There is a special report from the online journal STAT that reviews the dimensions of the crisis in opioid prescribing for patients with chronic pain. While not breaking new ground in the discussion, the report offers a succinct roundup of the different points of view on this issue of central importance to frontline practitioners today. PAINWeek participants will recognize several of our longtime faculty presenters who were interviewed for the report. Past PAINWeek faculty member Daniel B. Carr, MD, FABPM, puts it this way: “There’s a civil war in the pain community. One group believes the primary goal of pain treatment is curtailing opioid prescribing. The other group looks at the disability, the human suffering, the expense of chronic pain.”
Another PAINWeek contributor, Sean Mackey, MD, PhD, Chief of the Division of Pain Medicine at Stanford University, comments, “There’s almost a McCarthyism on this, that’s silencing so many people who are simply scared. The thing is, we all want black and white. We don’t do well with nuance. And this is an incredibly nuanced issue.” Confounding our ability to decipher the nuance, the report notes, is the dearth of conclusive evidence on the risks and benefits of long term opioid therapy. And the perspective of pain patients often gets lost in the debate. Migraine sufferer Thomas Yacoe notes, “What people forget is, those who end up on opioid pain management have usually tried everything else unsuccessfully.”
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