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Appropriate Treatment of Chronic Pain and Prevention of Drug Over-dose Deaths Needs to be a Priority for Military Medicine and American Healthcare

A Position Statement from the American Academy of Pain Medicine


Glenview, IL- Several recent unintentional deaths of military personnel have drawn national attention on major news websites and Sunday morning television talk shows. While these deaths are tragic and deserve deep societal mourning and introspection, the pain experts from the American Academy of Pain Medicine (AAPM) urge media and government officials to rightly assess the many complexities of these deaths so that viable solutions can be put in place to save lives and help people with chronic pain.

Because the loss of life is such an emotional issue, it is natural to want to assign blame for the cause of these deaths. For instance, the focus of recent reports touched on the problems of over-medication, but experts remind us that there are many difficult paths for those living with chronic pain and related serious consequences from traumas experienced in war zones, including functional loss, brain injury and depression. Suicide risk is a very serious concern that requires ongoing assessment.

The American Academy of Pain Medicine calls on anyone who is communicating about the treatment of chronic pain to be very concerned about using generalizations and simplifications of the serious and very daunting challenges inherent in helping people who are suffering with pain.

“Because of the complexity of the patient with pain in both military and civilian settings, integrated clinical training for the primary care physician is necessary,” Dr. Perry G. Fine, President of AAPM explains. For example, AAPM members have led the VA and military in designing a stepped care model of pain management that includes education to equip primary care providers with skills in clinical diagnosis, decision-making and treatment—backed by an interdisciplinary team of experts in this rapidly evolving and increasingly specialized field—that enable them to manage the integration of pain, functional restoration and psychiatric care into a tailored rehabilitation treatment plan for each patient.

AAPM’s physician leaders emphasize that root causes in many of these deaths are far from simple. “The answer to pain is not to just prescribe a pain killer or block a nerve,” Dr. Fine continues. “These tragic reports are truly a ‘call to arms’ for better education and training for physicians about the science and specialty of pain medicine. These skills, along with supportive services to help returned veterans re-establish themselves socially and psychologically are critical elements to reverse preventable morbidity and mortality.”

The American Academy of Pain Medicine has long seen the growing need for better pain care and has led the medical community by actively advocating on behalf of pain patients, including those in the military. Through its joint efforts with other pain organizations, the Academy strongly advocated for the passage of two bills, the 2009 National Defense Authorization Act and the Veterans Pain Care Act of 2008.

The American Academy of Pain Medicine continually seeks to advance the specialty of pain medicine and the comprehensive care of patients with pain through promotion of the best clinical practices, research, advocacy, and continuing medical education. One of its most recent efforts, The Pain Medicine Position Paper, was published in the journal Pain Medicine in September, 2009 (Pain Med 2009; 10(6); 972-1000). This Position Paper defines the practice of pain medicine, and sets forth the need for better pain care through adequate education, improved residency programs and a comprehensive, integrated delivery of pain care.

Through these many initiatives, including a special supplement on Opioids that releases in Pain Medicine on June 13, 2011, AAPM seeks to eliminate uncontrolled pain as a major public health problem—and the related, avoidable tragedy of untimely death in those who are unable to find relief from its torment.

News source: The American Academy of Pain Medicine

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