Barriers to Chronic, Non-malignant, Pain Management in Primary Care

Abstract

Chronic pain was recognized by the World Health Organization as the number one health problem in America. It is estimated that 50 million Americans suffer from chronic, non-malignant pain, accounting for more than those affected by diabetes, heart disease, and cancer combined (Payne et al, 2010). This epidemic significantly impacts healthcare, costing approximately $85 to $90 billion annually (Jackman, Purvis, & Mallett, 2008). In recent years, providers have agreed that opioids are important in addressing the problem and in long-term use they remain safer than other pain medications. However, patients suffering from chronic pain continue to face significant systemic barriers when seeking treatment, including obtaining prescription pain medications (Payne et al, 2010).

Primary care providers (PCPs) play an important role in alleviating this problem. These providers act as the gate-keeper between other healthcare disciplines. However, many PCPs are reluctant to initiate or manage opioid treatment (Hudspeth, 2011). Therefore, the primary aim of this article is to answer the question: What are the current barriers to treatment of chronic pain with opioids in the primary care setting?

With the growing epidemic of chronic non-malignant pain in America, action is needed to assist PCPs, to safely and effectively treat these patients. Evidence has shown that a multidisciplinary approach to treatment of chronic nonmalignant pain can benefit patients by improving quality of life (Jackman et al., 2008). Further research would be needed to evaluate the effectiveness and adherence to standardized guidelines.