Axios Event: U.S. pain crisis needs a more holistic approach, experts say

WASHINGTON – Improving effective pain management for chronic pain "has to be a multidisciplinary integrated approach to pain and not a single intervention," said Dr. Linda Porter, NINDS Office of Pain Policy and Planning director at the National Institutes of Health.

• She pointed to research that shows changing lifestyles and implementing physical activities, like yoga and meditation, can be helpful holistic strategies.

Why it matters: Millions of people suffer from pain, yet there has been little innovation in acute pain treatment over the past two decades.

• Axios senior policy reporter Caitlin Owens and senior health care reporter Tina Reed moderated conversations with Dr. Porter, Johns Hopkins Medicine assistant professor of physical medicine and rehabilitation Dr. Stephanie Van, and Voices for Non-Opioid Choices executive director Chris Fox at the event, which was sponsored by Vertex Pharmaceuticals.

America is dealing with an opioid crisis and mental health crisis, which Dr. Van highlighted how providers' mindsets need to shift when they approach pain management.

• She noted that providers often focus on treating the pain rather than thinking about a patient's overall goals for getting better. "We're not focusing on these functional goals. We're not focusing on how someone can get back to spending time with their family, traveling, working, the things that people actually care about."
• "We got so fixated on the pain itself that all this energy and time is being put into what medicines, what is safe, as opposed to how can we approach this with a multimodal menu of strategies."
• Dr. Van also said the stress of today's world can affect a person's mental health and perpetuate their pain and suffering. "These are not new problems. They're just even more abundant, and I think the system really needs to undergo a big shift, a big evolution, so that we're putting resources where it really matters."

Fox emphasized the need for access to affordable non-addictive forms of pain management.

• "We know that many patients when they go to fill their prescription for a generic opioid, pay between $0 and $5 out-of-pocket…We don't think that patients should have to make an economic consideration and take extra steps to access a non-addictive form of pain management," Fox said.

• "So if you ask a patient to choose between a $1 medication or a $100 medication, we know which medication they're going to choose and we don't think that either patients or family members or loved ones should have to make those choices."

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In a View From the Top conversation, Vertex Pharmaceuticals senior vice president & disease area executive for pain Paul Negulescu said acute pain can have a "disruptive impact" on people's lives despite not lasting very long, according to their recent survey.

• "Nine out of 10 of the people in the survey indicated that acute pain had had a disruptive impact on their life. This includes disruption in sleep…It included their inability to function and…on average, these patients reported missing 19 days of work."
• Negulescu also said there is a gap "in the treatment paradigm that we have today" when it comes to including non-opioid alternative options for patients.