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

Pain prevalence globally
Pain prevalence globally


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


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?

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