Thursday, May 12, 2011

Florida Faces Challenges of Pervasive Pain

Chronic Pain According to a new survey from the American Osteopathic Association (AOA), more than 85% of Florida residents say they, or someone they care for, have experienced pain in the past month. This comes at a unique time in Florida when the state legislature is revamping health policies and introducing safeguards to prevent prescription analgesic abuses, which may inadvertently thwart access to those pain medications.

In a news release [PRNewswire, 5/10/2011], Joseph A. Giaimo, DO — Assistant Clinical Professor at Nova Southeastern University College of Osteopathic Medicine in Fort Lauderdale — said, "Chronic pain is a serious public health issue. Many Florida residents live with pain because they believe it is just a part of the aging process or fear their pain cannot be treated. We're encouraging patients to take the first step to finding relief by openly discussing pain with their physician and then working together to develop an individualized treatment plan."

The AOA survey found most Floridians underestimate the severity and prevalence of chronic pain and also believe common myths associated with pain…

  • Half of those surveyed mistakenly believe pain is just a part of life.

  • Nearly 4 out of 10 (39%) do not believe pain is something that can be eased with proper treatment.

  • Fewer than half (47%) said they would speak to a specialist if experiencing chronic pain.

  • Almost a third (31%) would not speak to a medical professional about their pain for fear they could not afford treatment.

  • More than 2 out of 5 (44%) fear that prescription pain-relief medications are easily addictive, while 39% believe those medications come with side effects that are worse than the pain itself.

While the Association is concerned about the rise of prescription drug abuse and supports efforts to protect patients, Karen J. Nichols, DO, AOA president says, “We are also mindful of the fact that pain is a major health problem and also do not want to see these efforts hinder access to quality care." [The AOA website can be accessed at:]

Meanwhile, according to the Wall Street Journal [“Florida Targeting Pill Mills”; 5/9/2011], the Florida State Legislature recently passed a bill expected to squelch the notorious "pill mills" that have made the state a center of unlawful prescription-drug distribution. The bill stiffens penalties for practitioners who overprescribe medication, namely opioid analgesics, and for individuals who improperly set up pain-management clinics.

The bill also tightens requirements regarding a soon-to-be-created prescription-drug monitory program (PDMP). Republican Governor Rick Scott, who had been criticized for his opposition to the PDMP earlier this year [reported in an UPDATE here], is expected to sign the measure into law.

The new bill shortens the deadline from 15 to 7 days for reporting prescriptions to the PDMP. It also prohibits healthcare providers from dispensing analgesics in their offices or clinics, though certain exceptions were carved out, such as for surgeons and hospices.

Still, as Florida’s lawmakers battle the pill mill plague, the prevalence of chronic pain among the state’s residents is perhaps the highest in the U.S. The latest data indicate that an astounding 33.6% of all American adults (78 million persons) suffer from chronic pain lasting 3 months or longer [reported in UPDATE here]. Florida, with a high percentage of elderly retired persons, tops that percentage, according to the AOA survey above. In contrast, a recent report from the U.S. Centers for Disease Control and Prevention notes that the chronic pain prevalence in Kansas is only 26%; still high, but below the national average and far less than in Florida [Toblin et al. 2011].

So, it is ironic that a state with such tremendous need for effective treatments to ease the chronic pain of its residents also has some of the greatest problems with opioid abuse and unlawful distribution. It remains to be seen whether measures of the new legislation will stem the pill mill problems while facilitating better pain care for those in need; or, will there be greater barriers to achieving effective chronic pain management in the state?

REFERENCE: Toblin RL, Mack KA, Perveen G, Paulozzi LJ. A population-based survey of chronic pain and its treatment with prescription drugs. Pain. 2011(Mar); Epub ahead of print [abstract here].