antique
Banned
Reged: 09/01/03
Posts: 215
Loc: east coast
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The following are web sites that provide information on chronic pain treatments and prescription guidelines:
http://www.AmPainSoc.org
http://www.Partnersagainstpain.com
http://www.medsch.wisc.edu/painpolicy (The Pain and Policy Studies Group site hosted by University of Wisconsin)
I'll post more as I come across them. If any of you have recommendations for good chronic pain-related websites, please post here. I have seen various websites posted here on DB. I just thought it might be useful to have them in one thread.
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Sky_Queen
Fly Girl
Reged: 12/03/02
Posts: 1966
Loc: Texas
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Antique - ironic you just posted this, I was just looking over the Partners Against Pain website you posted in that other thread - interesting info on that website. Thanks for posting these links! 
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antique
Banned
Reged: 09/01/03
Posts: 215
Loc: east coast
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Thanks, Legitimate. I'll take that as a big compliment coming from someone who is a superb researcher of info.
That is a website with lots of interesting info. Here is an interesting article from that website that will strike a chord with many DB'ers.
Chronic pain: A new disease?
Nearly one-third of the American population experiences chronic pain at some point in life. This figure, disturbing on its own, becomes more problematic in light of recent studies which demonstrate that chronic pain is a destructive disease process that creates pathologic changes in the central and peripheral nervous systems. This means a paradigm shift for physicians who must begin to understand chronic pain not as a simple disorder, but as a serious medical disease that demands early and aggressive treatment.
Chronic pain is being understood more clearly today as far more and far more pernicious than a protracted version of acute pain. The repeatedly generated neural signals characteristic of chronic pain can become embedded in the spinal cord like a memory, creating physiochemical changes in the neural pathways and creating hypersensitivity to those same pain signals. Patients who have suffered from uncontrolled pain for months or years often develop pain in areas well beyond the organ or dermatone originally affected.
Physicians unfamiliar with this concept of neural plasticity may deem their patients chronic pain psychogenic because it fails to conform to their pre-conceived map of the nervous system. Instead, physicians need to realize that failure to treat chronic pain can result in physical, psychological, and behavioral consequences. The changes wrought by chronic pain on neural pathways may also require new treatment approaches. Author Daniel Brookoff, M.D., says the clinical implications of such neural phenomena are clear but underappreciated inadequately treated pain is a much more important cause of opioid tolerance than the use of opioids themselves.
Brookoff concludes by suggesting that opioid analgesics can be the mainstay of safe, effective treatment for chronic pain disease, and so, prevent the damage of untreated chronic pain. (Brookoff D. Hosp Pract. 2000;35(7):45-52,59.)
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antique
Banned
Reged: 09/01/03
Posts: 215
Loc: east coast
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Some of these articles are a real boost to my morale. We've had so many discussions about the DEA cracking down on OPs; it's good to see that someone out there is on our side and is trying to help.
Here's another one:
Pain is an epidemic, undertreated disease, experts say
With chronic pain affecting over 40 million Americans, experts are now recommending that it be considered a disease state of the nervous system, not merely a prolonged acute symptom. Left untreated or undertreated chronic pain can consume a patients life, making even the most basic activities difficult to perform. Compounding the problem is physicians reluctance to prescribe opioids for fear they will lose their license or face criminal action. Fortunately, state and federal legislation, as well as professional society guidelines, are in the works and/or being adopted which will make it easier for physicians to prescribe pain medication to those who need it most.
But conquering this new epidemic will take more than legislation. Effective treatment of chronic pain is going to require widespread education to dispel providers misconceptions and to teach proper diagnosis. Chronic pain can manifest as headache, myofascial pain, fibromyalgia, neuropathic pain, phantom limb pain syndromes best diagnosed on the basis of clinical criteria. Unfortunately, physicians too often rely on results of MRIs or CT scans; and these imaging tests wont pick up nerve damage or other problems that can contribute to pain. As a result, physicians end up describing the patients problem rather than providing a diagnosis or they may dismiss the pain as psychogenic. The author suggests that physicians can learn to treat chronic pain more effectively if they begin to trust their own clinical judgment rather than rely solely on routine tests or mechanical evaluations. Pain medicine specialists interviewed for the article conclude that, while diagnostic tools and treatment options continue to be refined, most pain today can be managed using the tools we have available. (Sipkoff M. The Quality Indicator. May, 2000;1-8)
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antique
Banned
Reged: 09/01/03
Posts: 215
Loc: east coast
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Gilson AM, Joranson DE, Maurer MA. Improving state medical board pain policies: Influence of a Model. Journal of Law, Medicine & Ethics. 2003; 31(1):119-129.
http://www.medsch.wisc.edu/painpolicy/publicat/03jlme/index.htm
This article has a table listing state medical board policies that were evaluated for each state.
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