Consequences of Undertreated Pain

STATISTICS

Researchers from Johns Hopkins Hospital have reported that 40-80% of chronic pain patients are misdiagnosed.

Additionally, 100 million adults suffer from chronic pain in the US. About 1/2 have daily pain, up to 1/3 have mild pain, 1/3 or more have moderate pain and less than 1/3 have severe pain.

NONCANCER CHRONIC PAIN

Despite the routine use of opioids for all types of pain, there remains controversial evidence for the use of opioids in noncancer chronic pain patients.

Although evidence indicates a small benefit from opioid use in chronic noncancer pain, pain intensity is only reduced by 30% on average. Evidence also indicates that the long-term use of opioids in patients with noncancer chronic pain is associated with reduced health-related quality of life assessment scores, calling into question the validity of long-term opioid use for patients without cancer.

CHRONIC PAIN

Further pain management research has also suggested that after 12 months of continued opioid use, opioid users experienced more side effects, increased pain intensity, but no difference in pain-related function when compared to non-opioid users with chronic pain.

Importantly, despite greater availability of opioid analgesics, many patients with chronic pain still report inadequate pain relief after opioid treatment.

In a survey of patients currently on an opioid for chronic pain, it was found that 51% of respondents felt as though they had no or little control over their chronic pain, 77% reported feeling depressed, and 86% were unable to sleep well due to pain - suggesting pain medications provide some pain relief at the cost of increased side effects.

CAUSE OF PAIN

While effective at providing symptomatic pain relief, opioids do not have mechanisms or effects that treat the source of pain. Conditions such as tension headaches, arthritis, and lower back pain tend to have underlying, physical causes that cannot be repaired or healed by a pain medication.

DRUG INTERACTIONS

Polypharmacy, or the use of more drugs than medically necessary, is common among adults using opioids. Studies show polypharmacy increases the likelihood patients will experience a drug interaction or an adverse drug event (a side effect). Opioids are amongst the most prescribed medications involved in drug interactions and can result in an altered therapeutic response or life-altering injuries.