as-opioid-prescriptions-plummet
- ^ Millions of Patients Face Pain and Withdrawal as Opioid Prescriptions Plummet. (2017, November 21). Bloomberg.Com. Retrieved from https://www.bloomberg.com/news/articles/2017-11-21/millions-of-patients-face-pain-and-withdrawal-as-opioid-prescriptions-plummet
- ^ Genetic study defies “one-size-fits-all” approach to prescribing opioids for chronic pain. (n.d.). Retrieved November 24, 2019, from https://medicalxpress.com/news/2017-12-genetic-defies-one-size-fits-all-approach-opioids.html
- ^ Millions of Patients Face Pain and Withdrawal as Opioid Prescriptions Plummet. (2017, November 21). Bloomberg.Com. Retrieved from https://www.bloomberg.com/news/articles/2017-11-21/millions-of-patients-face-pain-and-withdrawal-as-opioid-prescriptions-plummet
- ^ National Pain Strategy Overview | Interagency Pain Research Coordinating Committee. (n.d.). Retrieved November 24, 2019, from https://www.iprcc.nih.gov/National-Pain-Strategy/Overview
- ^ Injury and Illness Prevention Programs—Frequently Asked Questions. (n.d.). Retrieved November 24, 2019, from https://www.osha.gov/dsg/InjuryIllnessPreventionProgramsWhitePaper.html
