Raymond Tait, Ph.D., is the vice president for research at Saint Louis University and recently served on a federal committee that was one of five groups to help draft the National Institute of Health’s National Pain Strategy.
On Wednesday’s St. Louis on the Air, Tait joined host Don Marsh to discuss the new strategy for treating chronic pain to ensure patients get the most appropriate treatment to manage pain and avoid opioid addiction.
“We need to recognize that the issue is not just opioids. It is opioids within the context of more effective management of chronic pain,” Tait said. “A person who is entirely dependent on opioids as the one and only way of managing pain could be at a really tough crossroads at the time the prescription ends. On the other hand, if that person is working closely with his or her provider, there are a host of ways you could go forward with not only medications but rehab, psychological, spiritual approaches. I think that the job is to look for alternative ways for people to manage pain as opposed to running away from opioids.”
Earlier this week, President Obama called for more funding and a new approach to help people addicted to heroin and opioid medications. According to the CDC, over 28,000 Americans died from heroin and painkiller overdoses in 2014. That’s up from 16,000 in 2010. As a corollary, from 1999 to 2011, opioid prescriptions skyrocketed from 79 million to 220 million.
“In the ‘80s, the main push in treatment was to move people away from opioids,” Tait said. “That was typically done through multidisciplinary clinics and those have faded out, many in the face of adversarial insurance payment. We moved more toward the use of medications, opioids among them. We’re now seeing a pendulum swing. It is a pendulum swing that is overdue.”
Tait said that the solution to opioid abuse does not necessarily lie in punishing doctors who may be seen as too quick to prescribe these medications, but in becoming “much more rational and make much more available other effective treatments for pain.”
Tait said that studies show that 1/5 of U.S. medical schools have no course on pain.
“What is the most frequent symptom people go to the doctors for? It is pain,” said Tait.
In addition to upping pain training for doctors, Tait also said that pharmacologists need to be involved in managing opioid prescriptions.
“You need to bring a number of these disciplines together so that each perspective can inform the others,” said Tait. “I think that you can put together training programs and if providers are given training and if there is support for bringing other providers into care, it can be done.”
Tait said that he doesn’t want people to lose track of the underlying concern about opioids: “our failure as a society to adequately approach pain problems.”
“If we can get better at that, there will be downstream ripple effects that positively impact the opioid issue,” Tait said.
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