A glimmer of hope in American pain medicine?

<p>Opioid moderatism and the imperative of rapprochement in pain medicine</p>

“…Boston PainCare is a community-based, tertiary chronic pain care facility that was founded by a group of anesthesiologists in 2007. Despite pain management’s reputation as operating primarily for financial incentives,91–96 Boston Pain-Care’s philosophy of integrated chronic pain care transcends what is being seen as the “new normal” in American pain medicine 97. One way in which this is being done is through extremely comprehensive yet patient-centered opioid risk mitigation.…”

<p>Damaging State Legislation Regarding Opioids: The Need To Scrutinize Sources Of Inaccurate Information Provided To Lawmakers</p>

“…Some pain management professionals have blamed the current suffering and potential suffering of chronic pain patients and those who prescribe opioids to them on the 2016 Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain 18,19. One of the most common criticisms of the Guideline pertains to its chilling effect on prescribers and appropriate use of opioid analgesia 20,21. However, others have unabashedly defended the Guideline,22 although often these opinions have been written by CDC itself, its representatives, and/or those who were involved in the Guideline writing process 23,24.…”

The hardest thing to see is what is in front of your eyes &ndash; quo vadis placebo analgesia?

“…A fourth and final argument is the increasing economization of medicine in general, and pain medicine in particular, driven by the sole concern of cost containment and profitability. 16 , 17 The empathic and time-consuming doctor–patient communication so essential to the symbolic import of treatment is no longer a fundamental part of the art of medical healing; rather, it is reduced to the status of a problematic cost factor. In both Germany and the US, for instance, there is an overutilization of interventional procedures and spine surgery, which is at least partially attributable to dubious incentives from industry and the health care system.…”

“…In both Germany and the US, for instance, there is an overutilization of interventional procedures and spine surgery, which is at least partially attributable to dubious incentives from industry and the health care system. 16 – 18 Complete transparency is a necessary requirement to disclose these entangled relationships. 19 , 20 While somewhat controversial, the Physician Payment Sunshine Act in the US is a first step in this direction.…”