Over the years I have listened to many of my chronic pain patients talk about how angry they were at their pain management doctors. That’s why I wasn’t surprised to read about the latest report presented at the American Academy of Pain Medicine (AAPM) meeting in Florida this week. The presentation was by psychiatrist David Fishbain, M.D., of the University of Miami and Rollin Gallagher, M.D., a clinical professor of psychiatry and anesthesiology at the University of Pennsylvania. Below are some brief passages from their presentation. To read it in full go to:
“Acute pain patients and chronic pain patients were at greater risk than patients without pain for affirming the hostile wish statements,” Dr. Fishbain reported at the American Academy of Pain Medicine meeting. The study found that the chronic pain patient most likely to harbor the hostile wish is involved in litigation — and most frequently that is a worker’s compensation legal tussle. These patients are forced to see physicians against their will — often because of dictates of the litigation, and patients don’t trust the doctors.
Dr. Gallagher, who was not part of the studies, said that pain patients tend to be frustrated and have loss of hope, problems that doctors need to address and be aware of when they are treating these individuals. He also said the study points out the need for further education of doctors on the complexity of chronic pain and “emphasizes the need for the timely referral of patients to pain specialists.”
Many of the angry patients that I worked with had been seeing their General Practitioner (GP) for their pain management and when their pain worsened or the dose of the necessary medications increased, both physicians and patients became frustrated. I agree with Dr. Gallagher that there is a very great need for more timely referrals of chronic pain patients to providers who have training and expertise in dealing with this population.
If people don’t get effective pain management within six months to a year they can develop other major coexisting disorders that cause major quality of life problems. Many chronic pain conditions require a multidisciplinary approach instead of just covering up the pain with opiates. Some conditions may require opiate interventions, but there are many other medications, as well as nonpharmacological approaches that should and can be implemented at the same time.
For more information about chronic pain management with coexisting psychological disorders including addiction, please go to my publications page http://www.addiction-free.com/publications.html and check out my latest book Managing Pain and Coexisting Disorders. For an overview of my book you can go to my Article Achieve page http://www.addiction-free.com/articles/articles/archive and read Serving People with Chronic Pain & Coexisting Disorders.