Pain Action Alliance to Implement a National Strategy - Sitting Down in DC

This meeting is by INVITATION ONLY!

As patients and as advocates with and for chronic pain issues, it is important to know that we are supported and that others are moving forward in an effort to improve the way pain is perceived, judged, and treated.  Following is the agenda for the Pain Action Alliance to Implement a National Strategy  for the upcoming meeting January 26 - 28, 2014 in Washington DC. People representing organizations that support  IOM report "Relieving Pain in America"will be traveling great distances as they come together for this collaborative effort.

Pain Action Alliance to Implement a National Strategy (PAINS)

2^nd Annual  Meeting

January 26-28, 2014

One Washington Circle Hotel, Washington, DC

Meeting purpose:  Gather those involved in PAINS, leaders at HHS, other policy makers, funders and other key stakeholders to review and discuss the state of pain, importance of a public health approach, promising innovations/projects, and what it will take to establish chronic pain as a major public health issue.

Date/Time	Activity and Speakers/Presenters	Room
Sunday, January 26
6 – 7:30 pm	Welcome Dinner – Myra Christopher, PAINS Director Dr. Kathy Foley, Society of Memorial Sloan-Kettering                              Cancer Center Chair	Meridian
Monday, January 27
7:45 – 8:30 am	Breakfast and Networking	Lounge
8:45 – 9:00	Welcome and overview of the day – Richard Payne, PAINS Medical Director	Meridian
9:00 – 9:45	The state of pain – a post IOM report update – Anand Parekh, Deputy Assistant Secretary for Health (Science and Medicine)	“
9:45 – 10:45	Why a public health approach to pain – Jim Burdine, School of Rural Public Health, Texas A & M Michael Felix, PAINS Community Health Network Development Director	“
10:45 – 11:00	Break
11:00 – 11:20	HHS Health Literate Care Model  – Linda Harris, HHS	“
11:20 – 11:45	Innovations in patient-centered outcomes research – Suzanne Schrandt, PCORI Kim Kimminau, PAINS Research Consultant	“
11:45 am – 12:45 pm	Lunch and remarks – Phil Pizzo, Chair of IOM Task Force:  Relieving Pain in America	Lounge
12:45 – 2:15	Promising Community Practice Innovations/Projects ·         Oregon’s statewide efforts to  transform pain care – Jennifer Wagner, Western Pain Society ·         Successful chronic disease self-management focused on pain - Orvie Prewitt, Regional Arthritis Center ·         Community based practice guidelines for a biopsychosocial approach to pain management – Dr. Vikas  Agarwal , Heartland Health Center, St. Joseph, Missouri	Meridian
2:15 – 2:30 pm	Break
Monday, January 27	Continued
2:30 – 4:00	Discussion of current efforts to “transform the way pain is perceived, judged and treated”, including the work of PAINS and that of others ·         Progress ·         Trends ·         Opportunities and challenges Myra Christopher, PAINS Director	Meridian
4:00	Adjourn and break until reception
5:30 – 7:00	Reception - A Nation in Pain: Healing our Biggest Health Problem – Remarks and book sale and signing by Judy Foreman, author and nationally syndicated health columnist	Lounge
Tuesday, January 28
7:30 – 8:45 am	Breakfast   Note:   Lounge space will be open until              10 am for networking opportunities	Lounge
8:00 – 10:00	PAINS Steering Committee Meeting	Meridian
10:30 am – 12:30 pm	HHS efforts to develop an interactive educational video focused on strategies for effective chronic back pain management and informed patients based on the Health Literate Care Model and discussion on how to maximize the tool’s effectiveness and impact – Linda Harris, HHS and Yael Harris, HHS	“
12:30 – 1:30	Lunch	Meridian
1:30 – 3:30	Facilitated discussion on the potential unintended consequences of opioid control programs, and recommendations for policy research or action at state and federal level  - Katie Horton George Washington University School of Public Health & Health Service’s  Department of Health Policy and Kima Taylor, Open Society Foundation	Meridian
3:30	2nd Annual PAINS meeting adjourns – safe travels home!

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All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Celeste Cooper is a retired RN, educator, fibromyalgia patient, and lead author of the Broken Body Wounded Spirit: Balancing the See Saw of Chronic Pain devotional series (coauthor, Jeff Miller PhD), and Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome and Myofascial Pain: The Mind-Body Connection (coauthor, Jeff Miller PhD) She is a fibromyalgia expert for Dr. Oz, et al., at Sharecare.com, here, and she advocates for all chronic pain patients as a participant in the Pain Action Alliance to Implement a National Strategy, here. You can read more educational information and about her books on her website, http://TheseThree.com

Bias and the Band. Concerns and comments, “Are Doctors Paying Attention to Women in Pain?” from the National Pain Report

RE:

Are Doctors Paying Attention to Women in Pain?

July 8th, 2013 by Ed Coghlan

At the National Pain Report, here.

CDC Vital Signs. “Prescription Painkiller Overdoses: A growing epidemic, especially among women,” saying opioid deaths are as “under-recognized problem, here.

My comments:

This is what I have to say about the CDC report. [Vital Signs]. The IOM report "Relieving Pain in America..." states there are three groups of people who are discriminated against when it comes to adequate pain management, WOMEN, the poor, and African-Americans. [Complete report, pg 69-70, here. IOM Brief, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, here.] 

It perplexes me that opioids are the big concern when the first drug used to treat women is antidepressants and psychoactive drugs, because after all, we are a stressed out lot in an emotional state, right? 

Antidepressants are handed out like candy. I would argue that opioids are not, at least in my experience. The culture on managing pain has changed drastically over the past 5 years. Antidepressants interact with more medications, and when prescribed inappropriately, can increase the likelihood of suicidal ideation even when the patient wasn't clinically depressed. 

[See Dr Oz, Antidepressant Serotonin Imbalance, Suicide Warning, Depression, here]

One must bid the question, "Why are the effects of this classification of drugs not sensationalized, or considered?"  “How many women were also on these meds?” “Where is the data collection tool for this classification of medications? They are not only expensive; they come with far greater consequences.  They are not as effective as the pharmaceutical sales agent attempts to convince physicians, i.e. relieving pain and IMPROVING symptoms. There is an “under-recognized problem” on the effect of antidepressants, which completely restructure the brain. 

[See. CDC Vital Signs. “Prescription Painkiller Overdoses: A growing epidemic, especially among women,” saying opioid deaths are as “under-recognized problem, here.]

In their own report, they say men are more likely to die from overdose, so we focus on educating women? Hey! Aren't men important too?  This reeks of bias, just as stated in the IOM report. [And, the band rolls on, but the sound is deafening]

Statistics are just that, statistics. They can be skewed in data collection and study constructs.  Pain is pain. The CDC only focused on "illicit" pain killers. I would argue that NSAIDS are abused because they are about all we have left to take, and they are equally life threatening. [See, Study Finds NSAIDs Overused for Chronic Pain, here.]  Where are the stats on those? We were given opioid receptors for a reason, and I would like to see the research move in that direction. We should be focusing on the patient.

Summing up post comment:

I am not a proponent of any one thing except the right to choose and have our pain treated adequately. Instilling fear in our physicians and pharmacists creates malfeasance.  The biased culture on pain is not improving things. Look at the correlation with the CDC report.

I have the same concerns as Dr. Mehmet Oz regarding overprescribing of antidepressants. Read “Antidepressants: Are They Right For You?” here. or Dr Amen, expert psychiatrist, on “Do Antidepressants Do More Harm Than Good?” here.

In my search I found studies suggesting that antidepressants aren't treating clinical depression effectively, if at all. Other information suggests that antidepressants are treating the depression angle of chronic pain, but even in these studies, they were considering people with MAJOR depression, a clinical psychiatric condition.  We need research on psychoactive drugs that are NOT conducted by pharmaceutical companies.

Opioid medications have been around for centuries, physicians have a firm understanding of what they are, but there is a educational deficit between defining addiction vs. dependence, and patient teaching needs, but I would argue that patients do not receive enough information on psychoactive drugs of ANY sort. Also to be considered are any medications that increase tolerance, antidepressants happen to be among that group. Any medication that requires you to reduce the dose slowly has the propensity to be life threatening.

Wouldn't it be better to educate physicians and patients on how to watch for untoward symptoms and restore the doctor and patient relationship?    Relieving pain responsibly is only manifested by an improvement in function. We don’t need new tools, we have them. They are called patient assessment. Have we become so technological that we have forgotten how to interact with a human being?

You might be interested in reading the PAINS/Project Environmental Scan, Chronic Pain Management and the Practical Implications of Addressing Recommendations Put Forth in the Institute of Medicine (IOM) Report, Relieving Pain in America, here.

Treatment without bias is our right, and we as patients  must speak up. You can find ways of doing that on my website, here. I encourage you to leave comments when you read an article.  Feedback from the people like us is not only needed, it is desired. We must begin the dialogue.

We are law abiding citizens. Most of us do play by the rules, so why do we allow ourselves to be treated as criminals, or to be discriminated against because of our gender, our socio-economic status, our age, or the color of our skin? How can criminalizing a human condition be legal? What is happening to our society?

All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  For more information about the author see http://TheseThree.com

Celeste Cooper is a retired RN, educator, fibromyalgia patient, and lead author of the Broken Body Wounded Spirit: Balancing the See Saw of Chronic Pain devotional series (coauthor, Jeff Miller PhD), and Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome and Myofascial Pain: The Mind-Body Connection (coauthor, Jeff Miller PhD)

She is a fibromyalgia expert for Dr. Oz, et al., at Sharecare.com, and she advocates for all chronic pain patients as a participant in the Pain Action Alliance to Implement a National Strategy (PainsProject.org).