Axios Event: Effective pain management requires a patient-centered approach, doctors say

NEW YORK – Medical experts emphasized the importance of considering different patient needs when deciding which treatments to employ for pain management at a May 29 Axios event.

Axios' Maya Goldman and Erica Pandey spoke with Maimonides Medical Center research director Sergey Motov, Friends of Recovery director of policy Christopher Assini and Montefiore Einstein program director Karina Gritsenko at the event, sponsored by Vertex Pharmaceuticals.

The big picture: While overdose deaths from opioids have seen an overall national decline from pandemic-era peaks, some states saw increases in communities still battling addiction and unequal access to treatments for opioid abuse.

• "We need to celebrate any decrease in overdose deaths," Assini said. "But it's been unequal. Folks in Black and Latino populations have seen overdose deaths surge in recent years, tripling."

What they're saying: "When it comes to [the] opioid crisis and [the] role of emergency physicians, I usually like to say that we … are very uniquely positioned to take care of patients in pain in a safe and effective manner," Motov said.

Zoom in: Doctors are trying to minimize the risk of opioid addiction if those drugs are deemed to be the right treatment option for the patient.

• Motov approaches acute pain management with a combination of non-pharmacologic and pharmacologic treatments, both non-opioid and opioid.
• Opioids still belong in the spectrum of acute pain treatment options, he said. "But they just need to be refined, and I like to use the word optimization."
• Opioids are no longer the mainstay treatment for chronic pain but are still appropriate for certain patients, Gritsensko said. "In general, I think the culture has shifted away from opiates as a first-line treatment for chronic pain."

Zoom out: The stigma surrounding substance use disorder has often led to punitive policy frameworks, Assini said, calling for a public health approach to the issue instead.

• "When I say a public health approach, I'm talking about the social determinants of health – economic factors, social factors, environmental factors, housing, things of that nature," he added.

Content from the sponsored segment:

In a View From the Top conversation, Vertex Pharmaceuticals senior vice president and disease area executive Paul Negulescu said that despite long-standing interest in non-opioid pain treatments, there aren't many options on the market.

• "There just hasn't been a lot of innovation in the pain space in the last decades. Just no new medications, no new approaches. A lot of interest in that, but nothing really coming to the fore," he said.
• In addition to new treatment options, improving medication access and patient-physician communication can help improve pain management for patients overall, he said.