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A Message from the Coordinator
February 2012
Support and Education for Chronic Pain Management
You may be an individual with long-standing pain issues.  You may be a family member or friend of someone with persistent pain.  Or perhaps you are a healthcare provider who treats individuals with chronic pain.  The one element that you all have in common is the need for accurate information and ongoing education about the treatment of pain.  One of the missions of the Oregon Pain Management Commission (OPMC) is to improve pain management in the State of Oregon.  From time to time, I try to share helpful pain treatment resources. 
A resource that I would like to discuss today is the American Chronic Pain Association (ACPA).  The ACPA was founded in 1980 by an individual with chronic pain.  After participating in a pain management program at the Cleveland Clinic, Penney Cowan wanted to incorporate the knowledge she had gained into her day-to-day life.  She formed an initial support group by placing a notice in her church bulletin.   That support group has mushroomed into several hundred support groups today that meet across the United States, Canada, Great Britain, and many other countries. 
I encourage you to visit the ACPA​ website.  Here you will see how the OPMC mission meshes with that of the ACPA.  The ACPA mission is “to facilitate peer support and education for individuals with chronic pain and their families so that these individuals may live more fully in spite of their pain” and “to raise awareness among the health care community, policy makers, and the public at large about issues of living with chronic pain.”  To accomplish this mission, The ACPA website provides pain management information for use by individuals with pain and for the professionals who treat them.
Each year, the ACPA publishes “A Resource Guide to Chronic Pain Medication and Treatment” on the website. 
There are a number of things that I think are important about this document.  The information provided recognizes the essential ground floor upon which pain management is built: “each person is different and will respond differently to situations, interventions, surgeries, and medications.”  The guide also emphasizes that it does not cover every approach that can be used in treating chronic pain and that it is not meant to serve as medical advice for any one individual’s specific condition.  It notes: “the best source of information about your health care regarding treatment and medications needs is from an open dialogue with your health care professional or therapist.”
While health care providers will find an abundance of detailed information throughout this guide, it is also useful for consumers.  Although the guide provides a thorough discussion of each topic, it is fairly “reader friendly” for individuals without a medical background.  It begins with some background information about pain types and chronic pain classification, pain in children and older adults and clarifies information about clinical trials and off-label medication use.  There are many useful website links scattered throughout this document, including a link to the FDA “Buying Prescription Medicine Online: A Consumer Safety Guide.”  The final section is a listing of “References: Links to Chronic Pain Sites & Resources.” 
The guide is sprinkled with nuggets of important insights for consumers with pain issues. For example, the section on over-the-counter (OTC) pain relievers stresses the importance of reading the label of any OTC medications and discussing the use of any OTC medications with your health care professional.  It reminds individuals that OTC medications—including the use of herbal preparations, supplements, and vitamins—can have harmful side effects and cross reactions with each other and other prescribed medications.  It also points out the role of family members; for example, a family member’s attentive, truthful, and honest observation about how treatment is affecting an individual can provide additional useful information when shared with the health care provider.
The largest portion of the guide is dedicated to the discussion of medications used in the treatment of pain—from OTC medications, non-opiod analgesic pain relievers, opioid analgesics to antidepressants, anticonvulsants, herbal medications, etc.  There is a section on tobacco, alcohol, marijuana and illegal substances.  This section is especially informative about the negative effects of cigarette smoking upon pain and offers support and encouragement for individuals who are ready to quit smoking.
The guide provides a short section on non-medication pain treatment options such as intra-articular steroid injections, spinal cord stimulation, manipulation and mobilization, trigger point injections, nerve blocks, complementary and alternative medicine treatment options, etc.  While discussing different treatment approaches, the guide supports important concepts such as: a “whole person approach” to treating pain; coordinated and collaborative care; and notes that “education of the patient and family should be the primary emphasis in the treatment of chronic pain.”  It also highlights the role of exercise, behavioral health support and mind-body interventions in managing chronic pain. The guide notes, “The overwhelming theme in the treatment of most persons with chronic pain is to keep as physically active as possible.”
I will end my discussion of the ACPA “A Resource Guide to Chronic Pain Medication and Treatment” with a statement noted in the introduction.  This statement very strongly mirrors my wish for those of you dealing with persistent pain.  The ACPA states: “A ‘successful’ person with chronic pain is someone who has learned to independently self-manage their condition in such a way as to achieve maximum function for everyday life activities while minimizing discomfort and avoiding a bad outcome from treatment.”
Kind Regards,
Kathy Kirk, RN