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#Pain, Perceptions and Prescriptions

Recently, there have been a number of major media sites that are starting to focus and explain chronic pain. One such outlet is AOL’s Huffington Post.
In this article, written by doctor Richard Besdine, a lot of time is taken to explain how overlooked chronic pain is in the US.  Besdine also explains the paradigm of why chronic pain affects so much of the older population and at the same time is under-treated and often by physicians that are not trained in the field.

How can caring and competent physicians allow this suffering? For older adults with multiple conditions, the cause of pain can be hard to pin down. Similarly, older adults often take many medications, which put them at risk for adverse reactions, particularly if pain medications are added. Older adults themselves may compound the problem, being reluctant to “complain” to their doctors, who, through ageism, wrongly assume that pain is simply part of growing old. As a result, many physicians, who may not have had any formal education on pain management, may be overly cautious, and thereby not treat their older patients’ pain.

Something else very important the article discusses is medication, and its impact on the pain population. The American FDA and other interested groups don’t test pain and other medications on older people, even if they are the target market. The result is that the elderly may be given medication that has been tested on bodies that process the drug differently:

For now, we must use what we have, but the common exclusion of older adults from clinical studies means that we lack an evidence base documenting analgesic safety and effectiveness for them. Since older bodies metabolize and respond to drugs differently, results generated from studies of younger subjects are not necessarily interchangeable.

When discussing or considering chronic pain, remember that stigmas are only now being challenged.  Ignorance in the mainstream medical community and general public has been because of a lack of communication, research and understanding. What’s exciting about today is that our seeing where we have gone wrong will inspire better research. From better research will hopefully come better evidence-based care.

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