In overwhelming bipartisan support, on July 14, 2016, the Senate approved the Comprehensive Addiction and Recovery Act (CARA) 19-4. While the act isn’t yet funded, both the House and the Senate support of the bill communicates a commitment to addressing the problem of addiction to opioids for chronic pain on a large scale. This, coupled with the CDC guidelines introduced in March have created a heightened concern from primary care physicians around treating their patients suffering from chronic pain. As a result, they are turning to pain specialists who are better equipped to comprehensively manage pain.
In 2014, almost 2 million Americans abused or were addicted to prescription opioids. That number is escalating at an alarming rate. One in four people who receive prescription opioids in a primary care setting struggle with addiction. The problem is compounded by the fact that more than 100 million Americans suffer from chronic pain, according to a recent study by the American Academy of Pain Medicine.
The challenge of healthcare providers is to find the balance between treating the epidemic of chronic pain without escalating the epidemic of opioid misuse. Turning to providers who specialize in pain medicine early in the diagnosis process can offer patients and their primary physicians far more options for managing chronic and acute pain.
“Since January, CPS has seen a 19% increase in referrals from Primary Care Physicians,” said Comprehensive Pain Specialists CEO John Davis. “By taking a seat on a patient’s care team, CPS is able to work with their physicians to address both the cause and the treatment of their pain. Putting patients on long term pain medication certainly isn’t the goal.”
Comprehensive Pain Specialists (CPS), one of the nation’s largest interventional pain management practices, takes a diagnostic approach to designing a patient’s care plan, incorporating imaging, EMGs and genetic testing when appropriate. When the use of medication is relevant and required, CPS providers use advanced laboratory testing to determine the appropriate use for the unique genetic make-up of a particular patient. Treatment plans often include innovative procedures designed to eliminate or alleviate pain to the point that pain medication isn’t necessary. In addition, the company offers in-house comprehensive wellness management that addresses some of the other chronic conditions often experienced by chronic pain sufferers.
“There is no ‘one-size-fits-all’ approach to managing pain,” noted Comprehensive Pain Specialists founder and Medical Director, Dr. Peter Kroll. “Finding the right therapies for a patient requires a comprehensive approach and must be diagnostically supported and data driven. The long-term use of medication is never the goal.” Only 3% of patients visiting CPS with no pain treatment history are put on a plan that include opioid medications.
Patients under the care of Comprehensive Pain Specialists are evaluated on a frequent basis, as often as every month for those on a protocol that includes medication. In addition to care consultation, patients on medication protocols participate in random urine drug screenings and pill counts and are required to use a single pharmacy for prescription narcotic fills to ensure compliance with the company’s strict medication compliance agreement. Kroll also noted, “CPS has high compliance standards for everyone involved. Drug screens and pill counts are not done because providers do not believe their patients, rather it is very important that patients are safe when dealing with highly controlled narcotics that can be dangerous to those who do not comply.” Patients who are found to be out of compliance with the company’s strict policy are moved to alternative treatments and are offered supportive care that includes referrals to addictionologists or rehabilitation centers.
Helping patients find the right balance of medication, treatments and wellness plans to both manage and address the root causes of pain is paramount for CPS and its providers. Imperative to achieving that is addressing the epidemic misuse of opioids for chronic pain by educating peers and communities as to the appropriate use of medications as well as the alternatives to managing pain that can only be managed by relying on a specialist.