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The status of treatment for chronic non-cancer pain: July 2010

July 25, 2010 | Filed Under: Uncategorized | Comments(0)

Henry E. Adams, Ph.D., Coalinga State Hospital, July 23, 2010

In the almost two years since the October 2008 global financial crash, access to effective care for chronic pain patients has gotten significantly worse.


  • 37 million Americans now have access to health care that didn’t have it previously.
  • in 2011, 78.5 million Baby Boomers will start entering Medicare at a rate of 3.5 million per year until 2030. We all know what the financial health of Medicare is, so the prospect of improved pain care occurring is low.
  • both of these conditions will put an enormous professional and financial strain on American health care and there are no financial resources that can radically alter the crisis situation that is already under way.

  • as the number of patients needing care has increased, the number of physicians expected to treat them is decreasing, due to the growing cost of sustaining a pain practice and the disincentives created in Washington by not developing meaningful cost-of-living formulas for reimbursing physicians treating America’s patients.

  • third-party payors won’t cover the costs of treating chronic diseases of any kind – they are still rejected on the basis of their being “pre-existing conditions,” which they will fight to avoid covering, so there is no way to obtain the pain programs that work best to restore patients’ ability to function and return to work.
  • lack of access to appropriate care, for a combination of reasons, has produced a state of desperation for pain patients, due mainly to the uncertainty of getting the type of care that optimizes restoration of their ability to function as normally as possible.
  • at the same time, due to legal and bottom-line reasons, US physicians choose to work as solo practitioners, a practice approach that is contrary to the needs of chronic diseases, including chronic pain, where the treatment goal is treating a complex disorder and optimizing rehabilitation of lost functions.

  • where previously, qualified multidisciplinary pain programs and credentialed pain specialists could be found in some of the major cities, today it is almost impossible to find either one anywhere. Some say the use of opioid is being jeopardized by the DEA’s goal of insuring deterrence. Yet, the facts indicate that where the prescriber is qualified in pain, the risk of regulatory action is low.
  • the implication of these trends – which the signs are that it will rapidly get worse – is that pain patients are going to have to learn to self-manage the conditions of their pain’s occurrence on their own, using the most effective advice they can get from specialists credentialed and experienced in successfully restoring pain patients to higher levels of functioning, and return to work.

  • patients should note that the Internet is not where solid scientific findings are found. The reason is that material in scientific journals, congresses, conferences and technical books is copyrighted and copyrighted material is rarely made available on the Internet to the general public. makes available summaries of this type of material as well as issue-videos and private consults with Dr. Adams. The site has also noted previously what the most effective way is to find the most recent developments in the treatment of chronic non-cancer pain.
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