Pain Treatment Teams a Great Alternative to Pain Medication

With up to 15 percent of the US population reporting chronic pain and as many as five percent needed strong painkillers such as Vicodin just to get through the day, it’s no wonder that instances of prescription drug addiction are increasing rapidly. But a new study suggests that rather than simply prescribe addictive pain medication, doctors can better help people with chronic pain if they have a ‘pain team’ approach that includes visits with a psychologist.

In the study, Dr. Steven K. Dobscha, of Portland VA Medical Center in Oregon, looked at 401 people with an average age of 61-62 who were in pain for at least three months (excluding chronic fatigue syndrome and fibromyalgia). The subjects had chronic pain due to arthritis, a bad back, or neck and joint pain that sometimes had been present for years, and many also had other physical and mental health problems such as depression or post-traumatic stress disorder.

The patients and their primary care doctors were randomly assigned to either a collaborative-care group or a standard-care group. In the collaborative group, a physician and psychologist helped manage the patients’ care and their primary care doctors participated in two 90-minute workshops. The psychologist talked to patients about their treatments and goals, and the team came up with a plan for each patient. People who needed an additional consultation with a mental health professional received it.

Over a year, patients in the collaborative group had an average of 10-11 meetings with team members, unlike people with standard care. Those with team treatment had measurable declines in their pain-related disability, and were also less depressed.

Because opioids can lead to dependence and undesirable side effects, these type of treatment programs are a safer alternative because they give people advice and encouragement, reassurance, and explanations about why they might be having pain, says Michael Von Korff, a senior investigator at the Group Health for Health Studies in Seattle, Washington.

"There are a lot of different things we can do, a lot of different things patients can do, that can be helpful," said Von Korff, who was not involved in the research. "The approach being advocated here is a more conservative approach that has the advantage of potentially being less costly and potentially getting better outcomes at the same time."

Source: CNN, Ann Harding, Plagued by Chronic Pain? Treatment Teams Can Help, March 26, 2009

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The Pain of Addiction

Vicodin addiction often starts innocently enough. Most people start taking Vicodin or other pain medications after surgery or an injury. But then they can’t stop. They need more to get the same pain relief. They start doctor shopping to get more pills. And the cycle continues until it takes over their lives.