BOSTON — You can’t see it, measure it with an instrument, even adequately describe what pain feels like. Which is why the medical profession has simplified pain assessment to a number between 1 and 10.
And a new study suggests a sizable number of Americans are dealing with upper-level pain nearly all the time.
“We saw that 50 million U.S. adults are suffering with chronic pain,” said Dr. Jason Yong, study author and medical director of the Pain Management Center at Boston’s Brigham and Women’s Hospital. “And 25 million are suffering from high-impact chronic pain, meaning that it affects their activities of daily living, it affects their ability to function.”
Lauren DeLuca of Worcester is one of those people. Until four years ago, she was a commercial insurance agent.
“I went to the emergency room with pancreatitis,” DeLuca said. “And I was actually discharged without getting proper care.”
That led to a six-week bout with acute pancreatitis, Deluca said, which led to the complications that left her in chronic pain.
“When I finally did find a doctor, he took an x-ray and he found multiple parts of my digestive tract had become completely crushed,” DeLuca said. “And immediately put me on pain medicine and immediately signed me up for surgery to get a feeding tube.”
DeLuca said she relies on pain medication to keep her from getting “sick all day.” Her experience led DeLuca to create the Chronic Illness Advocacy & Awareness Group, an educational and activist group centered around the needs of those living with chronic pain.
“It dominates your whole life,” DeLuca said of her chronic pain. “Everybody works to keep their pain down. It might be they need rest. Or they need to eat a special diet. Or they need medications. Whatever the case may be. They have to follow an extraordinarily regimented life.”
At the Pain Management Center, a variety of modalities are used to treat chronic pain, Yong said. One of the most important is use of pain psychologists.
“What we saw in the study was that behavioral health was actually an underutilized resource,” Yong said. “That is something that if I were a czar of health care I would really prioritize that behavioral health component whenever managing pain.”
DeLuca knows that the so-called multi-modal approach to pain management might work for some chronic pain sufferers. But she worries it’s now considered the solution for everyone with chronic pain -- because doctors are moving away from prescribing pain-killing opioid analgesics because of their earlier link to the opioid crisis -- a crisis now largely fueled by illegal fentanyl.
In fact, an FDA study recently found the number of opioid analgesic tablets dispensed in the U.S. dropped from 17.8 billion in 2012 to 11.1 billion in 2018.
During a similar period, the study also found the number of new opioid analgesic patients dropped by about ten million.
“It’s become a toxic wellness movement. Where these things could be beneficial,” DeLuca said. “But they’ve become overstated. And it’s really harmed a lot of these people both physically, because they didn’t get their care, but also mentally.”
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