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 Individualized Care Is Key to Better Pain Management, HHS Official Says

A top pain management expert at the Department of Health and Human Services (HHS) says the path forward on not only curbing the use of opioids, but also in finding the best way to treat pain for people across the care continuum is by taking a person-centered approach, or rather to focus on each individual and how possible nonpharmacologic or other pharmacologic methods work best.

Speaking at an event sponsored by the news service Axios on May 15, Vanila Singh, MD, chief medical officer at HHS and chair of the HHS Pain Management Best Practices Inter-Agency Task Force (with the Departments of Defense and Veterans Affairs), said the group’s final report to Congress will be released by month’s end, but there are already recommendations out.

“These recommendations focused on individualized patient-centered pain management,” Singh said, with the goal of relieving pain to get people’s functionality back and/or ability to perform as many activities of daily living as feasible, “which allows for the understanding of a broad range of options.”

One of the task force’s biggest discoveries is the gaps in care for chronic daily pain across the country, which affects more than 50 million people nationwide with 19 million of that number experiencing pain that affects their daily life or work, she said.

In the draft report of the task force, the assembled experts outlined five areas that are significant in achieving excellence in pain management: medications, physical or occupational restorative therapies, interventional approaches like minimally invasive procedures, behavioral health support, and complementary and integrative health like yoga and acupuncture.

Singh said an aspect of pain management that needs more attention is the stigma involved with people who are in pain, which can be an alarm bell of sorts to indicate a disease or problem with a person’s health, or the pain can stand alone as a separate entity, like in cases of nerve damage.

“There is a stigma for a lot of people with pain, and it is a barrier to care,” she said. For example, someone on opioids may feel a stigma for being on a set of medicines that are related to addiction and overdose. “There is also a feeling of weakness for some people as if they somehow have failed other people,” Singh said.

This is because unlike a person with a cast on for a broken bone, many cases of pain are invisible and can cause anxiety, depression, and be a challenge for not only those in pain but for family members and caregivers, she said.

“That is a challenge for so many people in pain … they cannot see why they are having trouble.”

There are also different cultural backgrounds for clinicians and caregivers to consider, as some cultures ignore pain and suffer silently, and for other cultures the pain is a source of openly stated anxiety and fear. Singh says these factors all play into the need for a complete “360” on the background and personal needs of

The work of the pain management task force was mandated by the White House and Congress as a result of The Comprehensive Addiction and Recovery Act of 2016 and is a bipartisan effort, Singh said.

More information on the task force is at www.hhs.gov/ash/advisory-committees/pain/index.html.

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