My view: Utah needs solutions to the silent epidemic of chronic pain

By Lee Smith

For the Deseret News

Published: Friday, Sept. 27 2013 12:00 a.m. MDT

Ray Ertmann of Midvale battles chronic pain. For some patients, standard doses of medication aren't adequate to manage pain, and some legal medications that curb pain come with side effects.

Scott G. Winterton, Deseret Morning News

Enlarge photo»

Nearly one million Utahns battle the silent epidemic of chronic pain every day. Of all medical problems, chronic pain is the most costly, with the majority of that cost from lost work productivity. Employers should thus be very interested in getting it effectively treated early.

Modern medicine has made great strides in the diagnosis and treatment of painful conditions like chronic headaches, back pain, rheumatoid arthritis and fibromyalgia, but Utah residents will only realize the benefits of these breakthroughs if policymakers take action to ensure timely and affordable access to care.

According to the U.S. Institute of Medicine (IOM), chronic pain affects approximately 100 million people in the United States every year, which is more than the number of Americans who are affected by cancer, heart disease and diabetes combined.

Chronic pain patients may endure pain for years before their conditions are properly diagnosed and treated, and many are forced to consult multiple physicians and miss significant time from work in the process. Painful conditions, however, are not the only obstacle that patients living with chronic pain must navigate; they also must frequently overcome barriers to care erected by some Utah health insurers.

In the name of cost containment, some insurers have enacted a suite of policies that could jeopardize patient health — some policies force patients to jump through administrative hoops; others force patients to try older, less-effective or more addictive medications before the insurer will allow access to the treatment originally prescribed by their physician. For treating chronic pain, more than pain medication is usually necessary. However, effective non-pharmacological approaches to patient self-care are often denied altogether. We need to solve the barriers these denial policies create. Pain and its associated health problems can be much better treated.

Those who treat pain patients every day know that early diagnosis and effective treatment are critically important. If pain goes untreated, it can deteriorate from a condition into a nervous system disease, significantly exacerbating many other of the patient’s health problems along the way, and making the pain more difficult to treat.

It is not only the physical and mental health of individual patients that suffers when chronic pain goes untreated; it is also the fiscal health of Utah taxpayers. Pain is a major driver of rising health care costs in Utah and around the country.

Chronic pain is responsible for billions of dollars in state Medicaid costs, and $635 billion every year nationwide, mostly from lost productivity. Studies show that better, earlier treatment of chronic pain could also reduce costs of workers compensation, lost tax revenues and by preventing opioid abuse.

Gov. Gary Herbert recognized the importance of increasing public awareness of these chronic pain issues, as well as the importance of effectively identifying and treating pain; that is why he declared September to be Chronic Pain Awareness Month in Utah.

Utah legislators and health policymakers should pursue comprehensive solutions to the epidemic of chronic pain, solutions that include increased education, awareness and prevention, as well as access to the pain treatments that doctors think best for their patients.

Dr. N. Lee Smith is a practicing physician at the Center for MindBody Health in Salt Lake City.

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