Personal injury attorneys are well aware of the chronic pain that may follow trauma. Med League nurses summarize outpatient medical records filled with references to prescriptions for opioids (morphine related or narcotic pain relievers).

All is not well in the pain management world. Patients are receiving prescriptions for more and more opioid pain relievers, according to a study called the National Ambulatory Medical Care Survey. The number of such prescriptions for noncancer pain nearly doubled from 11% to 19%) between 2000 and 2010. The use of nonopioid medications remained the same or declined.

Of approximately 164 million pain visits in 2010, roughly half were treated with some kind of pain-relieving drug: 20 percent with an opioid and 27 percent with a non-opioid pain reliever. Johns’ Hopkins physician, Dr. Caleb Alexander and his team, studied data collected in the National Ambulatory Medical Care Survey, sponsored by the Centers for Disease Control, and called this an “epidemic of prescription opioid addiction abuse”.

In addition to enduring chronic pain and becoming reliant on opioids, patients face the risk of oversedation, slowing of respirations and overdose. “By 2008, the annual number of fatal drug poisonings surpassed those of motor vehicle deaths and overdose deaths attributable to prescription drugs exceeded those of cocaine and heroin combined,” Alexander and colleagues wrote.

The study found that primary care physicians prescribe the majority of pain medication. The use of Tylenol and Ibuprofen, safer alternatives, has declined.

The study finding reminded me of chronic pain as an important element of damages and highlighted the difficulty in safely treating patients in chronic pain. It also emphasizes the need for more education about pain management for primary care physicians.

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