• Coordinate efforts across both public and private sectors. • Create a research agenda. • Improve pain assessment and management programs. • Ensure that the Interagency Pain Research Coordinating Committee and the NIH Pain Consortium (a group of NIH institutes with an interest in pain) cooperate in reaching out to private-sector participants as appropriate. • Enhance public awareness of chronic pain. HHS and other entities including the VA, DoD, and large health care providers should reduce barriers to pain care, especially for populations disproportionately affected by and undertreated for pain. Enlist pain-specialty and primary-care professional organizations in supporting collaboration between pain specialists and primary care clinicians; educate primary care providers as to when to refer patients to pain centers. Ask NIH to designate as lead institute an existing institute that includes pain as a central part of its mission. This lead institute should be responsible for the following: advancing pain research, including assessing NIH’s overall effectiveness in this area; assuming leadership of the Pain Consortium and increasing its scope; and identifying funding needs. Furthermore, require the Pain Consortium to do the following: conduct more frequent, structured, and productive meetings; improve the process for reviewing pain-related grant proposals; work with pain-advocacy groups to help identify public needs related to treatment and management; and improve and expand public-private partnerships.
Some have asked why the committee did not address other equally important aspects of pain, such as our national problem of chronic prescription opioid misuse and abuse or the formation of a national institute of pain. The committee acknowledged and described the problem of opioid misuse and abuse; however, an in-depth examination with specific recommendations was beyond the committee’s charge. Likewise, the committee discussed in its report the creation of a pain institute and concluded that creating one at this time is not feasible. We now have a wonderful opportunity to advance IOM’s report recommendations and encourage all physicians to support the report’s important messages. Please read the complete IOM report, including its executive summary at http:// www.iom.edu/Reports/2011/Relieving-Pain-in-America-ABlueprint-for-Transforming-Prevention-Care-Education-Research.aspx.
Sean Mackey, MD, PhD, is an associate professor of anesthesia (and of neurology and neurological sciences, by courtesy) at Stanford University. Dr. Mackey’s primary research interest involves the use of advanced research techniques such as functional and structural neuroimaging, psychophysics, and neurobehavioral assessment to investigate the neural processing of pain and neuronal plasticity in patients with chronic pain. The research mission of the lab is to “predict, prevent, and alleviate pain.” Dr. Mackey has served as investigator and as principal investigator for multiple NIH and foundation grants to research chronic pain and to investigate novel analgesics for acute and chronic pain. Additionally, Dr. Mackey has recently received an NIH K24 grant focused on mentoring INC. junior investigators to have successful careers. Dr. Mackey has published more PLACEMENT FIRM than sixty peer-reviewed articles and book chapters. He annually presents papers and lectures at both national and international pain medicine, neurosci~ Physician Assistants ence, and anesthesiology meetings and has been interviewed extensively by the popular press (http://paincenter.stanford.edu/press).
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April 2012 San Francisco Medicine