Advocates Demand Funding for Pain Treatment
WASHINGTON (AP) -- Shawn Spriggs went through a slew of doctors and medicines before he found relief from the waves of muscular pain that shot through his body from muscular dystrophy.
A doctor who specialized in pain management dipped into her own pocket to buy him two $530 boxes of morphine lollipops made for cancer patients. Spriggs died of respiratory and heart failure in March, a 65-pound 20-year-old lying in his mother's arms in their Crestline, Ohio, home, a few suckers into the second box.
His mother, Kristi Spriggs, now has joined an emerging movement of pain sufferers, caretakers, scientists and others who want doctors to treat pain as its own disease and want government researchers to get more money to learn more about it.
In the last year, the American Pain Foundation has started mobilizing its members to relay their stories of living with constant pain. Kristi Spriggs said she has joined the cause as a way to grieve for Shawn.
Comedic legend Jerry Lewis, 80, has spoken on Capitol Hill about the relief he gets for chronic back pain from an implanted electric stimulator made by the pioneer of the pacemaker, Medtronic Inc. of Minneapolis.
As the U.S. population ages and medical advancements keep Americans living longer, chronic pain is becoming a more critical problem, said Dr. Edward Langston, chairman-elect of the American Medical Association board of trustees. An estimated 50 million to 75 million people live with chronic pain, defined as constant pain lasting at least three months.
Five years after it was introduced to little interest, proposed legislation now has the AMA's support to increase funding for pain research to the National Institutes of Health and create six pain research centers around the country.
"When you consider that a quarter of our population suffers from chronic pain, it is a burgeoning issue," said Langston, a family physician in Lafayette, Ind. "We believe this bill should be a significant priority."
But the proposal has languished for several reasons. The study of how pain works is relatively new, which has prevented money from flowing to developing new treatments, said Dr. Lawrence Tabak, co-chairman of an NIH consortium that coordinates pain research across the various institutes and centers.
With budget deficits holding total NIH funding at about $28 billion a year, Congress has not been willing to pay for a whole new program. Langston said the problem of pain has become profound enough that the NIH should adjust its funding priorities.
There are about six times more Americans living with chronic pain than with all kinds of cancer. The NIH has its own Cancer Institute, which received $4.8 billion in 2005, or about 20 times more than the $229 million that went to pain research.
Rep. Mike Rogers, R-Mich., whose brother's 20-year battle with serious back pain inspired him to propose the pain bill in 2001, said too many medical schools and residency programs push pain into the background, making it the subject of optional courses and Saturday electives.
"Doctors leave school as bright, caring, compassionate people without the skill-set to treat those with severe chronic pain," Rogers said.
Langston agrees that more training should be available. In 2003, the American Medical Association created a free continuing education program for doctors to learn what medical school didn't teach them about treating pain, and 84,000 doctors signed up in the first six months.
There are also cultural and societal barriers to pain management. Army Capt. Jonathan Pruden of Gainesville, Fla., who was severely injured by a roadside bomb in Iraq, told one of Rogers' congressional hearings about wounded soldiers who won't acknowledge their pain or refuse to take narcotics because of the stigma of possible addiction.
Pain-care advocates complain that the U.S. war on drugs, while catching some criminal drug distribution by a few doctors, has scared many more good ones away from prescribing narcotics to those with legitimate chronic pain.
The federal Drug Enforcement Administration disputes any chilling effect, citing a 40 percent rise in prescriptions of the opioid hydrocodone in the last five years. Langston said more research and training for doctors and drug enforcement agents will help regulators keep drugs off the streets and flowing to patients in need.
Only recently have scientists agreed that there's a science behind diagnosing and treating pain, Langston said. Modern theories of how pain is felt, over a system of nerve pathways through the spinal cord to a pain center in the brain, weren't developed until the 1960s and are still being perfected. Tabak said federal funding will start to flow now that the science of pain is maturing.
"We're now seeing developments in genomics and proteomics brought to bear on the management of pain," Tabak said, referring to mapping of human genes and proteins. "Five years ago, those words didn't even exist."
Patient voices are driving new interest in Congress. At Rogers' first hearing in 2001, one reporter and three observers showed up, the Lansing-area lawmaker said. A hearing last month drew about 150 people, including the staff of 52 lawmakers.
"The patients have a significant amount of power to make things change, and that's the momentum we've seen in the last year," said Will Rowe, executive director of the American Pain Foundation.
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On the Net:
NIH pain information: http://painconsortium.nih.gov/
American Pain Foundation: http://www.painfoundation.org
Rep. Mike Rogers' proposed bill, H.R. 1020: http://thomas.loc.gov/ |
