Resources
Chronic Pain In America: Roadblocks To Relief
Summary of Findings
Attitudes Toward Narcotic Pain Relievers
- Profile of users.
- Reaction when first prescribed.
- Side effects attributed to them.
- Reactions of others to their use.
- Barriers among physicians as to their use.
CHRONIC PAIN SUFFERERS CURRENTLY TAKING NARCOTIC PAIN RELIEVERS DIFFER FROM OTHER CHRONIC PAIN SUFFERERS AS TO THE SEVERITY OF THEIR PAIN, BEING LESS LIKELY TO HAVE IT UNDER CONTROL, CHANGING DOCTORS MORE OFTEN, REQUIRING MORE INTENSIVE TREATMENT AT HOSPITALS, TAKING MORE PILLS PER DAY, MORE LIKELY FOLLOWING THEIR DOCTOR PRESCRIBED REGIMEN AND LASTLY, TO BEING REFERRED TO A SPECIALIZED PROGRAM/CLINIC FOR THEIR PAIN.
Base: All chronic pain sufferers.
| ---Currently Taking--- | ||
|---|---|---|
| Narcotic Pain Reliever % | Other Medicine Type % | |
| Severity of pain (8,9 or 10) | 56 | 31 |
| Have constant pain | 55 | 36 |
| Pain pretty much under control | 45 | 57 |
| Currently going to doctor | 88 | 60 |
| Have changed doctors | 57 | 45 |
| In past 12 months: | ||
| Gone to emergency room for pain relief | 27 | 12 |
| Been hospitalized for their pain | 19 | 10 |
| Have had counseling | 23 | 13 |
| Total mean number of pills taken in typical day | 5.7 | 4.4 |
| Take as prescribed by their doctor | 80 | 68 |
| Referred to specialized program/clinic | 36 | 19 |
ALTHOUGH THE GREAT MAJORITY OF CHRONIC PAIN SUFFERERS REACT POSITIVELY WHEN FIRST PRESCRIBED A NARCOTIC PAIN RELIEVER, THERE ARE CONCERNS RELATING TO SIDE EFFECTS AND BECOMING HABIT FORMING; HOWEVER, THERE IS RELATIVELY LITTLE CONCERN ABOUT WHAT OTHER PEOPLE THINK ABOUT THEIR USE.
"Which of the following statements describe your reaction when a narcotic pain reliever was first prescribed for your pain?" (Q. 11)
Base: All chronic pain sufferers ever taking narcotic pain relievers.
| ---Severity of Pain Now--- | |||
|---|---|---|---|
| Total % | Currently Taking % | Past User % | |
| Optimistic and pleased that it would work | 73 | 76 | 70 |
| Would manage your pain successfully | 72 | 76 | 69 |
| Very concerned about its potential side effects | 60 | 52 | 65 |
| Concerned, went along since couldn't cope anymore with pain | 55 | 57 | 53 |
| Very concerned it would be addictive | 49 | 43 | 52 |
| Very concerned, would have to take it for the rest of your life | 42 | 46 | 39 |
| Very concerned it would require higher dosage over time | 38 | 30 | 43 |
| Felt you could manage pain without drugs | 35 | 28 | 39 |
| Didn't know it was a safe option | 32 | 37 | 29 |
| Surprised, didn't know it was an effective option | 25 | 23 | 26 |
| Very concerned, other people would view it negatively | 20 | 24 | 17 |
THE MORE COMMON SIDE EFFECTS ATTRIBUTED TO NARCOTIC PAIN RELIEVERS ARE DROWSINESS AND DRY MOUTH ALONG WITH A RANGE OF STOMACH RELATED PROBLEMS; THE MOST BOTHERSOME ONES ARE THE ONES THAT OCCUR LESS FREQUENTLY SUCH AS VOMITING, URINARY PROBLEMS AND CONFUSION.
What side effects, if any, have you ever had that you believe were caused by the narcotic pain reliever you used for your pain versus a non-narcotic pain reliever?" (Q. 13a) "How bothersome was (SIDE EFFECT) you experienced? Was it very bothersome, somewhat bothersome or not bothersome at all?" (13b)
Base: All chronic pain sufferers ever taking narcotic pain relievers. Percent experiencing side effect. Percent saying symptom was very bothersome.
| ---Severity of Pain Now--- | ||||
|---|---|---|---|---|
| Total % | Currently Taking % | Past User % | Very Bothersome % | |
| Had side effects | 82 | 78 | 85 | |
| Drowsiness | 61 | 54 | 66 | 31 |
| Dry mouth | 51 | 46 | 54 | 24 |
| Upset stomach | 35 | 28 | 40 | 34 |
| Nausea | 31 | 27 | 33 | 36 |
| Constipation | 30 | 33 | 28 | 36 |
| Confusion | 21 | 17 | 24 | 40 |
| Itching | 17 | 18 | 17 | 36 |
| Vomiting | 11 | 10 | 11 | 61* |
| Urinary problem | 10 | 11 | 10 | 47* |
(* Caution small base)
THE MAJORITY OF CHRONIC PAIN SUFFERERS EVER USING NARCOTIC PAIN RELIEVERS NEVER HAD ANYONE EXPRESS A CONCERN ABOUT IT; AMONG THOSE WHO HEAR CONCERNS FROM OTHERS IT IS LIKELY TO BE A FAMILY MEMBER OR THEIR DOCTOR. THE CONCERNS EXPRESSED RELATE TO ADDICTION AND, ESPECIALLY AMONG FAMILY MEMBERS, SIDE EFFECTS.
"Have any of the following people ever expressed concern about your taking a narcotic pain reliever versus a non-narcotic pain reliever?" (Q. 12a) "What is your (PERSON'S) concern about narcotic pain relievers?" (Q. 12b)
Base: All chronic pain sufferers ever taking narcotic pain relievers. Percent identifying a person. Percent of other people stating a specific concern.
| Total % | Currently Taking % | Past User % | |
|---|---|---|---|
| Other people expressed concern | 44 | 47 | 41 |
| Family member | 27 | 31 | 25 |
| Addiction | 80 | ||
| Side effects | 52 | ||
| Stigma | 10 | ||
| No insurance coverage | 10 | ||
| Doctor, specialist | 24 | 24 | 23 |
| Addiction | 81 | ||
| Side effects | 35 | ||
| Stigma | 9 | ||
| No insurance coverage | 6 | ||
| Friend | 16 | 20 | 13 |
| Addiction | 85 | ||
| Side effects | 36 | ||
| Stigma | 9 | ||
| No insurance coverage | 8 | ||
| Pharmacist | 10 | 14 | 8 |
| Managed care gatekeeper | 5 | 8 | 4 |
FEW CHRONIC PAIN SUFFERERS BELIEVE DOCTORS HAVE EVER REFUSED TO PRESCRIBE A NARCOTIC PAIN RELIEVER TO THEM FOR FEAR OF BEING PERSONALLY CRITICIZED BY OTHERS.
"At any time has a doctor not prescribed a narcotic pain reliever for relief of your pain because the doctor was concerned that he/she would be criticized by others for prescribing that type of pain reliever?" (Q15e)
Base: All chronic pain sufferers.
| ---Severity of Pain Now--- | |||
|---|---|---|---|
| Total % | Currently Taking % | Past User % | |
| Didn't prescribe, concerned about being personally criticized |
5 | 13 | 4 |
| Has not occurred | 86 | 84 | 87 |
| Don't know | 8 | 2 | 10 |
THE QUALITY OF LIFE HAS IMPROVED SIGNIFICANTLY AMONG THOSE WHO HAVE THEIR PAIN UNDER CONTROL.
"For each of the following activities, please tell me whether you could do it all the time, some of the time or never?" (Q. 3d) "For each of the following activities, please tell me whether you could do it right now all the time, some of the time or never because of your pain?" (Q. 19)
| ---Pretty much under control--- | ||||
|---|---|---|---|---|
| Before % | After % | Point Diff. # | Not under Control % | |
| Maintaining relationships with family/friends | 58 | 77 | +19 | 68 |
| Concentrating | 41 | 64 | +23 | 51 |
| Walking | 37 | 50 | +13 | 41 |
| Doing full days work at job | 34 | 43 | +9 | 27 |
| Caring for your children | 30 | 35 | +5 | 27 |
| Participating in social activities | 29 | 48 | +19 | 33 |
| Doing chores at home | 29 | 50 | +21 | 34 |
| Doing usual hobbies/leisure activities | 29 | 47 | +18 | 31 |
| Having sex | 26 | 38 | +12 | 27 |
| Being in a good mood | 26 | 45 | +19 | 29 |
| Sleeping | 26 | 41 | +15 | 20 |
| Exercising | 17 | 27 | +10 | 17 |