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By R Carter

This update on trends reflects changes on how chronic pain has been viewed and managed as America’s struggle with opioids continues. It’s often insightful to look back at how our government viewed chronic pain and compare that to how they have responded. This report from the CDC published thirteen years ago in 2006 stands in stark contrast to the 2016 CDC Guidelines for Chronic Pain Management, at a time when anti-opioid zealots had clearly gotten the upper hand. More importantly is how our healthcare system has responded, indicating what appears to be an effort to cherry pick the data which fits an ideological point of view. 

As America’s population lives longer, in 2004 as long as 77.4 years, and this group utilizes surgical interventions to prolong life and functionality, the need for pain management to maintain functionality also increases.

In recent years emergency departments have adopted a practice of prescribing anti-psychotics for patients who enter the ER with complaints of unmanaged chronic pain. This appears to be a new philosophy which had it’s roots in nursing homes where some physicians used non-opioid chemical restraints in an effort to manage patients, whose behavior in part, was due to chronic pain. The foundation arm of AARP has been fighting such abuses in court for some time, yet the practice continues and in some areas has increased, in large part due to how our healthcare system has changed in its views.

From the CDC

One in four U.S. adults say they suffered a day-long bout of pain in the past month, and one in 10 say the pain lasted a year or more, according to the government’s annual, comprehensive report of Americans’ health, Health United States, 2006, released today by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics.

“We chose to focus on pain in this report because it is rarely discussed as a condition in and of itself – it is mostly viewed as a byproduct of another condition,” said lead study author Amy Bernstein. “We also chose this topic because the associated costs of pain are posing a great burden on the health care system, and because there are great disparities among different population groups in terms of who suffer from pain.”

Low back pain is among the most common complaints, along with migraine or severe headache, and joint pain, aching or stiffness. The knee is the joint that causes the most pain according to the report. Hospitalization rates for knee replacement procedures rose nearly 90 percent between 1992-93 and 2003-04 among those 65 and older.

Some of the other pain statistics include:

  • One-fifth of adults 65 years and older said they had experienced pain in the past month that persisted for more than 24 hours.
  • Almost three-fifths of adults 65 and older with pain said it had lasted for one year or more.
  • More than one-quarter of adults interviewed said they had experienced low back pain in the past three months.
  • Fifteen percent of adults experienced migraine or severe headache in the past three months. Adults ages 18-44 were almost three times as likely as adults 65 and older to report migraines or severe headaches.
  • Reports of severe joint pain increased with age, and women reported severely painful joints more often than men (10 percent versus 7 percent).
  • Between the periods 1988-94 and 1999-2002, the percentage of adults who took a narcotic drug to alleviate pain in the past month rose from 3.2 percent to 4.2 percent.

The report also finds that the United States spent an average of $6,280 per person on health care in 2004. Seven percent of adults under 65 said they passed up getting needed care in the past 12 months due to costs.

The report also notes a number of other significant health findings:

  • Life expectancy at birth reached a record 77.9 years in 2004, up from 77.5 in 2003 and from 75.4 in 1990. Since 1990, the gap in life expectancy between men and women has narrowed from seven to just over five (5.2) years. At birth, life expectancy for females is just over 80 years and nearly 75 for males. The gap in life expectancy between white and black Americans also has narrowed from seven years in 1990 to five years in 2004.
  • Infant mortality fell to 6.8 deaths per 1,000 live births in 2004, down from 6.9 deaths per 1,000 live births in 2003.
  • Heart disease remains the leading killer, but deaths from heart disease fell 16 percent between 2000 and 2004, and deaths from cancer – the No. 2 killer – dropped 8 percent. The age-adjusted death rate for heart disease was 217 deaths per 100,000 in 2004; for cancer the rate was 186 per 100,000.
  • Diabetes poses a growing threat, especially among older adults. Eleven percent of adults aged 40-59 years, and 23 percent of those 60 and older have diabetes.