The pain test
Doctors have no idea how much their patients are suffering. That’s about to change.
by Susannah Locke on October 15, 2014
http://www.vox.com/2014/10/15/6895171/how-doctors-measure-pain-brain-scan-fmri
If this becomes FACT… it would sure puts the screws to the DEA agenda 🙂
Filed under: General Problems
Screws to the DEA? Put the DEA out of the business of playing doctor? Wishful thinking guys but not necessarily.
Not so fast guys. The scenario of adding more cost (and false positives in testing/75-80% correct) could make pain care even LESS accessible to legitimate patients is just as likely. These tests ($$) could be just one more unbearable financial burden for the poor and disabled. There are tests NOW that can provide irrefutable evidence of painful disease states and failed surgeries.(that obviously cause severe pain) They do not currently prevent the DEA, State & local LE, state legislatures, insurance companies, doctors, pharmacists, etc from withholding treatment for pain. What makes you so sure this would change anything.
Depending on how much (if any) insurance companies/Medicare are willing to pay for a new sophisticated test, on top of all the other expenses associated with PM like all the UDTs, specialist consults, abuse resistant pills, etc, etc, it could be just one more hurdle to overcome for those w/ chronic pain.
I also feel that it could add one more insult to legitimate patients that could seriously jeopardize anything that is left of a rapport within the context of trusting doctor/patient relations. Another test just to prove to a doctor that you are being truthful (at the patients expense of course). This is not a valid reason for ANY testing IMO.
ALTERNATIVES TO TREATING PAIN WITH OPIOIDS.
There ARE medications that are being researched now that may one day make opioids unnecessary.
One such medication is called ARA 290. It was recently granted orphan drug status, and has been shown to significantly help reduce debilitating neuropathic pain due to sarcoidosis, diabetes mellitus, and other diseases. The great thing about it is, it is non addictive and has little incidence of side effects.
IMO We need to defund this idiotic ‘War on Drugs’ and the ‘too big for its britches’ DEA and use their appropriations to fund further studies on the outcome/efficacy of long term opioid use and especially alternatives to opioids in general.(other than another psychoactive drug such as MJ).
Below is from: http://www.ncbi.nlm.nih.gov/pubmed/24555851
“Painful peripheral neuropathy is a common, difficult-to-treat complication associated with a variety of diseases, including diabetes mellitus and sarcoidosis. It is caused by damage of small and autonomic nerve fibers, resulting in potentially debilitating symptoms of neuropathic pain and autonomic dysfunction. The limited efficacy of current treatment options dictates a rationalized design of novel compounds……………..”
Safety and efficacy of ARA 290
http://www.ncbi.nlm.nih.gov/pubmed/23168581
Novel therapeutic agents such as ARA 290, a nonhematopoietic erythropoietin analogue with potent anti-inflammatory and tissue protective properties, are interesting to explore in the treatment of SFN in sarcoidosis.
http://www.ncbi.nlm.nih.gov/pubmed/23304492
*Imagine going to a doctor. He looks at your records. They positively indicate your diagnosis and include supporting evidence in accompanying laboratory results, biopsies, measurable levels of excessive inflammation, damage to tissue/bones, compromised neuro and/or other functioning, xrays/CTs/MRIs, etc. He then ‘asks’
(orders) for testing such as this pain test to validate that you are not making up symptoms of pain in order to obtain an Rx for opioids or attention
Pain and its subjective nature.in my experience
After hearing a recent statement made by my new PM doc (same practice) I was shocked and speechless.. Upon learning I had systemic sarcoidosis he said ooohhhh that can be very bad…very painful. Since my diagnosis (2ooo), dozens of doctors including many specialists have either dismissed my accounts of pain, minimized them, a couple even flat out told me that the disease does not cause pain! The implications of such treatment negatively affected not only my quality of life,increased disease activity, but also my hopes and dreams, and finally my trust in the medical system as a whole and my general outlook on life. It was so bad that when diagnosed with MCTD (also called lupus overlap) a connective tissue disease in 2009 that eventually and strangely enough I was somewhat relieved. My accounts of pain (and other symptoms as well) were taken seriously and not dismissed.
Aside from my neurologist and rheumatologist, I rarely ever mentioned the sarcoidosis when discussing pain as it was a waste of time and quite depressing, Now having.added a ‘recognized disease’ about which docs know SOMETHING of or have at least heard about changed the whole ballgame. My accounts of pain were suddenly validated and noted and properly TREATED.
Thanks for the interesting post Steve. I hope you get many replies.
I am interested in the knowing what others think about this new test and the future use of such a tool to identify pain.
Coonhound
In the article, there are pro’s and con’s to an objective way of measuring pain. The MRI test is not 100% correct. But, it being 85% correct would be good enough to confirm that some people are in pain and need pain medication. As you say, this could put the DEA out of the business of playing doctor with peoples lives.