June 29, 2011 -- More than 100 million Americans suffer from chronic pain at a cost of around $600 billion a year in medical treatments and lost productivity, according to a report from the Institute of Medicine (IOM).
An IOM committee commissioned by Congress concluded that pain is not optimally managed in the U.S. and that effective treatment of chronic pain will require a coordinated national effort to transform how the public, policy makers, and health care providers view the condition.
The report included recommendations for achieving what the committee referred to as a "cultural transformation" in how Americans understand and approach pain management and prevention.
"We see that for many patients chronic pain becomes a disease in its own right," committee chair Phillip Pizzo, MD, of Stanford University School of Medicine, said at a Wednesday news briefing. "We need to address this in a more comprehensive and interdisciplinary way and include prevention as a very important goal."
Pizzo said the IOM analysis probably underestimates the costs of chronic pain in the U.S. because the research did not include children and military personnel.
Committee member Sean Mackey, MD, PhD, noted that about a third of the population is affected by chronic pain -- more people than are affected by heart disease, diabetes, and cancer combined -- yet very little is spent on research to find better ways to manage pain.
Mackey is chief of the division of pain management at Stanford.
Opiods and nonsteroidal anti-inflammatory medications remain the main drug treatments for pain.
"We have been using the same agents in one form or another for hundreds of years," Mackey said, adding that new classes of drugs are desperately needed to prevent and manage chronic pain.
The shortage of pain specialists in the U.S. and a poor understanding of pain by general practitioners remains a major barrier to effective pain management, Pizzo said.
The committee members called on the Department of Health and Human Services (HHS) to develop a comprehensive population-based strategy for addressing pain prevention as well as pain management and research by the end of 2012.
Other recommendations included:
Calling on the HHS and other government agencies to develop strategies for reducing barriers to pain care by 2012.
Take steps to support more collaboration between pain specialists and primary care physicians.
Called on federal officials to improve the collection and reporting of pain data and expand and redesign pain education programs by the end of 2015.
Designate a lead institute at the National Institutes of Health responsible for overseeing pain research.