APS Press Room
News Highlights from The Journal of Pain • September 2007
The Peer Review Journal of the American Pain Society
| For immediate release | Contact: Chuck Weber (847) 705-1802 |
Study Shows State Medical Boards Believe Prosecutions of Doctors are Increasing for Pain Drug Prescribing
GLENVIEW, Sept. 15, 2007—A national survey of state medical board members, published in The Journal of Pain, shows a significant majority recognize that prolonged opioid prescribing for chronic cancer and noncancer pain is legitimate, but they also believe that prosecutions of doctors for overprescribing pain medications are on the rise.
The survey was conducted by the Federation of State Medical Boards and the Wisconsin Pain and Policy Studies Group. It is the third in a series of surveys dating back to 1991 designed to evaluate the knowledge and attitudes of state medical board members about prescribing opioid analgesics for pain management.
According to the most recent survey data (2004), there is considerable improvement since the early 1990s in overall understanding of pain management issues, particularly the legality of prescribing opioids for chronic noncancer pain and in knowing the correct symptoms of addiction. Still, only two in three respondents said they believe prescribing opioids for chronic noncancer pain is a lawful and generally acceptable medical practice.
Sixty-nine percent of those surveyed perceive drug addiction in both behavioral and physiological terms, but the respondents did show a better understanding of what constitutes addiction compared with previous survey findings. Despite increased awareness that addiction is a behavioral condition, nearly one in five respondents said they consider addiction as only a physiological phenomenon.
"These results may be due to the history of confusing terms and definitions that has influenced the belief of many in the healthcare field," the authors stated. "These findings point to a need to continue educating healthcare professionals and regulators about what does and does not constitute addiction." The study recommended that medical regulators must understand the differences between addiction, physical dependence, and tolerance in patients with pain because such misconceptions can adversely influence disciplinary determinations.
With regard to the increasing presence of law enforcement in medical practice, the data showed that some 35% of medical regulators believe law enforcement is becoming more involved in the investigation and prosecution of physicians for opioid-prescribing practices. The authors noted it wasn’t clear whether the board members approve of increased criminal sanctions against physicians.
The study concluded, in general, that medical board members’ knowledge and views are consistent with what the medical community accepts and understands about pain management practices.
Source: State Medical Board Members’ Beliefs About Pain, Addiction and Diversion and Abuse: A Changing Regulatory Environment, Aaron M. Gilson, Martha A. Maurer and David Joranson, Wisconsin Pain and Policy Studies Group
Positive Thinking Helps Children Tolerate Pain
A study gauging responses to laboratory-induced pain in healthy children and adolescents showed that positive self-statements and behavioral distraction help reduce acute pain responses. These findings could have implications for managing children undergoing painful medical procedures.
Researchers from UCLA’s David Geffen School of Medicine Pediatric Pain Program studied 244 subjects ages 8 to 18 and exposed them to four different experimental pain stimuli. Laboratory pain studies have the advantage of controlling the administration of painful stimuli across participants. The study found that when internalizing, catastrophizing, or seeking emotional support were used as coping mechanisms, the subjects showed higher pain intensity. When coping was evidenced by making positive self statements or distraction, the subjects showed higher pain tolerance.
The authors concluded that in healthy children internalizing, catastrophizing, and seeking emotional support are pain-prone coping strategies, while positive self-statements and behavioral distraction are pain-resistant strategies. They also noted the findings might be more relevant for children experiencing acute pain in a clinical setting, such as procedural pain in a doctor’s office or emergency department.
Source: Coping Predictors of Children’s Laboratory-induced Pain Tolerance, Intensity and Unpleasantness, Qian Lu, Jennie C.I. Tsao, Cynthia D. Myers and Lonnie K Zeltzer, Pediatric Pain Program, David Geffen School of Medicine, UCLA