Pain medicine is a specialty of medicine that deals with the relief and management of pain in patients. The World Health Organization defined it as “the discipline dealing with the study of the mechanisms and effects of pain to control its manifestations and relieve suffering”.
This branch gradually evolved from anesthesia during the past few centuries, where surgeons were mainly interested in producing surgical analgesia for painless suturing.
The development of newer analgesics, advances in physiology and anatomy led the field into new directions that include pain pathophysiology, neurochemistry of pain, clinical pharmacology, and biobehavioral aspects of pain as important aspects of Pain Management Clinton MD.
Pain is an unpleasant sensory or emotional experience associated with actual or potential tissue damage.
However, inadequate pain management remains one of the most common forms of medical malpractice. Inadequate pain management includes under-treatment or non-treatment of pain, as well as overtreatment or giving an inappropriately large amount of medication to a patient with pain.
4 barriers for effective pain management
Here are the 4 common causes of inadequate pain management:
1. Patient and Family Issues:
Psychological aspects such as fear, anxiety, and depression can prevent a patient from receiving adequate pain management. In some cases, patients, as well as family members, will not believe that the physician is trying to help or maybe in denial about the severity of their condition.
2. Healthcare professionals’ psychological barriers to optimal pain management:
Physicians are simply not immune to personal biases, fears, and stereotypes associated with pain management. They may have personal beliefs that are contrary to the use of opioids or other pharmacological agents for the treatment of acute/chronic pain.
For example, physicians may have concerns about addiction in certain populations, diversion of legal drugs for illegal purposes, tolerance development despite constant dosing, etc. They may lack knowledge, training, and confidence in pain management.
3. Lack of knowledge:
Physicians may lack understanding of the epidemiology of pain and how it affects different individuals or populations. They may not understand that certain medications such as analgesics should be given at specific doses and via specific formats such as orally, rectally, transdermally, etc.
They may not understand the geriatric population (over age 65) and how older adults manage pain differently.
4. Regulatory, legal, and policy issues:
Regulatory policies limit the number of medications that can be prescribed at one time, which results in delay or failure to provide adequate analgesia to patients who need it. Physicians are restricted from prescribing schedule II opioids for chronic pain without an associated procedure. Federal/state agencies regulate the scheduling of drugs, which may affect the availability of medications. Physicians are subject to criminal prosecution if they prescribe outside their scope or violate state prescription drug monitoring program (PDMP) rules.
Pain management has evolved significantly in the past few decades. The use of opiate drugs is one of the most studied topics in pain management. Opiates are derived naturally or synthetically from opium, which contains alkaloids such as morphine, codeine, and papaverine.
Morphine is one of the most commonly used opiates for medical purposes. Its derivatives are also available in the market for pain management.