After All, Pain Is a Complex Sensory and Emotional Experience (IASP, 1994). Clinical Economics and the Treatment of Persistent Pain

Strassels, Scott A.

doi:10.1016/j.jpain.2006.09.009

Cited by 8 publications

(6 citation statements)

References 11 publications

(1 reference statement)

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“…Chronic idiopathic (ie, noncancer related) pain is a major public health concern; indeed, it has been experienced by approximately 10% of the general US population in the past 12 months, 14 is characterized by considerable emotional distress and impairment of social and occupational functioning, 15,16 and costs $100 billion annually in direct costs and $200 billion annually when considering associated absenteeism and lost productivity 17–19 . There is an increasing recognition that persons with chronic pain are at an increased risk for substance abuse and dependence 20,21 .…”

Section: Introductionmentioning

confidence: 99%

Chronic Pain and Marijuana Use among a Nationally Representative Sample of Adults

Zvolensky¹,

Cougle²,

Bonn‐Miller³

et al. 2011

The American Journal on Addictions

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This study sought to examine the relations between chronic pain and marijuana use in a large nationally representative survey of adults (n = 5,672; 53% female; M(age) = 45.05, SD = 17.9) conducted in the United States. After controlling for sociodemographic variables, lifetime history of depression, and alcohol abuse/dependence, there was a significant association between lifetime chronic pain and lifetime and current marijuana use. Moreover, current chronic pain was significantly associated with lifetime marijuana use. There was no significant association between current chronic pain and current marijuana use, possibly owing to limited statistical power. Results suggest that there are generally consistent statistically significant relations between chronic pain and marijuana use. Future work is needed to explicate the developmental patterning between chronic pain and marijuana use. This paper presents the potential linkage between chronic pain and marijuana use. Results from this study suggest that it may be beneficial for clinicians to assess for marijuana use among patients suffering from chronic pain. Such patients may be using marijuana as a maladaptive coping strategy.

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Section: Introductionmentioning

confidence: 99%

Chronic Pain and Marijuana Use among a Nationally Representative Sample of Adults

Zvolensky¹,

Cougle²,

Bonn‐Miller³

et al. 2011

The American Journal on Addictions

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“…Chronic musculoskeletal pain (CMP) is a pervasive, costly, debilitating global health care concern (Gatchel, 2004;Sjogren et al, 2009;Strassels, 2006). Accordingly, numerous interventions have been developed, including pharmacotherapy (Burns and Ineck, 2006;Chamberlin et al, 2007), surgery (Sapkas et al, 2007), and physical therapy (Critchley et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

A comparison of anatomical pain sites from a tertiary care sample: Evidence of disconnect between functional and perceived disability specific to lower back pain

Carleton

Abrams

Kachur

et al. 2010

European Journal of Pain

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Heterogeneity has been identified within chronic musculoskeletal pain (CMP) patient samples; however, investigations have typically focused on psychological constructs or coping (e.g., pain-related anxiety, catastrophizing) in this regard. Furthermore, studies to date have included either samples presenting with a specific anatomical site (e.g., only lower back pain) or a mix of anatomical sites (e.g., lower back, shoulder, or leg pain) as the primary pain complaint, without making comparisons based on the anatomical site of reported pain. For example, patients with chronic lower back pain (CLBP) may differ from those with chronic upper or lower extremity pain (ULEP) in presentation, recovery trajectory, and psychological variables. The current investigation explored whether systematic differences existed between patients participating in a multidisciplinary reconditioning third-party-payer program who have CLBP relative to patients with ULEP. Patients included those with CLBP (n=23; 35% women) or ULEP (e.g., arm, shoulder, leg, knee; n=28; 29% women). The ULEP group began and finished the program with more pain-related anxiety, more catastrophic thoughts, and more fearful cognitions than the CLBP group. There were no significant correlations between functional deficit and perceived levels of disability or associations between group and return to work status; however, there was an unexpected significant interaction between group and perceived disability. Specifically, CLBP patients reported increasing perceived disability despite improvements in functional deficit, whereas ULEP patients did not. These findings suggest a disconnect between perceived disability and function that may be specific to lower back pain. Implications and directions for future research are discussed.

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“…There was an estimate of $357,000 in lifetime savings for a patient who participated in such a program. In response, Strassels [50] challenged the estimate, noting that predicting such savings is difficult given the multiple variables involved. Even years earlier, in commenting on the costs associated with interdisciplinary care, Joseph Gerstein, a nationally recognized managed care director, wryly lamented that such programs “never saw a discipline they didn't like”[25].…”

Section: Challenges To the Pharmaceutical Industry And The Medical Comentioning

confidence: 99%

The Business of Pain Medicine: The Present Mirrors Antiquity

Kulich¹,

Loeser²

2011

Pain Med

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The practice of pain medicine is often considered a fledgling field, as are the economic, business, and related ethical issues associated with providing these services. This article first traces the history of pain care and its relationships to industry and business, as well as the impact of government regulations over the ages. The authors challenge the view that the commonly discussed health care issues facing pain medicine are new by tracing the business and regulatory-related antecedents of pain care practice from the first through 21st century. The controversies associated with the practice of delivering pain-related health care services in an ethical manner are discussed with specific reference to the early work of clinicians, health care activists, and policy makers. The early activities of noteworthy individuals such as Pliny the Great, Hua T'o, John Locke, Benjamin Franklin, Oliver Wendell Holmes Sr., William Morton, Henry and William James, Heinrick Dresser, and other recent health care activists are reviewed. Issues of practitioner liability and regulatory restrictions on practice are also discussed in a historical context. The authors conclude that familiar ethical dilemmas commonly arose in past centuries, and history may be repeating itself with respect to the concerns now being discussed within our field. These arguments are reflected against the pain medicine Ethics Charters of the American Academy of Pain Medicine throughout the document. Finally, we outline the challenges for the present and future. With an understanding of these eight historical events as a backdrop, we may be at an opportune time to better address these issues in a manner that could provide the most effective pain care in our society.

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After All, Pain Is a Complex Sensory and Emotional Experience (IASP, 1994). Clinical Economics and the Treatment of Persistent Pain

Cited by 8 publications

References 11 publications

Chronic Pain and Marijuana Use among a Nationally Representative Sample of Adults

Chronic Pain and Marijuana Use among a Nationally Representative Sample of Adults

A comparison of anatomical pain sites from a tertiary care sample: Evidence of disconnect between functional and perceived disability specific to lower back pain

The Business of Pain Medicine: The Present Mirrors Antiquity

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