Equalizing The Pain Pendulum

The tendency to overprescribe opioids and undertreat pain will swing back and forth until generalists and pain specialists can come to a common understanding about controlled substances and opioids.

As the opioid epidemic continues to make headlines in the United States, many wonder where generalists and pain specialists can find common ground when it comes to prescribing opioids for chronic pain.

Rabia Atayee, PharmD, BCPS, a board-certified pharmacotherapy specialist with a backround in pain management and palliative care medicine, grew into her role as a pharmacist on the palliative care team at the University of California San Diego, where she gained clinical insight into patient care in both ambulatory and inpatient settings.

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The Refill” is a Q&A column designed to provide Clinical Pain Advisor‘s readership with clinical perspective and suggestions for operating a pain management practice.

Clinical Pain Advisor (CPA): What is the biggest challenge to your practice?

Dr. Atayee (RA): Ensuring that specialist and generalist who are involved in a patient’s care understand safe medication practices with evidence-based fundamental understanding of pharmacotherapy to ultimately optimize patient care.

CPA: Have you been impacted by the Affordable Care Act (ACA)?

RA: Not directly. There are opportunities from ACA involving palliative care, but our institution hasn’t participated in them yet. Working in an academic institution I feel relatively removed from any pressures from ACA. Additionally, any changes to outpatient prescription coverage has not looped back to impact how I assess or treat a patient’s pain and symptoms differently.

CPA: Where do you believe the future of pain management is going?

RA: The pain pendulum of overprescribing opioids and undertreating pain will swing back and forth until generalists and pain specialists can come to a common understanding and practice involving controlled substances and opioids.

An initial approach is to understand the underlying cause of the pain, the unique symptoms that the patient is presenting, and to then critically evaluate the therapeutic options for each individual patient.