Event 1: Pain Prevalence

The Scope of Pain in the US

1. Persistent Pain: 100 million 
   • (Institute of Medicine, 2011)
2. Coronary Heart Disease: 81 million
   • (Centers for Disease Control)
3. Insomnia: 70 million 
   • (IOM, 2006)
4. Hypertension: ~ 65 million 
   • (NHANES 2005-2006)
5. Diabetes: 24 million 
   • (American Diabetes Association, 2007)
6. New Cancer Diagnoses: 1.6 million 
   • (American Cancer Society, 2012)

Pain is Prevalent Globally

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Reference

Adapted from data from: Tsang A, Von Korff M, Lee S. et al. Common Chronic Pain Conditions in Developed and Developing Countries: Gender and Age Differences and Comorbidity With Depression-Anxiety Disorders. J Pain. 2008(Oct);9(10):883-891

Barriers to Pain Treatment I

Access to any healthcare system

• Rural dwelling
• Urban areas are still underserved
• Insurance coverage

Access to new-generation and opioid analgesics

• Inner-city pharmacies less likely to stock
• Developing countries

Barriers to Pain Treatment II

Access to specialty pain clinics

(Not all PCPs are comfortable managing chronic pain)

e.g., Opioids require:

• extensive documentation 
• Risk assessment 
  • (misuse, abuse potential)
• Pt education; provider education
• Behavioral contracts
• Periodic drug testing
• Vigilance for opioid diversion

Barriers to Pain Treatment III

• Provider attitudes lead to disparities
  • English as a second language
  • Race & ethnicity
  • Sex
  • Vulnerable populations: prisoners, victims of abuse
• Socioeconomic status
• Age
• Cognitive Impairment
• Health literacy

Think-Pair-Share

How will your personal experiences with pain affect your pain treatment practices?

Faces of pain look different. Who are you most/least likely to treat for pain?