Clinical Pain Advisor: What are pain specialists not focusing on that they should be scrutinizing?
Dr. Twillman: We need to continue encouraging pain specialists to look beyond their traditional stock in trade – opioids, other analgesic medications, and procedures – to other treatments that make up a good plan of care. Increasing knowledge about the benefits of and increasing access to integrative treatments such as psychotherapy, physical therapy, acupuncture, chiropractic services, massage, etc. will only make those specialists more successful in achieving good outcomes for their patients. We are hearing a lot more talk about integrative pain care now, but so far my perception is that it has mostly been talk. It’s time to find ways to get from talk to action.
Clinical Pain Advisor: What is the most effective way for clinicians to combat opioid overdose, misuse, and abuse?
Dr. Twillman: The most effective means of combating these problems involves really spending the time needed to get to know the patient on a much deeper level than is typically done. Assessing someone’s risk of misuse, abuse, and overdose prior to prescribing is the first challenge. It necessarily involves finding out about the patient’s developmental, occupational, medical, and substance use history; family history; current emotional and social/occupational circumstances; and current medical condition. As opioid treatment begins and progresses close observation of the patient, supplemented by reports from significant others, is necessary, with a willingness and ability on the part of the clinician to respond quickly if things seem to be going awry. In short the admonition, “Know your patient,” is absolutely the most important aspect of providing safe opioid treatment.
Clinical Pain Advisor: What can clinicians look forward to from AAPM in 2016?
Dr. Twillman: We’re excited to be launching a learning management center on the AAPM website with fresh continuing education opportunities becoming available monthly. We think that we’ll be able to provide clinicians with a wealth of education about integrative pain management through this vehicle.
We’re also going to be starting a blog, with regular postings about the latest news in pain management, and we’re planning to begin providing resources organized by pain condition, so that busy clinicians can more easily find focused information that will help provide good care.
We are also going to be making our Advanced Credential Pain Practitioner program available to advance practice registered nurses (APRNs) and physician assistants (PAs), so they can demonstrate their superior knowledge of pain care. Add all of that to our new shared interest groups, free membership for students, and ongoing policy advocacy work that no other pain organization can provide, and I think it’s a very exciting time to be part of the academy.