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Relieving Pain in America: A new report from the Institute of Medicine

The past couple of days have been hard. Struggling with work deadlines, I was also trying to comfort my sobbing six-year-old son as he suffered for hours through what seems suspiciously like his first migraine. Hands tied, I could do little except rub his back, keep the room dark and quiet, and agonize over how to answer his plaintive midnight question, "Why do I have to feel like this?" No medicine seemed to work, and I've been haunted by the idea that this may be the first of many episodes of unremitting pain in his life.

I finally snatched some minutes late Monday evening while he was sleeping to complete the news release I was writing about the latest report by the Institute of Medicine. The title of the report? Relieving Pain in America. The irony did not escape me.

We're all familiar with at least some forms of pain. The sharp, sickening pain after a hammer hits a thumb. The throbbing of a stubborn headache. The grinding, daily, inescapable pain of arthritic joints or a slowly progressing disease like cancer, or chronic pain with no obvious cause or cure. What I (and probably you) hadn't realized is the shocking public and private toll such pain extracts.

The report, which was publicly released this morning, describes how more than 100 million Americans suffer pain each year. What's more, the medical treatment of such pain, and the lost productivity it entails, costs our country up to $635 billion annually. According to our release:

"We need to change the way we approach and treat patients with pain," said Sean Mackey, MD, PhD, chief of Stanford's division of pain management and a member of the Committee on Advancing Pain Research, Care, and Education. "Chronic pain is a disease that affects more people than heart disease, diabetes and cancer combined, and yet we spend only a small portion of the budget of the National Institutes of Health on understanding its cause or how to treat it. Our hope is that this report will serve as a wake-up call to our country."

Mackey was a member of the 19-person committee that recommended that the effective treatment of pain be categorized as a "national priority;" Stanford medical school dean Philip Pizzo, MD, chaired the committee.

The report, which I found fascinating, outlines specific short-term and long-term goals that include coordinating care between primary care physicians and pain specialists at centers like Stanford's Pain Management Center, educating physicians and medical students on how to assess and treat pain, empowering sufferers to better manage their pain, and fostering research into the biology of pain and new agents for its treatment. If you or anyone you know has ever suffered from pain, you should read it.

As Pizzo says in the IOM release:

Given the large number of people who experience pain and the enormous cost in terms of both dollars and the suffering experienced by individuals and their families, it is clear that pain is a major public health problem in America. All too often, prevention and treatment of pain are delayed, inaccessible, or inadequate. Patients, health care providers, and our society need to overcome misperceptions and biases about pain. We have effective tools and services to tackle the many factors that influence pain and we need to apply them expeditiously through an integrated approach tailored to each patient.

Thankfully, my son is feeling better today. But I hope for his sake, and the sake of all the other 100 million people who suffer needlessly, that things get better. Someday I want to be able to do more than just pat his back and dry his tears.

Previously: Elliot Krane discusses the mystery of chronic pain, Stanford's Sean Mackey discusses recent advances in pain research and treatment, Helping kids manage chronic pain, and Oh what a pain

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